Drug information resources

  

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Various types of pharmacy publications and references have different characteristics. These can typically be broken into categories based on the following criteria:

  • pharmacy literature which is based on how far removed it is from the original research (primary, secondary, and tertiary); and
  • material based on format (books, articles, websites, etc.).

This article provides an overview of these types of resources along with some commonly used references. The mention of any particular reference is not intended as an official endorsement, but simply recognition of its common use.

Legal Aspects

Pharmacies should be aware of any requirements made of them with respect reference materials, both to avoid any citations for noncompliance and in order to provide an appropriate level of assurance that they are providing proper medication therapy.

On the federal level, there are currently no specified requirements for pharmaceutical references. The federal government has opted to leave these requirements up to each state.

States, as would be expected have a wide variety of requirements, depending on which state you are in, and what kind of practice setting you are in (community, institutional, mail order, etc.). To let's look at the reference requirements for Pennsylvania and California in order to get an idea of what states require.

Pennsylvania Chapter 27 State Board of Pharmacy:

An adequate reference library which meets the following standards:

(i) Enables a pharmacy to prepare and dispense prescriptions properly, consistent with its scope of practice.

(ii) Includes reference sources appropriate to the type of pharmacy practice at that particular location. A pharmacy shall include in the pharmacy’s library current material regarding the technical, clinical and professional aspects of practice with emphasis in the area in which the pharmacy specializes.

(iii) Enables the pharmacist to compound medications in a safe and effective manner consistent with accepted standards of pharmacy practice.

(iv) Lists the possible drug interactions and possible adverse effects of medications dispensed by the pharmacy.

(v) Lists the therapeutic equivalents for medications.

(vi) Lists the therapeutic usage and dosages of medications dispensed by the pharmacy.

(vii) Provides guidelines for the counseling of patients.

(viii) A pharmacy that specializes in nuclear or parenteral prescriptions may limit the library it maintains under subparagraph (ii) relating to the pharmacy’s own specialization.

(ix) Maintains the latest editions including current supplements of each of its reference sources.

California 2013 Lawbook for Pharmacy:

1751.8. Sterile Injectable Compounding Reference Materials.

In any pharmacy engaged in compounding sterile injectable drug products, there shall be current and appropriate reference materials regarding the compounding of sterile injectable products located in or immediately available to the pharmacy.

Whichever state(s) your pharmacy is practicing in, make sure your pharmacy is in compliance.

Pharmacy literature

Scholarly fields, such as pharmacy, requires much research, means for cataloging/indexing the research, and eventually compilations from the various research studies. All aspects should involve competent professionals capable of properly interpreting the information.

Primary

Primary literature provides direct access to the most current information resulting from contemporary research. It is the largest and most current source of information. This type of literature includes original reports of scientific, clinical, technological, and administrative research projects and studies.

Examples of primary pharmacy literature includes peer reviewed journals such as the New England Journal of Medicine (http://www.nejm.org), the American Journal of Health-System Pharmacy (http://www.ajhp.org), and the International Journal of Pharmaceutical Compounding (http://www.ijpc.com). For additional pharmacy journals, a list of popular pharmacy journals can be found at http://www.pharmacy.org/journal.html.

Secondary

Secondary literature involves the interpretation and evaluation of information derived from or in reference to the primary literature sources. This secondary literature takes the primary literature and synthesizes, generalizes, and integrates new research.

Examples of secondary literature includes review articles, systematic reviews, meta-analyses and reference works. Secondary literature also includes indexing and abstracting services. PubMed (http://www.ncbi.nlm.nih.gov/pubmed) and The Cochrane Library (http://www.thecochranelibrary.com) are common examples of secondary literature.

Tertiary

Tertiary literature references are condensed works based on primary and secondary literature, such as textbooks, encyclopedia articles, and guidebooks or handbooks. The purpose of tertiary literature is to provide an overview of key research findings and an introduction to principles and practices. These are the types of references most commonly used in both the classroom and pharmacy environment.

Some common examples of these are the Drug Information Handbook (http://webstore.lexi.com/Drug-Information-Handbook), Micromedex (http://www.micromedex.com), and Drug Facts and Comparisons (http://www.factsandcomparisons.com).

Common references

Depending on the types of information specifically needed, along with accessibility and individual preference, a particular format or specific resource may be better suited. With that in mind there are numerous books, websites, and dedicated applications to help ensure that professional have access to the necessary information. The listing below are not intended to be exhaustive, but simply to detail some of the more commonly used references.

Printed references

Print references usually offer some reasonable advantages over other types of media in that they are available off-line, relatively easy to navigate, and a format that most people are comfortable using. Conversely, a disadvantage is that most of them are limited to annual updates (although some publish monthly updates that would need to be inserted). In a dynamic field like pharmacy this can be a concern.

Some of the books listed below are very broad in subject matter (Drug Facts and Comparisons) while others are more specialized in their content (Drugs in Pregnancy and Lactation). As previously mentioned, any references listed are not intended as recommendations, but are simply being highlighted because they are commonly used.

Drug Facts and Comparisons

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The Drug Facts and Comparisons provides the following drug information:
  • medication availability,
  • drug formulations,
  • general dosing guidelines,
  • adverse drug reactions,
  • phamacokinetics,
  • drug interactions,
  • general pharmacology,
  • indications,
  • over the counter drugs,
  • the alcohol content of drugs, and
  • sugar-free liquid preparations.

The Drug Facts and Comparisons also provides information on manufacturers' phone numbers and diagnostic aids. The print version can receive monthly updates to ensure current content. There is also an online version of this available as a subscription service. The online version is discussed further in the online drug information resource section.

