8/16/18

DRUG INFORMATION
RESOURCES

Stepwise approach to find information

1.  Tertiary (textbooks, full-text databases, review articles)
○  General information
2.  Secondary (indexing or abstracting services)
3.  Primary (clinical studies)
○  Most recent and in-depth

*not all inquiries will need all the steps

*type of requestor may influence the resources used

1
 8/16/18

Tertiary Resources
●  provide information that has been summarized and distilled by the author or
editor to provide a quick easy summary of a topic
○  Textbooks, compendia, review articles in journals, other general information
●  provide a complete and concise overview of information available on a
specific topic
●  Convenient, easy to use, familiar
●  Disadvantages:
○  lag time with publication; less current information
○  May be incomplete
○  Errors in transcription, human bias, incorrect interpretation, lack of expertise of authors

Tertiary Resources
General Product Information
1.  AHFS Drug Information
○  Infomation on FDA-approved and off-label uses of medications
○  For determining reimbursement of unlabeled uses of medications
○  Dosing in specific populations
○  Compatibility and stability of injectable formulations
○  Paper format, mobile drug reference version

2
 8/16/18

Tertiary Resources
General Product Information
2.  Clinical Pharmacology
○  Monographs of prescription and nonprescription products, dietary supplements
○  Screen for drug interactions
○  Create comparison tables for products
○  Determine IV compatibility
○  Search for tablets by description or imprint codes
○  Electronic database (online or smartphone app)

Tertiary Resources
General Product Information
3.  Micromedex 2.0
○  FDA-approved indications, off-label uses, pharmacokinetic data, safety
information, pharmacology
○  Assess drug interactions, incompatibilities, pharmacokinetic adjustments
○  Toxicology - identification on imprint codes, overdose management
○  Patient medication materials
○  Electronic resource

3
 8/16/18

Tertiary Resources
General Product Information
4.  Facts & Comparisons
○  Prescription and nonprescription drugs organized by drug class
○  Inactive ingredients in commercial preparations
○  Comparative monographs of drug classes
○  Hardcopy, online, and for mobile device

Tertiary Resources
General Product Information
5.  Drug Information Handbook
○  Brief product monographs
○  Clinical use, safety, monitoring
○  FDA-approved and off-label use of medications
○  Tablet identification, medication pricing information (electronic format)
○  Treatment options and comparing agents in the same class
○  Hardcopy, online, for mobile device

4
 8/16/18

Tertiary Resources
General Product Information
6.  Handbook of Nonpresription Drugs: AN Interactive Approach to Self-Care
○  Disease states - self-care may be appropriate
○  Comparative efficacy of OTC agents
○  CI for self-treatment, drug interactions, other safety information
○  Treatment algorithms and patient care cases
○  Paper and e-book

Tertiary Resources
General Product Information
7.  Physicians’ Desk Reference
○  Compilation of prescription product package inserts
○  Contact information for manufacturers
○  List of poison control centers
○  Limited tablet identification
○  online, for mobile devices

5
 8/16/18

Tertiary Resources
General Product Information
8.  USP Dictionary
○  Official resource for determining generic and chemical names of drugs; international
nonproprietary name
○  Chemical structure, molecular weight, CAS (Chemical Abstracts Services) registry number,
pronunciation guide
○  Online and print

Tertiary Resources
General Product Information
9.  Epocrates
○  Drugs (monographs, interaction checker, safety data, tablet ID)
○  Diseases (epidemiology, prognosis, treatment)
○  Online and mobile device

6
 8/16/18

Tertiary Resources
Adverse Effects
1.  Meyler’s Side Effects of Drugs
○  Organized by drug classification
○  Adverse events are organized by drug name and then by organ system within each drug
○  Adverse events and management

Tertiary Resources
Adverse Effects
2.  Side Effects of Drug Annual: A Worldwide Yearly Survey of New Data and
Trends in Adverse Drug Reactions
○  Updated annually
○  Serves as a companion to the Meyler’s

7
 8/16/18

Tertiary Resources
Availability of Dosage Forms
1.  American Drug Index
○  Indexed by product and generic name
○  Product use, available dosage forms and sizes
○  Manufacturer information
○  Charts: LASA medications, pregnancy categories, normal lab values, pharmacy calculations

