Drug Resources

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Drug Resources
Nancy Clark, MEd, Director Medical Informatics
Education Dennis Baker, PhD, Assistant Dean for
Faculty Development Nadine Dexter, MLS, Associate
Director of Public Services
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Objectives

• Find the Drug Reference Library web page
• Locate basic prescription and herbal drug
  information (dosage, indication, etc.) online and
  on the PDA
• Calculate a drug dosage using an electronic
  resource
• Identify if a drug is on a particular formulary
  and locate alternatives
• Identify a pill from its imprint or description
• Perform a drug interactions check
• Use an infectious disease/antibiotics guide
• Use an immunization schedule tool

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Handouts

• Presentation
• Drug References Handout
• Worksheet
• Cases

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Medication Errors

• Adverse Drug Events (ADEs) rash drop dead
• ADEs due to inappropriate prescribing pt
  noncompliance 3-28 hospitalizations
• 30 of pts who suffer ADEs die or are disabled
  for 6 months
• IOM 98,000 deaths per year from medication
  errors in hospitals
• Cost of drug related morbidity and mortality in
  US estimated 1.56-5.6 billion/yr

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Fun Stuff

• Top 200 prescription drugs
• http//www.rxlist.com/
• Plan your overseas vacation
• http//www2.ncid.cdc.gov/travel/yb/utils/ybDynamic
  .asp

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Types of Drug Information Available
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Prescription Drug Monographs

• Class
• Indications
• Dosages (peds and adult)
• Forms
• Adverse reactions
• Costs
• Pregnancy and lactation
• Generic/brand names

• Interactions
• Contraindications
• Mechanism of action
• Pharmacology
• Metabolism and excretion
• Off label uses
• Black Box warnings
• Formulary Information

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OTC Drug Monographs

• Class
• Indications
• Active Ingredients Dosages (peds and adult)
• Forms
• Adverse reactions
• Costs
• Pregnancy and lactation

• Interactions
• Contraindications
• Mechanism of action
• Metabolism and excretion

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Natural/CAM drug monographs

• Reported dosages
• Reported uses
• Cautions
• Interactions
• Adverse Reactions
• Synonyms
• Brands/forms
• Pregnancy and lactation indications

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eTools

• Dosage calculators
• Drug interaction tools
• IV Compatibility tools
• Formulary tools
• Pill identifiers
• By imprint
• By description

• Drug comparison tables
• Drug of Choice tool
• Brand name/generic name translators
• Prescription writers

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Antibiotics (ID) guides

• By Drug
• By Pathogen
• By Condition

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Other Drug Related Resources

• Immunization schedules and guides
• Patient Education Handouts on drugs
• Drug News recalls, dosing and delivery changes,
  safety issues, FDA approvals, etc.
• Research articles on clinical trials, drugs,
  toxicology, etc.

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Using the WorksheetIdentify drug questions you
have had in the last 2 weeks.
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Library Web Site
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Subscription Drug Resources

• Epocrates Online or Essentials (web and PDA)
• Facts and Comparisons (web)
• Access Medicines Drugs (web)
• MDConsult (Mosbys Drug Reference) (web)
• FIRSTConsult (Mosbys) (PDA)
• InfoRetriever (web, desktop and PDA)
• Natural Medicines Database (web and in Epocrates
  PDA)
• Journals, News and periodical databases
• Prescribers Letter
• Medical Letter

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Free Drug Resources

• Johns Hopkins Antibiotic Guide (web and PDA)
  http//hopkins-abxguide.org
• CDC Travelers' Health http//www.cdc.gov/travel/
• Merck Medicus (Mosbys Drug Reference)
  (web)http//www.merckmedicus.com
• Drugs.com http//www.drugs.com/
• Shots (immunization schedules) (Web and PDA)
  http//www.immunizationed.org
• Toxnet (poisons and toxic agents)http//toxnet.nl
  m.nih.gov/

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Who Has What?
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MonographsPrescription, Non-prescription and
Alternative Medications

• Epocrates Online
• Epocrates PDA
• eFacts Comparisons Online

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Epocrates ONLINE
1. Pick a letter
2. Pick drug
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2. Pick sub category
1. Pick category
3. Pick drug
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1. Type
2. Pick drug
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Prescription Drug Monographs
3. Pick category
2. Pick drug
1. Type
1. Pick category
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Alt Meds Monographs
1. Pick category
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Natural Medicines Database
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Epocrates Pro PDA
2. Pick drug
3. Pick category
1. Type
Prescription and Alt Meds are combined in same
list.
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Epocrates PDA - Searching
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Dosage Calculator in Epocrates PDA
3. Type Amt, Wt Freq
2. Click dose
4. Click Calculate
1. Peds Dosing

• Online Dosage Calculator
• http//www.medcalc.com/pedidose.html

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Access Medicine Drugs Tab
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eFacts Comparisons Online
1. Type
2. Pick drug
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eFacts Comparisons Online
4. Pick category
3. Pick monograph
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Epocrates ONLINE Formulary
1. Pick formulary
2. Click to see meaning
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Epocrates ONLINE Formulary
1. Click Code
2. Under View Alternatives, click class
Alternatives
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Finding Substitutes
Codes
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Epocrates PDA

• Go to Epocrates.com
• Manage My Account
• Pick Formularies
• Sync to add

1. Pick formulary
2. Click Code
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Drug Interaction Tools

• Epocrates Online
• Epocrates PDA
• eFacts Online

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Epocrates ONLINE MultiCheck Tool
1. Type
2. Click drug
Interactions appear as found
Repeat until all drugs in list
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Epocrates PDA MultiCheck
2. Pick drug
1. Type
3. Repeat until all drugs in list
4. Click Drugs
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Epocrates PDA MultiCheck
Click interaction
Use to add more
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eFacts Drug Interactions
Type in patients drugs, food and herbals and
click Go
Check list, add more if needed then click List
Interactions
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eFacts Drug Interactions
Click on Interaction to see monograph
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Pill Identifiers

• Epocrates Online
• eFacts Online

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Epocrates ONLINE Pill Identifier
Scroll through results until you find your pill.
Click name to go to monograph.
Pick shape, color, etc. If imprint readable, type
it in and click Identify Pills
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eFacts Pill Identifier
1. Type in imprint and click Go
2. Click on underlined drug name
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Antibiotics/Infectious Disease Tools

• Epocrates ID PDA
• Johns Hopkins ABX Guide Online

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Epocrates PDA ID Tool
By System
2. Pick diagnosis
1. Pick System
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Epocrates ID Tool
Pick Specific Tx to see pathogens
Pick drug to go to monograph
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Epocrates PDA ID Tool
By Bug
1. Pick Bug
2. Pick disease
Pick drug to go to monograph
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Johns Hopkins ABX Guide Online
Pick the diagnosis, pathogen or antibiotics from
the drop down lists
(http//www.hopkins-abxguide.org)
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Johns Hopkins ABX Guide Online
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Johns Hopkins ABX

• Free
• Register for UserID and Password
• Warning PDA version crashed PocketPC but in
  Epocrates Pro, so unnecessary to load

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Immunization Tools

• Epocrates Online and PDA
• InfoRetriever (Web and PDA)
• Shots (Web and PDA

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Epocrates Vaccinations
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InfoRetriever Immunizations
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InfoRetriever Immunizations
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Shots on the Web
www.immunizationED.org
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Shots on the PDA
Free Resource
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Look up the drug questions on your worksheet.