Drug Information

Question 1

What are the 7 DI categories?

Answer 1

1. Availability & Identification
2. Parenteral administration & compatibility
3. Drug use in pregnancy and lactation
4. Drug interactions
5. Adverse drug reactions
6. Dosage & Administration
7. Choice of therapy / disease management

Question 2

What are the references to approach for product availability?

Answer 2

HSA website
Institution formulary

Question 3

Which references can be used to identify local products?

Answer 3

MIMS online
Mediview

Question 4

Which references can be used to identify overseas products?

Answer 4

MIMS online
Martindale

Question 5

Which references can be used to identify US products?

Answer 5

Lexi-drug ID
Micromedex Drug ID

Question 6

What are the top 3 suitable references for adult parenteral administration queries?

Answer 6

Product insert
AHFS Handbook on injectable drugs (Trissel’s)
Uptodate Lexicomp

Question 7

What are the suitable references for paediatric parenteral administration queries?

Answer 7

Product insert
Teddy Bear Book

Question 8

What are the top 3 suitable references for stability and compatibility of parenteral substances?

Answer 8

AHFS Handbook on injectable drugs
Trissel’s 2.0
King’s Guide

Question 9

What are the top 3 suitable references for drug use in pregnancy?

Answer 9

Briggs (Drugs in pregnancy and lactation)
Uptodate Lexicomp
Micromedex

Question 10

What are the specialised references for pregnancy?

Answer 10

Briggs (Drugs in pregnancy and lactation)
CDC Treating for Two
OTIS Mother to Baby

Question 11

What are the top suitable references for drug use in lactation?

Answer 11

Briggs
Hales
Micromedex
Uptodate Lexicomp

Question 12

What are the specialised references for lactation?

Answer 12

Hales
LactMed

Question 13

What are the top 3 suitable references for adverse drug reactions?

Answer 13

Uptodate Lexicomp
Micromedex
Meyler’s side effects of drugs

Question 14

What are the top 3 suitable references for general drug interactions?

Answer 14

Lexi-comp Drug Interactions
Micromedex Drug Interactions
Stockley’s Drug Interactions

Question 15

What are the top 2 suitable references for drug-herb interactions?

Answer 15

Natural Medicines
NIH Office of Dietary Supplements

Question 16

What are the top 4 suitable references for dosing and administration?

Answer 16

Uptodate Lexicomp
Micromedex
BNF
PIL

Question 17

What are the specialty references for renal dosing?

Answer 17

The renal dosing drug handbook
Drug prescribing in renal failure
Renal pharmacotherapy

Question 18

What are the specialty references for children?

Answer 18

Lexi-comp Peds and Neonates
BNF for Children

Question 19

What are the specialty reference(s) for hepatic dosing?

Answer 19

Drugs and the Liver

Question 20

What are the specialty references for antimicrobials?

Answer 20

Sanford guide to antimicrobial therapy

Question 21

What are the specialty references for enteral feeding tubes?

Answer 21

Handbook of drug administration vias enteral feeding tube

Question 22

What are the top 3 suitable references for disease management?

Answer 22

Pharmacotherapy textbooks
Uptodate topic guides
Clinical practice guidelines / review papers

Question 23

What should be done if the answer cannot be found in the references?

Answer 23

Primary literature should be looked at

Question 24

What information should be responded with for an availability & identification query?

Answer 24

Generic and brand name
Origin and uses of drug
Available form and strength
Special restrictions? (P-only, POM…)
If not available, recommend alternative / other pharmacy

Question 25

In what conditions should we be cautious about the types and amounts of fluid in parenteral administration?

Answer 25

Heart failure / renal: Fluid restriction Diabetes: cannot sugar too high (dextrose a problem) Renal / elevated sodium: cannot sodium too high

Question 26

What information should be responded with for a parenteral administration query?

Answer 26

Reconstitution instructions (diluent, withdraw, further dilution, route - IV/IM/SC)

Question 27

What information should be responded with for a parenteral stability / compatibility query?

Answer 27

Concentration Details of study Communicate compatibility (conc., diluent) or incompatible (why?)

Question 28

What is the safe % for relative infant dose (RID)?

Answer 28

10%

Question 29

What types of drugs are typically safe in preg and lact?

Answer 29

Drugs that are not bioavailable

Question 30

What information should be responded with for a pregnancy / lactation query?

Answer 30

Recommendation Classification ratings Monitoring required? Strategies to minimize exposure Non-pharm to minimize drug use

Question 31

What information should be responded with for an adverse drug reaction query?

Answer 31

Description of ADR Mechanism (Class effect?) Frequency Usual onset Dose-related? Reversibility Management Possible alternatives

Question 32

What information should be responded with for a drug interaction query?

Answer 32

Outcomes of DDI (signs and symptoms, labs) Mechanism Onset, severity, duration Significance Management Alternatives

Question 33

What information should be responded with for a dosing / choice of therapy query?

Answer 33

Route Dose and frequency Initial, titration, max Monitoring Safety tips