HYMR Sources of Information Flashcards
CATEGORY: BASICS IN EPIDEMIOLOGY
Which of the following services or databases would provide the reader with primary sources of literature that is focused more on drugs and pharmacology?
A. Cochrane database
B. EMBASE
C. CINHAL
D. AHRQ
B. EMBASE
- EMBASE is a biomedical database that is searchable and tends to have more focused information related to pharmacology.
- Cochrane database is a searchable database of systematic reviews and meta-analysis performed by the Cochrane working groups and extend to topics beyond
pharmacology. - CINHAL is a searchable database containing publications related to nursing, allied health, biomedicine, and healthcare.
- AHRQ provides systematic reviews and meta-analysis performed by the academic and U.S. government working groups and extend to topics beyond pharmacology.
A concerned mother contacts you because her 8-year-old daughter’s psychiatrist wants to prescribe Ritalin and Wellbutrin together to better control her daughter’s attention deficit disorder. She is worried that the drug combination will cause a serious drug interaction. Which resource would provide the most helpful in answering this question?
A. Goodman and Gilman’s The Pharmacological Basis of Therapeutics
B. The Orange Book
C. Micromedex
D. The Cochrane library
C. Micromedex
- Micromedex is a tertiary database providing evidence-based information about drug therapy, including pharmacology, adverse reactions, compatibility, drug identification, indications for use, and a drug interactions tool, DrugReax.
- Goodman and Gilman’s is a pharmacology text that provides data about mechanism of action, therapeutic use, and adverse effects for drug therapy but does not address specific drug interactions.
- The Orange Book is a resource provided by the Food and Drug Administration that cites FDA-approved medications based on safety and effectiveness and identifies therapeutic equivalence.
- The Cochrane library is a collection of six databases that address high-quality, evidence-based data to aid decision-making in healthcare, but does not address the specifics of individual drug interactions.
A patient asks you if it is safe to start breastfeeding again following a 5-day course of lamivudine/zidovudine (Combivir). What would be the best strategy for you to use to answer this question?
A. Contact the Poison Control Center
B. Review lactation data for lamivudine and zidovudine in a lactation drug resource
C. Review data about breastfeeding in the Combivir package insert
D. Review breastfeeding data for lamivudine and zidovudine in a pediatrics drug resource
B. Review lactation data for lamivudine and zidovudine in a lactation drug resource
- The optimal evidence-based strategy to use to answer this question would be to consult lactation references.
- While the package insert will have breastfeeding data, the data presented typically address concurrent medication use and breastfeeding and associated risks and do not always address breastfeeding safety when the medication is discontinued.
- Pediatric drug information resources do not provide specific information about drugs and breastfeeding to answer this question.
High-Yield Core Concept: - There are a number of tertiary reference sources that cover lactation related drug information such as Medications and Lactation by Dr. Tom Hale and Briggs Drug in Pregnancy and Lactation.
While on hospital rounds, a resident requests the appropriate dose for voriconazole to treat esophageal candidiasis in a two-year-old child. Which reference would provide the best response to this question?
A. Martindale: The Complete Drug Reference
B. American Drug Index
C. The Harriet Lane Handbook
D. Goodman and Gilman’s The Pharmacological Basis of Therapeutics
C. The Harriet Lane Handbook
- The Harriet Lane handbook is a tertiary resource that specifically addresses pediatric issues, including specific pediatric dosage regimens for specific indications.
- Martindale is an international reference that provides more general drug information with some general pediatric dosing data.
- American Drug Index provides brief information related to drug names, dosage forms, indications, and manufacturer information.
- Goodman and Gilman’s is a pharmacology reference that also provides brief general information about pharmacokinetics and dosing, with some general pediatric dosage recommendations.
Which of the following best describes a qualitative overview of the literature in a manner that is systematic and reproducible, but does not report on the overall magnitude of effect from that literature reviewed?
A. Case-series
B. Meta-analysis
C. Review article
D. Systematic review
D. Systematic review
- A systematic review is a “qualitative”, not a “quantitative”, overview of the literature in a manner that is systematic and reproducible, but does not report on the overall magnitude of effect from that literature reviewed.
