Lecture 3: Drug Information Tertiary Sources PDF

Lecture 3 By Dr. Sahar Badr 1 Sources of drug information 1- Primary sources of information 2- Secondary sources of information 3- Tertiary sources of information Tertiary sources consist of primary and secondary source information which has been collected, summarized, and...

Lecture 3 By Dr. Sahar Badr 1 Sources of drug information 1- Primary sources of information 2- Secondary sources of information 3- Tertiary sources of information Tertiary sources consist of primary and secondary source information which has been collected, summarized, and distilled. Tertiary sources present summaries or condensed versions of materials, usually with references back to the primary and/or secondary sources. They can be a good place to look up facts or get a general overview of a subject, but they rarely contain original material. to collect background information and to help locate primary and secondary research. 2 Examples of tertiary literature are Textbooks on various drug or disease topics (e.g. Pharmacotherapy) Encyclopedias Dictionaries Atlases Guidebooks Handbooks Drug Compendia (defined as summaries of drug information, a compendium should include a summary of pharmacologic characteristics for each drug that may include dosage and recommended uses, such as the Physician's Desk Reference (PDR)). The official compendium in the United States are the United States Pharmacopoeia Drug formularies (BNF (British National Formulary)) Online full-text databases such as Micromedex and Drugs Facts and Comparisons. 3 4 5 Examples of tertiary references are: Pharmacology and Drug Information Resources Goodman and Gillman's Pharmacological Basis of Therapeutics contains general principles of action, absorption, distribution and metabolism. It is a "gold standard" pharmacology text and is very well referenced. Handbook on Injectable Drugs Covers parenteral infusions, drug stability and compatibility; updated editions published approximately every two years with an annual supplement. 6 7 Basic & Clinical Pharmacology is a complete and comprehensive general pharmacology text which is utilized nationally as primary reference for many pharmacology courses. Drug Information Handbook:  alphabetical listing of drugs by generic name, Well referenced, updated editions published annually.  Format: Yearly print edition, online (in Lexicomp Online™), mobile application. 8 Monograph sections include: Alerts/warnings, pronunciation, brand names, pharmacologic category, dosages, uses, clinical practice guidelines, administration and storage issues, medication safety issues, medication guides, warnings and precautions, pregnancy and lactation, adverse reactions, interactions, patient and therapy management, preparations, pharmacology and pharmacokinetics, and references. 9 10 Martindale: The Complete Drug Reference: Include foreign drug information including selected US drugs; great resource for obscure information and for names of drugs in other countries; well referenced; published by the Royal Pharmaceutical Society of Great Britain. Physician's Desk Reference (PDR):  Format: Yearly print edition, online database, mobile application  FDA approved product information; usage and dosage information only as approved by the FDA, displays full-colour photos of products arranged by manufacturer which can be an aide in drug identification; lists manufacturers of specific drugs and manufacturer contact information.  Note that this resource is a not a complete listing of all FDA- approved drugs. Drug manufacturers pay for inclusion of their selected products.  lists FDA pregnancy categories for drugs (categories describe current knowledge of relative safety or harm for a product in pregnancy).11  Include alphabetical listings of drugs that should not be crushed and those causing photosensitivity 12 Drug Facts and Comparisons®  Format: Yearly print edition, online (in Facts & Comparisons® eAnswers), CD-ROM. Organization  Arranged in chapters by therapeutic use Monograph sections: Prescribing information, indications (FDA- approved and off-label uses), administration and dosage, actions, contraindications, warnings and precautions, drug interactions, adverse reactions, overdosage, and patient information Micromedex Micromedex is an online pharmacology database which has a vast array of information dealing with pharmacology, therapeutics, poison information, etc. Format: Online (in Micromedex®). DRUGDEX® System is one component of Micromedex® 2.0 13 14 Drug Interaction Resources 1-Stockley's Drug Interactions  Format: Yearly print edition, online.  A typical monograph contains a summary, clinical evidence for the interactions under discussion, the probable mechanism, clinical importance, management and references. Alphabetical by drug class  Covers interactions between therapeutic drugs, herbal medicines, foods, drinks, Pesticides. 