Drug Information Science

1
Drug Information Science

• Week 1
• Systematic Approach to Drug Information
• Types of Resources

2
Functions of a Drug Information Specialist, ie.
Pharmacist

• Pharmacists must know how to
• 1_____________________
• 2_____________________
• 3_____________________

3
Functions of a Pharmacist as an Information Source

• Provide drug information by
• answering information requests
• writing patient specific consultations
• communicating information that wasnt requested,
  but is necessary
• developing criteria/guidelines for drug use

4
Functions...

• Provide drug evaluations
• Develop policies for dept., PT comm.. Bulletins,
  newsletters, journal columns, education for
  practitioners.
• Be involved with
• ADR reporting, DUEs, publishing, developing
  protocols, IRB, Poison Control Center information.

5
Information Sources Utilized by Pharmacists

• ________________________________
• ________________________________
• ________________________________
• ________________________________

6
Systematic Approach to Answer Drug Questions

• 1. Secure demographics of requestor.
• 2. Obtain background information.
• 3. Determine and categorize ultimate question.
• 4. Develop strategy and conduct search.
• 5. Perform evaluation, analysis, and synthesis.
• 6. Formulate and provide response
• 7. Conduct follow-up and documentation

7
1. Request Demographics

• Obtain requestors knowledge base and position,
  training and knowledge of medicine.
• Obtain telephone , address, fax, etc for
  follow-up later.
• Determine approximate age (elderly, adolescent,
  etc.) (usually no need to directly ask)

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2. Background Information

• Think, Why is requestor asking for this
  information?
• Weigh time involved to get background info.
• Use tact, politeness and assertiveness
• Background questions should be specific for the
  nature of the request.
• Ask, What sources have already been used?
• Useful info age, gender, weight, allergies,
  other disease states, other meds, lab values, etc

9
3. Determine and Categorize Ultimate Question

• Find ________________________
• How _________________________
• Use __________________________
• Determine _______________________
  ___________________________________

10
Categories of Questions

• Strength, manuf, availability of product,
  approval
• Tablet identification, general product
  information
• Laws/policies/procedures, Cost, Foreign products
• Compatibility, stability, administration rate\
• Drug interactions (drug, lab, disease,food)
• Pharmaceutics (compounding, formulations)
• Pharmacokinetics (ADME/levels)
• Nutrition support

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Categories of Questions...

• Therapy evaluation-- picking drug of choice
• Dosage, regimen, recommendations
• Adverse effects
• Poisoning, toxicology
• Pregnancy, Teratogenicity
• Lactation/ infant risks

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4. Develop Strategy and Conduct Research

• 1.
• 2.
• 3.

13
Resources Available Primary Literature Resources

• Research studies published in biomedical
  journals.
• Provide details of research methodology and
  scientific results that lead to therapeutic
  conclusions.
• Advantages Most current resource for
  information. Least biased, so most accurate

14
Primary Literature Examples

• New England Journal of Medicine
• Archives of Internal Medicine
• JAMA (Journal of the American Medical
  Association)
• CHEST (from the American College of Chest
  Physicians)
• Clinical Pharmacy and Therapeutics
• Annals of Pharmacotherapy
• British Medical Journal

15
What do we find in Primary Resources (journals)?

• Advertisements
• Abstracts
• Letters to the Editor, Correspondence
• Review articles (considered tertiary resource)
• Meta analysis (considered tertiary resource)

16
What do we find in Primary Resources (journals)?

• Primary journal articles clinical drug trials
• These articles are the primary resources we
  are talking about
• Clinical trial types
• Intervention types (highly rated)
• Randomized controlled trial
• Parallel
• Crossover
• Before and After (time series)

17
Primary journal article resources

• Observational (weaker than interventional
  studies)
• Cohort (strongest in class)
• Case control
• Cross sectional
• Case series, Case report, descriptive

18
Secondary Literature Resources

• Indexing and Abstracting Services
• Indexing service provides only bibliographic
  information that is indexed by topic.
• Abstracting service also provides a brief
  description or abstract of information
  contained in a specific citation.
• Both provide access to primary literature
• Each can cover different journals, texts,
  publicat.
• Cost will vary from 150 to 60,000 / year

19
Secondary Literature Resources

• Medline- largest 380,000 ref, 4000 journals
• BIOSIS
• Embase
• Index Medicus
• IDIS (Iowa Drug Information System)
• PUBMED (access to Medline)

20
Tertiary Literature Resources

• Textbooks (Goodman and Gilman, Handbook of
  Non-Prescription Drugs, etc)
• Drug Encyclopedias (Martindales, Merck Index,
  etc)
• Review articles in primary journals, Meta
  Analysis articles in primary journals
• Drug Compendia (Facts and Comparisons, AHFS, PDR
• Full Text Computer Database(Micromedex)

21
Tertiary Literature Resources

• Advantages
• provide rapid access to information
• detailed sufficiently for quick reference
• good general information condensed into easy to
  read format
• Disadvantages
• Outdated quickly, may not reflect current
  standards of practice, incomplete, human bias,
  incorrect interpretation of research or lack of
  expertise by author

22
Alternate Sources for Drug Information

• Internet Sites
• Electronic Bulletin Boards (EBBs) FIX, FDA,
  Helix, Pharmnet, Pharmline
• Local and National Professional Organizations
• Pharmaceutical Manufacturers
• Drug Information Centers, Poison Control Centers

23
5. Data Evaluation, Analysis, Synthesis

• 1.
• 2.
• 3.

24
6. Formulate and Provide Response
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7. Follow Up and Follow Through

• Verify the appropriateness, correctness, and
  completeness of a response.
• Essential when judgement calls used.
• Essential when new data found or circumstances
  changed from original request.
• Document everything!

26
Ethical and Moral Responsibility

• How will they use your information?
• Are they asking for lethal dose of drug?
• Are they suicidal or homicidal?
• Are they seeking information for making illicit
  drugs?
• Are they trying to forge a prescription?
• Are they in serious need of an ER?

27
Ethical and Moral Responsibility.

• 1.
• 2.
• 3.

28
Important Rules for Drug Information

• Be _______________ with information
• Be _______________ with information
• Be _______________ with information