Drug Information Introduction Flashcards
What is Drug Information (DI)?
Drug Information: A Guide for Pharmacists
“The provision of unbiased, well-referenced, and critically evaluated information on any aspect of pharmacy practice.”
What is Medication Information?
Medication Information:
Conveys the management and use of information in relation to medication therapy
what is the difference between Drug information and Medication Information?
Drug information provide the information, medication information is the used of this information to patient specific therapeutic needs.
Fundamental responsibility of the pharmacist?
- Active role in clinical decision making
- Newsworthy vs. Applicability (Misleading, misused information)
When was drug information concept born?
Drug Information” concept born in the 1960’s
What year was the first Drug information Center started and what university?
1962: First Drug Information Center
University of Kentucky Medical Center
“Source of comprehensive drug information for staff physicians and dentists to evaluate and compare drugs”
What year was Medline Created and What ? what were the objectives
1971: MEDLINE (telephone)
Drug Information Specialist
Dencentralizing pharmacists
Clinical consultation services
What is MEDLINE?
Big database for research for journal article medication information started as a telephone line.
What are the event that lead to the beginning of clinical pharmacy?
Drug Information” concept born in the 1960’s
1962: First Drug Information Center
1971: MEDLINE (telephone)
What is the main goal of Drug information ?
To learn to retrieve, evaluate, and communicate relevant medication information as an integral part of pharmaceutical care.
What are the 3 skills needs for efficiency in Drug Information
As information masters, pharmacists should be able to:
- Find information
- Evaluate information
- Communicate information
What other skills as experts a pharmacist should also posses for effective Drug information skills?
We should also:
Possess biostatistics skills
Possess literature evaluation skills
What are the 3 types of Resources needed to proper research of drug information?
Primary literature
Original research
Secondary literature
Indexing and abstracting services
Tertiary literature
Resources of an established knowledge
Define Tertiary Resources?
Summary of Existing Medical Literature
Ex: Guidelines, Compendia, Textbooks, etc
It is the establish knowledge .It is where all the experts compile their research and knowledge for us to retrieve easily when necessary.
Examples of Tertiary Resources Are:
Textbooks, Dipiro: Pharmacotherapy: A Pathophysiologic Approach, Compendia, ational Formulary, Full-text Databases, Micromedex, Lexicom, Clinical Practice Guidelines, Review Articles, Cochrane Reviews, Prescribing information, Package inserts, Manufacturer websites
What are the advantages of Tertiary Resources?
Easy to use, Convenient, Concise,Compact, Often, compiled by experts
What are the Disavantages of Tertiary Resources
Information may be incomplete, May contain insufficient detail, May not be relevant/timely, Possible human bias
Possible transcription errors, Authors interpretation of research may be incorrect
Define Secondary Resources?
Databses,Indexing and abstract services used to locate existingTertiary primary literature
Examples of Secondary Resources
International Pharmaceutical Abstracts (IPA)
OVID, Embase,PubMed/Medline, Iowa Drug Information Services (IDIS), Google Scholar,
Advantages of Secondary Resources:
Fast access to a large amount of information
Offers abstracts for quick review of the information
Disadvantages of Secondary Resources:
Search strategies vary for each service
Variability of journals and periodicals indexed
Costly, Lag time from publication to availability
Define Primary Resources?
“Foundation of the literature hierarchy”
Where second and third literature come from. This is the rare material Journal original0 research
What are the sources of Primary Resources?
Primary Resources are:
1-Original research
Clinical studies, Pharmacoeconomic studies
Pharmacoepidemiologic studies
2-Unpublished original research
Professional meeting proceedings,Theses, Dissertations
Patents
Advantages of Primary Resources:
Original research
Most current
Expansive
Disadvantages of Primary Resources:
Practicality, Inefficient at times, Information may be false or misleading, Requires good drug literature evaluation skills, Costly
True or False most drug information are not patient specific
False
true or false casual interactions mean in-depth analysis is not needed
false
How many steps there are in the Modified Systematic Approach?
7 steps
What are the different steps of the Modified Systematic Approach?