Tertiary Resources
Availability of Dosage Forms
2.  Red Book
○  Prescription and OTC product availability and pricing
○  Tables: sugar-free, lactose-free, or alcohol-free preparations
○  National Drug Code numbers, routes of administration, dosage form, size, strength
○  Paper and electronically (within Micromedex 2.0)

8
 8/16/18

Tertiary Resources
Compounding/Formulations
1.  Extemporaneous Formulations for Pediatric, Geriatric, and Special Needs
Patients (Children’s Hospital of Philadelphia)
○  Compilation of published formulations with stability data
○  Most are oral formulations
○  Legal and technical issues in compounding practices

Tertiary Resources
Compounding/Formulations
2.  Merck Index
○  Descriptions of the chemical and pharmacological information of chemicals, drugs, and
biologicals
○  CAS number, chemical structure, MW, physical data (solubility)
○  Print and online

9
 8/16/18

Tertiary Resources
Compounding/Formulations
3.  Remington: The Science and Practice of Pharmacy
○  All aspects of pharmacy practice
○  Social issues
○  Basics of pharmaceutics, manufacturing, pharmacodynamics, nuclear pharmacy, medicinal
chemistry
○  Common compounding techniques and ingredients
○  Paper and CD-ROM

Tertiary Resources
Compounding/Formulations
4.  A Practical Guide to Contemporary Pharmacy Practice
○  Compounding techniques, pharmacy calculations, explanations of additives
○  Text and CD-ROM

10
 8/16/18

Tertiary Resources
Compounding/Formulations
5.  Trissel’s Stability of Compounded Formulations
○  Preparation of sterile and nonsterile dosage forms
○  Organized by drugs
○  Summary of the properties of drugs, general stability, stability of compounded preparations
○  Beyond-use dating

Tertiary Resources
Compounding/Formulations
6.  USP/NF
○  Official substance and product standards
○  Official preparation instructions
○  Print, online, flash drive formats

11
 8/16/18

Tertiary Resources
Dietary Supplements
1.  Natural Medicine Comprehensive Database
○  Rates the relative safety and efficacy
○  By brand names or by a variety of common names
○  Interaction checker and disease state/condition
○  Text, online and mobile device formats

Tertiary Resources
Dietary Supplements
2.  Natural Standard
○  Evidence-based information regarding efficacy
○  Monographs - dosing information (doses used in clinical trials and recommended by expert
opinion)

3.  PDR for Herbal Medicines

○  Indexed by common name
○  Action, usage, dosage

12
 8/16/18

Tertiary Resources
Dietary Supplements
4.  Review of Natural Products
○  Chemistry, pharmacology, toxicology of natural products
○  Relevant clinical trials
○  Limited patient counseling information
○  Loose-leaf, bound, online, mobile device formats

5.  Trease and Evans’ Pharmacognosy

○  Classic pharmacognosy, crude plant-based drug classification and examination, clinical
applications, pharmacology, phytochemistry
○  NOT a resource for patient care issues

Tertiary Resources
Drug Interactions
1.  Hansten and Horn’s Drug Interactions Analysis and Management
○  Summaries of, mechanism of, and management options for reported drug interactions
○  Severity of interaction
○  Risk factors
○  Loose-leaf, bound, some integrated in electronic Facts and Comparisons

13
 8/16/18

Tertiary Resources
Drug Interactions
2.  Drug Interaction Facts
○  D-D and D-F interactions
○  Significance of interaction
○  Suggestions for management
○  Bound, loose-leaf, CD-ROM, integrated in electronic Facts and Comparisons

Tertiary Resources
Drug Interactions
3.  Food- medication Interactions
○  Food impacts on medications
○  Foods to be avoided with specific medications
○  Print, online, mobile device formats

14
 8/16/18

Tertiary Resources
Geriatric Dosage Recommendations
1.  Geriatric Dosage Handbook
○  Dosing recommendations for geriatric patients
○  Specific concerns of geriatric populations
○  Online and for mobile devices

2.  The Merck Manual of Geriatrics

○  Management of diseases and conditions common in geriatric patients
○  Appropriate dosing of medications
○  Print and online