- A meta-analysis is usually done after a systematic review and combines the data from studies to report on the overall magnitude of effect from that literature reviewed (i.e., it is a quantitative assessment of the studies).
- A case-series is simple a review of several case-reports about an observation and cannot be used to determine causality or cause and effect.
- A review article is sometimes confused with a systematic review but is a general
overview of a topic that does not have clearly defined inclusion and exclusion criteria that would allow it to be reproducible.
Which of following best describe a freely available database that attempts to make it easier for clinicians to locate original citations of scientifically sound research in a more efficient manner?
A. MEDLINE
B. EMBASE
C. PubMed Clinical Queries
D. UptoDate
C. PubMed Clinical Queries
- PubMed Clinical Queries is a section within MEDLINE that was set up to make it easier for clinicians to find scientifically sound literature and is free to the public.
- EMBASE is a searchable database with a focus more on pharmacology and drug
therapy in Europe. It is less encompassing than MEDLINE. - UpToDate is not free and does not always provide the clinician with the original scientific literature citations.
Which of the following resources are considered tertiary resources?
A. Clinical trial journal articles, review articles, Medline
B. Clinical Pharmacology, review articles, FDA website
C. Clin-eguide, clinical trial journal articles, Micromedex
D. Lexi-Drugs, textbooks, clinical trial journal articles
B. Clinical Pharmacology, review articles, FDA website
- Tertiary references include textbooks, compendia, general information (including data that can be found on internet, and review articles in journals).
- Secondary resources index or abstract the primary literature, while primary literature includes the actual clinical research studies/reports.
While on rounds, an attending physician asks whether diclofenac comes in a liquid formulation to treat migraine headache. What would be the most accurate resource to provide a response for this inquiry?
A. Trissel’s Handbook on Injectable Drugs
B. Pharmacotherapy: A Pathophysiologic Approach
C. Clinical Pharmacology
D. Review of Natural Products
C. Clinical Pharmacology
- Clinical Pharmacology (the third answer choice) is a tertiary reference containing drug monographs which describe pharmacology, pharmacokinetics, adverse reactions, drug reactions, dosage and administration issues, as well as drug availability.
- Trissel’s Handbook of Injectable Drugs is a handbook that provides data about parenteral products including stability and compatibility; diclofenac does not have a parenteral formulation.
- Pharmacotherapy: A Pathophysiologic Approach is a pharmacotherapy text that addresses pathophysiology of and pharmacotherapy for disease states. This text may provide data about dosage forms, but not for every drug available.
- Review of Natural Products is a resource that provides monographs about select alternative, natural products. Diclofenac is a prescription medication, not an alternative remedy.
Which of the following is true about Medline/Medline searching?
A. Medline is a premier bibliographic database provided by the National Institutes of Health
B. Medline uses the Medical Subject Headings indexing system to categorize articles
C. Medline is available through PubMed as well as other information distributors like Ovid and Scopus free of charge
D. Medline provides access to the full text of all articles identified through a Medline search
B. Medline uses the Medical Subject Headings indexing system to categorize articles
- Medline, which is provided by the National Library of Medicine, uses the MeSH indexing system to categorize articles.
- Only PubMed provides Medline access free of charge; other vendors charge a fee to provide more streamlined access to Medline.
- Medline provides free access to some, but not all, articles indexed in the Medline database. Most of the free articles are those where the NIH provided funding to the researcher.
Which of the following databases utilizes Medical Subject Headings (MeSH) terms to search for citations?
A. PubMed
B. Embase
C. Google scholar
D. International Pharmaceutical Abstracts
E. National Cancer Institute
A. PubMed
- Medical Subject Headings (MeSH) is the controlled vocabulary used for indexing PubMed citations.
High-Yield Core Concept:
* MESH is a thesaurus or a controlled library that is used to index, catalogue, and to aid in searching the National Library of Medicine (i.e., PubMed) database.
