Lecture 12: Provision Of Medicines Information

Question 0

What are reactive/passive ways of providing medicines info?

Answer 0

By answering questions in the
Community
Hospital
Residential care facility

Question 1

What are the two main types of providing medicines information?

Answer 1

Reactive/passive

And proactive/active

Question 2

What are the proactive/active ways of providing medicines info?

Answer 2

Bulletins
Information sheets
Training and education
Medsafe, PHARMAC, PHOs etc

Question 3

What are information sheets?.

Answer 3

New sheets that detail some safety concerns, usually providing info to providers

Question 4

What are the main types of questions regarding medicines info!

Answer 4

Administration and dosage of medicines

Adverse reactions

Formulation queries

Classification queries

Question 5

What are some examples of the type of questions that could be asked?

Answer 5

Selection of drugs for particular disease

Drug identification

Interactions

Pharmaceutical (storage and stability)

Drugs in pregnancy, lactation

Pharmacokinetics & pharmacology

IV compatibility

Availability and funding

Poisoning centres

Herbal and complementary therapies

Athlete enquiries

Question 6

What if you don’t know the answer?

Answer 6

Pharmacists are not expected to know the answer to everything

But you need to know what you can answer and how to find the answer

Don’t answer under pressure

Question 7

When is it not appropriate to answer?

Answer 7

When you are asked what you should prescribe - e.g. By junior doctor. You should give general guidance but can’t say which drug because we don’t know the patient

When there are ethical issues e.g. If woman presents medication found in boyfriend’s room and asks what they are. You should ask yourself whether it is actually your role to provide this information.

Question 8

What should you do in cases where you are not sure if you should answer?

Answer 8

Refer to expert,
experts are different for different things, its okay to refer
E.g. there are a team of doctors for infectious diseases
Other experts could be pharmacists, GPs etc. utilise your network!

check with colleague
If unsure of answer ask someone,
Utilise networks

Question 9

What information do YOU require in order to answer?

Answer 9

Enquirers details

Enquiry details

Question 10

What are enquirer details you may need to know?

Answer 10

Full name
Contact number
Designation (e.g. Dr. Nurse, patient- mr smith 145 Hartley street)
Urgency of reply

Question 11

What are enquiry details you may need to know?

Answer 11

Understand subject and significance of question
Don't interrupt
Gather patient specific info
   Concurrent medication
   Renal & liver function
   Ward (hospital)
   Pt name/identifier

Question 12

If doctor calls you and wants to know if drug C can cause seizures, what questions should you ask?

Answer 12

Specifics about the situation like

Is the patient currently taking drug c
Has a seizure occurred?
What is patients history of seizures? 
Why is drug c used/considered
What are patients other medications
What are patients other medical history

Question 13

what are some search strategies when finding out medicines info?

Answer 13

Planned systemic approach of searching defence sources to answer a specific question

Always use more than 1 reference source where possible due to:
Consensus
Contradictions

Question 14

Where do you look if it is a NZ specific enquiry?

Answer 14

Medicines licenses: state what a medication is licensed to be used for in NZ- this is not always the same in other cuhtries

Subsidy prices in NZ
Availability of strengths, dosage forms in NZ

Question 15

What does your search strategy depend on..

Answer 15

Your role, 
The query
The time frame
What resources are appropriate 
What resources you have access to - use the most up to date versions of resources wherever possible

Question 16

What are the 6 general tertiary reference sources?.

Answer 16

BNF- uk brand names, some medicines we don’t have, good general info, available via medicines complete database

Martindale- aka the complete drug reference. Worldwide. Contains drug dose, contraindications, precautions, interactions, pregnancy and breast feeding. Referenced

MIMS- NZ. Lists all registered medicines, brand names, licensed doses, P450interaction tables, some guidelines

Data sheets- from Medsafe website, written by drug company, specific data for brand/formulation. Not biased, regulated by govt.

NZF from 2012- independent resource, clinically validated medicines info and guidance, uses NZ universal list of medicines, incorporates info from BNF, adapted to NZ context. Continually updated

Pharmaceutical schedule-

Question 17

What are secondary sources?

Answer 17

Micromedex

Medline

Embase

IDIS

Plumbed

International pharmaceutical abstract

Question 18

What are primary reference sources?

Answer 18

Current literature
Journal articles
   Clinical trials
   Case studies
   Cohort studies

Question 19

Why are other info sources?

Answer 19

Pharmaceutical society

Poisons service

CARM

Internet

Drug companies

Specialise colleagues

Question 20

What are some advantages of using the pharmaceutical industry?

Answer 20

Accuses to full text references
In house data
Can provide better information for some enquiries than other things

Question 21

What are some disadvantages to using pharmaceutical industry as a source

Answer 21

Specific MI service not always available

Potential for biased/ skewed data