Tertiary Resources
Identification of Product
1.  IDENT-A-DRUG
○  Organized by imprint codes and provides ID of drugs based on codes
○  Description of medications, NDC, Canadian DIN
○  Electronic and text

2.  Drugs.com
○  Easy-to-use imprint search
○  Available to patients and NO charge

15
 8/16/18

Tertiary Resources
Incompatibility and Stability
1.  Handbook on Injectable Drugs
○  Commonly called Trissel’s
○  Compatibility and stability of parenteral medications
○  In the form of charts and tables
○  Routes of administration and commercially available strengths
○  Pocket-sized handbook and online

Tertiary Resources
Incompatibility and Stability
2.  King Guide to Parenteral Admixtures
○  IV drug monographs
○  Focuses on compatibility
○  Limited on stability
○  Loose-leaf, bound, online, mobile device formats

16
 8/16/18

Tertiary Resources
Incompatibility and Stability
3.  Trissel’s 2 Clinical Pharmaceutics Database
○  Compiles data from other Trissel publications
○  Parenteral admixtures, compounded formulations, physical compatibility,
chemotherapy formulations
○  Intranet, CD-ROM, internet

Tertiary Resources
International Drug Equivalency
1.  Index Nominum: International Drug Directory
○  Drugs available in over 130 countries
○  Structure, therapeutic class, proprietary names
○  Contact information for pharmaceutical manufacturers worldwide
○  CD-ROM

17
 8/16/18

Tertiary Resources
International Drug Equivalency
2.  Martindale: The Complete Drug Reference
○  Domestic and international drugs
○  Proprietary names and manufacturer contact information for a variety of
countries
○  Common herbal products, diagnostic agents, radioactive
pharmaceuticals, some veterinary products
○  Hardcopy, CD-ROM, online

Tertiary Resources
Pediatric Dosage Recommendations
1.  The Harriet Lane Handbook
○  Assembled by medical residents
○  Common diseases and conditions of newborn to adolescent patients
○  Medication dosing
○  Common side effects and dosage forms available
○  Palliative care and toxicology
○  Antimicrobial therapy (separate publication)
○  Paper and mobile device

18
 8/16/18

Tertiary Resources
Pediatric Dosage Recommendations
2.  Pediatric Dosage Handbook
○  Dosage recommendations for pediatrics
○  Extemporaneous preparations
○  Online, CD-ROM, mobile devices

Tertiary Resources
Pharmacokinetics
1.  Basic Clinical Pharmacokinetics
○  Basic principles of pharmacokinetics
○  Interpretation and implications of plasma concentrations
○  Monographs and discussions on drugs assessed by blood concentration levels

2.  Applied Biopharmaceutics and Pharmacokinetics

○  Role of pharmacokinetics to drug development and patient care
○  Impact of pharmacogenetics on drug metabolism
○  Text and included in electronic Access Pharmacy

19
 8/16/18

Tertiary Resources
Pharmacology
1.  Goodman and Gilman’s: The Pharmacological Basis of Therapeutics
○  Pharmacokinetics and pharmacodynamics
○  Provide correlation between principles of pharmacology and contemporary clinical practice
○  Text and in electronic Access Pharmacy

2.  Basic and Clinical Pharmacology

○  Organized by therapeutic class of agents
○  Pharmacology principles
○  Text and in electronic Access Pharmacy

Tertiary Resources
Pharmacology
3.  Brody’s Human Pharmacology: Molecular to Clinical
○  Designed with student focus
○  Therapeutic impact of pharmacology
○  Organized by organ system
○  Text, mobile device, internet updates

20
 8/16/18

Tertiary Resources
Pharmacology
4.  Modern Pharmacology with Clinical Applications
○  Clinical application of drugs
○  Emphasis on SAR
○  Some dietary supplements
○  text

Tertiary Resources
Pharmacy Law
1.  Pharmacy Practice and the Law
○  Federal laws and regulations impacting pharmacy practice
○  Federal and state regulation of product development,
dispensing, and development