15 2-Drug Interaction Facts  Format: Yearly print edition, online (in Facts & Comparisons® eAnswers), CD-ROM Alphabetical by generic name or drug class Provides information regarding: Significance and severity, effects, onset of action (rapid or delayed), mechanism, management, discussion, and references.  This resource includes drug–drug and drug–food interactions. It includes more than 1,800 monographs covering 20,000 drugs. 16 3-Drug Interactions Analysis and Management Format: Yearly print edition. Organization: Alphabetical by generic name This resource contains more than 2,500 interactions. It includes prescription, nonprescription, and herbal medications. This resource is often referred to as Hansten and Horn, the authors’ last names. The two authors are pharmacists. 4-Lexi-Interact is a tool available in Lexicomp Online™ 5-Micromedex® has a drug interaction tool that lets users enter a single drug and search for interactions with that drug or enter multiple drugs and see if they interact. 17 Medical And Pharmacy Therapeutics Resources Applied Therapeutics: The Clinical Use of Drugs: pathophysiology and pharmacotherapeutics in a case presentation format. focus is on drug therapy; well written; updated editions published approximately every four years. Clinical Pharmacy and Therapeutics: provides an accessible and complete account of all major aspects of therapeutics and rational drug use. Written by a distinguished multi- author team of pharmacists and physicians, it is organized primarily by body systems and disorder. 18 Pharmacotherapy: A Pathophysiologic Approach: pathophysiology and treatment of disease; focuses upon drug therapy; very well written; updated editions published approximately every four years. Textbook of Therapeutics: Drug and Disease Management: focus is on drug and disease management; organized by disease groups; an excellent text; updated editions published approximately every four years. 19 Drug Information Resources For Special Patient Populations Drugs in Pregnancy and Lactation: excellent reference that discusses all aspects of drug dosing in pregnancy and lactation; updated every four years. Pediatric Injectable Drugs (The Teddy Bear Book) This book is called The Teddy Bear Book because it has a teddy bear on the cover. It only contains information about the most common intravenous and intramuscular drugs used in children. Drug Prescribing In Renal Failure: discusses all aspects of drug dosing in renal failure including recommended dosages of individual drugs. 20 21 Cancer Chemotherapy Handbook: excellent references relevant to the pharmacology and use of chemotherapeutic agents. Other Information Resources Remington: The Science and Practice of Pharmacy: information concerning the practice of pharmacy and pharmaceutical sciences; republished approximately every five years. 22 23 Advantages of tertiary literature: 1. Tertiary references are convenient and accessible, especially in light of their full text availability on the Internet. 2. Drug information references may be divided into specific subjects to make them easier to use. For instance, one text may be devoted only to drug interactions, while another might discuss principles of pharmacotherapy or use of drugs in pregnancy. This way, if a specific subject needs to be queried, a specific reference can be reviewed. 3. Usually the information contained in tertiary literature is well accepted in medical practice. This is because most forms of tertiary literature are referenced with primary literature sources and should undergo a stringent review process to ensure that the information presented is generally well regarded in the medical community. 24 Disadvantages of tertiary literature: 1. Because of the lag time between when a text was written and the actual publication date whether in print or electronically, time passes before the information is available, and more updated information may be available in a database. 2. Space limitations within a text may prevent extensive discussion of a drug or topic. 3. The tertiary literature may not be referenced appropriately, thus preventing a proper check of the primary care literature. 25 4. If the information presented in the tertiary literature is based on flawed (imperfect) primary care literature, (i.e. poorly designed research studies are referenced) then the tertiary information may not be the most accurate and reliable. 5. In the case of print resources that are tertiary literature, any updated or new information may need to be inserted into the printed copy of the tertiary literature in a timely fashion. This is time consuming, and may not get accomplished. 26 Thank you 27