Step 1: Secure demographics of requestor
Step 2: Obtain background information
Step 3: Determine and categorize ultimate question
Step 4: Develop strategy and conduct search
Step 5: Perform evaluation, analysis, and synthesis
Step 6: Formulate and provide response
Step 7: Conduct follow-up and documentation
Step 1: Secure demographics of requestor Includes:
Obtain requestor demographics
Contact information, Practice setting
Physician?, Nurse?, Specialist?, Patient?, Parent?
Why do we want to know the contact information?
Determine the requestor’s:
Training
Position
Anticipated Knowledge, Urgency of Answer
What is included in step 2?
Obtain background information
Why do we need to obtain background information?
- We need to learn what type of information is needed
- Learn the level of detail needed
- To determine the ULTIMATE QUESTION
Examples of some background questions:
- Is this for a specific patient?
- Age, gender, race
- Diagnoses & PMH
- What disease state does this patient have?
- What other medications is the patient on?
- Where are we in the course of therapy?
- Has the physician been involved?
- Has medication already been administered?
- Unusual or special circumstances
What is included in step 3?
Determining and categorizing the ultimate question. The question may be different than the original question asked. You may need to refocus the question. Also, be sure to repeat the ultimate question back to the requestor.
What 4 things should you consider when determining the ultimate question?
- patient factors (age, pregnancy, mental capacity, etc.)
- disease factors (kidney or liver failure)
- medication factors (cost)
- background information (recent hospitalization, failed prior course of therapy)
What are examples of ways to classify drug information requests?
- adverse drug reaction/allergy
- alternative medicine
- compounding or manufacturing
- dose
- drug interaction
- drug therapy or therapeutics
- economics/cost
- IV therapy
- legal/regulatory
- pediatrics
- pharmacokinetics
- pharmacology
- poison/toxicology
- pregnancy or lactation
- product availability
- product identification
- route of administration
- stability and compatibility
- shortages
What is included in step 4?
Develop a strategy and conduct research. Base it on a category chosen in step 3–this will help you decide where to look.
What is a primary resource?
original research
What is a secondary resource?
Indexing/Abstracting services like MEDLINE, Google Scholar
What is a tertiary resource?
Summary of existing medical literature (guidelines, compendia, textbooks)
Where do you normally start when conducting research?
Tertiary sources
What is included in step 5?
Evaluate, analyze, and synthesize. You need to evaluate the information found. Analyze it to see if the chosen resource is applicable. Then synthesize a response.
It is a systematic process of combining information from multiple sources into one coherent response. You should objectively critique the information retrieved. Look at the information with consideration of background information to apply it to your patient.
What is included with step 6?
Formulate and provide a response.
True/False
It is NOT our professional responsibility to inform when one course of action is clearly more desirable than alternate action.
False
When providing a response to a question, what should we keep in mind?
- we have to inform them of the most desirable action
- conflicting data should be shared
- answer in a timely manner
- appropriate level of sophistication
- anticipate further questions to save time and make yourself look good
What is included in step 7?
Conduct follow up and documentation
Why is documentation needed?
- reduce liability
- reduce confusion, conflict, duplication of work
- promotes patient relationship
- demonstrates work
Why is a follow up needed?
- verify appropriateness and completeness
- required for patient specific requests
- learn from it
Our responsibility extends beyond…
…simply providing an answer to a question.
Informal environments do not eliminate the need for…
…in-depth analysis and extensive involvement in patient management.
Failure of the requestor to disclose critical information does not…
…obviate the need for such information.
Most questions pertain to what type of patients?
To specific patients
Requestors usually act in what way?
They are typically vague in verbalizing their needs. And are often uncertain what the pharmacist needs to know.
What are the 2 goals?
- Execute a modified systematic approach for answering drug information questions.
- To learn to retrieve, evaluate, and communicate relevant medication information as an integral part of pharmaceutical care.
Go over the highlights of the case study presented in this section.
Doctor calls asking for what interacts with warfarin. The patient is a 36 year old female with a UTI. The doctor wants to start an antibiotic. Wants a recommendation because he knows many antibiotics interact with warfarin. The ultimate question is “Can you provide a recommendation for an antibiotic to treat a UTI in a 36 year old female on warfarin?” This is a therapeutic or drug interaction category question. Use Diprio’s, LWW, or IDSA for therapeutic search. Use micromedex, lixi-comp, fact and comparisons, or epocrates for drug interaction. Most appropriate is macrobid because the other options can interact with warfarin, while macrobid does not.