21
 8/16/18

Tertiary Resources
Teratogenicity/Lactation
1.  Drugs in Pregnancy and Lactation
○  Often referred to as Brigg’s
○  Use of medications in pregnant and lactating women
○  Fetal exposure in utero or exposure through breastmilk
○  Animal literature is provided in cases human literature is lacking

2.  Catalog of Teratogenic Agents

○  Teratogenicity of pharmaceuticals, chemicals, environmental pollutants,
food additives, household products, viruses
○  International and domestic information

Tertiary Resources
Therapy Evaluation/Drug of Choice
1.  Applied Therapeutics: The Clinical Use of Drugs
○  Disease states and treatment options
○  Cases with follow-up discussion
○  Clinical case-based presentation
○  Pocket-sized handbook, CD-ROM, mobile device

2.  Goldman’s Cecil Medicine

○  Organized by disease state and color-coded
○  Etiology, manifestations, diagnosis, treatment, prognosis
○  Print, CD-ROM, mobile device, internet

22
 8/16/18

Tertiary Resources
Therapy Evaluation/Drug of Choice
3.  Harrison’s Principle of Internal Medicine
○  Comprehensive introduction to clinical medicine
○  Pathophysiology, differential diagnosis, and disease management
○  text , electronic, included in Access Pharmacy

4.  The Merck Manual of Diagnosis and Therapy

○  Summary of disease state information - pathology, symptoms, diagnosis,
and treatment
○  Online and mobile device

Tertiary Resources
Therapy Evaluation/Drug of Choice
5.  Medscape
○  Extensive information about disease states and conditions
○  News and updates on treatment
○  Monographs of prescription and OTC medications
○  Electronic

6.  Pharmacotherapy: A Pathophysiological Approach

○  Management of disease states
○  Epidemiology, etiology, presentation of disease, treatment, and treatment
outcomes
○  Text and electronic

23
 8/16/18

Tertiary Resources
Therapy Evaluation/Drug of Choice
7.  Pharmacotherapy Principles and Practice
○  Management of disease states - diseases most likely to be seen by
pharmacists, nurses, and physician assistants
○  Has features to help student learning
○  Epidemiology, etiology, presentation of disease, treatment, and treatment
outcomes
○  Text and electronic

Tertiary Resources
Therapy Evaluation/Drug of Choice
8.  Textbook of Therapeutics
○  Treatment of disease states and development of therapeutic plan
○  Pathophysiology and clinical presentation
○  CD-ROM, PDA, print

24
 8/16/18

Tertiary Resources
Toxicology
1.  Casarett & Doull’s Toxicology: The Basic Science of Poisons
○  Serve as a textbook
○  Extensive information on organ- and nonorgan-directed toxicity
○  Text and electronic in Access Pharmacy

2.  Goldfrank’s Toxicological Emergencies

○  Case study approach to toxicology
○  Basic toxicology data
○  Management of toxicological emergencies - common drugs, botanicals,
pesticides, occupational and environmental hazards

Tertiary Resources
Veterinary Medicine
1.  Plumb’s Veterinary Drug Handbook
2.  Textbook of Veterinary Internal Medicine
3.  Compendium of Veterinary Products
4.  FDA/CVA Homepage
5.  American Veterinary Medical Association, Scientific Reference
Material on Veterinary Compounding
6.  Animal Poison Control Center

25
 8/16/18

Tertiary Resources
Veterinary Medicine
7.  Veterinary Pharmacology and Therapeutics
8.  Small Animal Clinical Pharmacology and Therapeutics
9.  The Merck Veterinary Manual
10. Pet Place
11. Pets with Diabetes
12. American Veterinary Medical Association

Secondary Literature
●  References that either index or abstract primary literature
●  Directing the user to relevant primary literature
●  Help practitioner keep abreast of recently published information
●  Help find more recent or detailed information on treatment or disease

26
 8/16/18

Secondary Literature
A.  Indexing
○  Bibliographic citation information
○  Title, author, citation of the article

B.  Abstracting
○  Also includes brief description (abstract)

Secondary Literature
Search Strategies
A.  Identify key terms
B.  Use of Boolean operators: AND, OR, NOT