AHFS Drug Information

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The AHFS Drug information (AHFS DI) provides the following drug information:
  • medication availability,
  • drug formulations,
  • general dosing guidelines,
  • adverse drug reactions,
  • drug interactions,
  • general pharmacology,
  • indications,
  • over the counter drugs,
  • unlabelled (off-label) uses, and
  • immunizations.

The AHFS Drug information is broken into sections divided by drug classifications. The print version is updated annually with a new edition. It is also available through online subscription and through specific apps for Android and iOS.

Physician's Desk Reference

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The Physician's Desk Reference (PDR) provides the following drug information:
  • approved FDA product information equivalent to package insert,
    • general pharmacology,
    • indications and usage,
    • adverse drug reactions,
    • drug interactions, and
    • dosage and administration
  • tablet and capsule identification, and
  • the manufacturer's telephone numbers.

The Physician's Desk Reference effectively prints the information approved by the FDA for the package insert. The PDR is also available online at http://www.pdr.net, and for various smart phones and tablets (Android, BlackBerry, and iOS).

Martindale: The Complete Drug Reference

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The Martindale: The Complete Drug Reference provides drug information on:
  • drug availability,
  • formulations,
  • general dosing,
  • investigational drugs,
  • manufacturer information,
  • foreign drugs,
  • compatibility,
  • adverse drug reactions, and
  • efficacy of drug therapy.

Besides pharmaceuticals, the Martindale also covers herbals, diagnostic agents, radiopharmaceuticals, pharmaceutical excipients, toxins, and poisons.

Drug Information Handbook

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The Drug Information Handbook provides drug information on:
  • drug availability,
  • formulations,
  • general dosing,
  • adverse drug reactions,
  • pharmacokinetics,
  • drug interactions,
  • general pharmacology,
  • and indications.

The Drug Information Handbook is updated annually and is conveniently organized alphabetically by generic drug names with cross-references from common brand names. It is also available as an app for Android, BlackBerry, and iOS. The publisher of the Drug Information Handbook, Lexicomp, also provides an online version at http://online.lexi.com.

Pharmacotherapy A Pathophysiologic Approach

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Pharmacotherapy A Pathophysiologic Approach provides information on:
  • disease state and appropriate drug therapy including:
    • diagnostic flow diagrams,
    • treatment algorithms,
    • dosing guideline recommendations,
    • monitoring approaches, and
    • evaluation of therapeutic outcomes
  • details disease signs and symptoms
  • covers clinical controversies
  • includes pharmacoeconomic issues/concerns
  • discusses challenges with patient compliance

This is highly detailed therapeutic text is available in both a traditional printed format and as an ebook.

Applied Therapeutics: The Clinical Use of Drugs

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Applied Therapeutics: The Clinical Use of Drugs provides information on:
  • drug therapeutics including:
    • comparative drug information,
    • pharmacokinetic properties,
    • dosing guidelines, and
    • risk factors
  • disease information including:
    • common disease and disorder diagnosis information,
    • treatment options (including drug regimens),
    • risk factors, and
    • Q & A sections for major disease states

The information in this textbook is often provided through the use of specific case studies in the attempt to provide demonstrative examples of patient care and the challenges associated therein.

Goodman and Gilman's Pharmacological Basis of Therapeutics

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“Gold Standard” for Pharmacology text

Deficient on information for clinical application

Red Book

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Provides information on

Tablet/capsule identification, availability of drugs, sugar-free liquid preparations Manufacturers telephone numbers and addresses Average Wholesale Prices (AWPs) and Direct Purchasing prices of both legend and OTC products This product is also available on CDROM for MS Windows and can be integrated into Micromedex online subscription service.

Trissel's Handbook on Injectable Drugs

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I.V. rates of administration, admixture compatibilities

Stability of parenteral medications Contains monographs on concentration, pH, dosing and administration Can be integrated into online version of Facts and Comparisons

King's Guide to Parenteral Admixtures (“Cutter” Guide”)

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Provides information on compatibilities of parenteral admixtures

Drugs in Pregnancy and lactation (Briggs)

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Provides information on

The effects of drug use during pregnancy and breastfeeding Can be integrated into online version of Facts and Comparisons

Medications and Mothers' Milk (Hale)

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Provides information on

Drug use and breastfeeding

Online references

There is a vast amount data related to health care available through the internet. With that in mind, there are several things that should be looked at in this section:

  • the pros & cons of health care information available on the internet
  • how to properly evaluate the claims and statements made by various websites
  • good online resources for students and professionals
  • easy to understand and reliable online resources for patients
  • contending with the potential bias of a particular search engine
  • dispelling online rumors/hoaxes concerning health care

The pros & cons of online health care information

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Evaluating information from online resources

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Online resources for professionals

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Free websites

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Websites requiring paid subscriptions

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Online resources for patients

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Mollifying biased search engine results

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Dispelling online rumors and hoaxes

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Smart phone and tablet applications

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Additional external resources

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See also

Pharmacology
Patient package insert

References

  1. Types of Medical Literature, Mercer University Atlanta Swilley LibGuides: Updates to Colleges of Pharmacy and Health Professions Resources, http://mercer.libguides.com/content.php?pid=81289&sid=802112
  2. CHAPTER 27. STATE BOARD OF PHARMACY, The Pennsylvania Code, http://www.pacode.com/secure/data/049/chapter27/chap27toc.html
  3. 2013 Lawbook for Pharmacy, California Board of Pharmacy, http://www.pharmacy.ca.gov/laws_regs/lawbook.pdf
  4. Journals, Virtual Library Pharmacy, http://www.pharmacy.org/journal.html