27
 8/16/18

Secondary Literature
Search Strategies
C.  Use of limit fields
a.  Language, year of publication, type of article or journals
D.  Address all possible search phrases (spellings or disease states that changes
over time)
E.  Use of filters
a.  Content filters - specific to drug or disease state
b.  Validity filters - a way to narrow the search to only the highest quality studies (RCT, double-
blind)

Secondary Literature
1.  BIOSIS PREVIEWS
○  Comprehensive database of biological information
○  Abstracts from conferences relating to basic science
○  Activity of compounds on a cellular level

2.  CANCERLIT
○  Indexes literature from variety of sources specific to cancer literature
○  Oncology therapy and quality of life issues

28
 8/16/18

Secondary Literature
3.  CINAHL
○  Fields of nursing and allied health
○  Patient care from the perspective of allied health professionals
○  Updated monthly

4.  COCHRANE LIBRARY

○  INDEXES about medical treatments, conditions, and alternative therapies
○  ABSTRACTS of international systematic reviews
○  BIBLIOGRAPHY of systematic reviews in worldwide literature

Secondary Literature
5.  CURRENT CONTENTS CONNECT
○  Overview of recently published literature
○  Clinical medicine, life science
○  Recent drug research and developments

6.  EMBASE
○  Covers biomedical literature worldwide
○  Less lag time
○  Dietary supplements or medications available in other countries

29
 8/16/18

Secondary Literature
7.  GOOGLE SCHOLAR
○  Scholarly materials available online
○  May not be able to access full-text versions

8.  INTERNATIONAL PHARMACEUTICAL ABSTRACTS

○  Drug-related information - drug use and development
○  Pharmacy information - pharmacy administration and clinical services

Secondary Literature
9.  IOWA DRUG INFORMATION SYSTEM
○  Full-text articles from biomedical publications in PDF or microfiche
○  Indexing is by drug- and disease-specific terms
○  Standard medications

10. JOURNAL WATCH
○  Recent information, summarized by physicians from medical literature
○  New clinical trials involving specific medications

30
 8/16/18

Secondary Literature
11. LEXISNEXIS
○  Medical, legal, and business news

12. MEDLINE
○  Basic and clinical sciences as well as nursing, dentistry, veterinary medicine, and many other
health care disciplines
○  5000 journals in 40 languages

Secondary Literature
13. PHARMACOECONOMICS & OUTCOMES NEWS WEEKLY
○  Biweekly publication
○  Recent publications regarding economic use of health care resources
○  Prescribing trends, recent health care news, and regulatory updates
○  Economic impact of disease states and medical interventions

14. REACTIONS WEEKLY
○  Adverse events, drug interactions, drug dependence, and toxicology data
○  Case reports of adverse reactions or drug safety
○  Very short lag time

31
 8/16/18

Primary Literature
●  Clinical research studies and reports
●  Published and unpublished
●  Controlled trials, cohort studies, case series, case reports

Primary Literature
●  Advantages:
○  Detailed information
○  Personally assess the validity and applicability of study results
○  More recent than tertiary and secondary
●  Disadvantages:
○  Misleading conclusions - one trial without context of other research
○  Need to have good skills in medical literature evaluation
○  Time needed to evaluate the large volume of literature available

32
 8/16/18

Alternative Resources
●  INTERNET SEARCHES
○  Especially helpful to serve as a starting point for questions about uncommon diseases, new
terms, drugs in development, or marketed OTC and dietary supplements
○  Helpful in identifying information or specific product claims by the manufacturer
○  Useful for topics that have been recently in the news

Alternative Resources
●  INTERNET SEARCHES
○  Carefully evaluate the quality of information
■  Site maintained by educational institutions, not-for-profit medical organizations, or a
division of the US government VS. company selling or promoting specific product
■  Information appropriately detailed and referenced
■  Possibility to contact author

33
 8/16/18

Alternative Resources
●  ALTERNATIVE INFORMATION SOURCES
i.  News network websites, i.e. CNN, ABC, CBS
■  A recent news story reporting the removal of a medication from the market
■  May not provide all information but may at least serve as a point to search additional
information
ii.  Expert in the field or persons performing research in the area
iii.  Organization affiliated with disease state
iv.  Product manufacturer

Understanding where to access

information is only the first step in the
provision of quality drug information.

34