Lecture 12: Provision Of Medicines Information Flashcards
What are reactive/passive ways of providing medicines info?
By answering questions in the
Community
Hospital
Residential care facility
What are the two main types of providing medicines information?
Reactive/passive
And proactive/active
What are the proactive/active ways of providing medicines info?
Bulletins
Information sheets
Training and education
Medsafe, PHARMAC, PHOs etc
What are information sheets?.
New sheets that detail some safety concerns, usually providing info to providers
What are the main types of questions regarding medicines info!
Administration and dosage of medicines
Adverse reactions
Formulation queries
Classification queries
What are some examples of the type of questions that could be asked?
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
What if you don’t know the answer?
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
When is it not appropriate to answer?
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.
What should you do in cases where you are not sure if you should answer?
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
What information do YOU require in order to answer?
Enquirers details
Enquiry details
What are enquirer details you may need to know?
Full name
Contact number
Designation (e.g. Dr. Nurse, patient- mr smith 145 Hartley street)
Urgency of reply
What are enquiry details you may need to know?
Understand subject and significance of question Don't interrupt Gather patient specific info Concurrent medication Renal & liver function Ward (hospital) Pt name/identifier
If doctor calls you and wants to know if drug C can cause seizures, what questions should you ask?
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
what are some search strategies when finding out medicines info?
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
Where do you look if it is a NZ specific enquiry?
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
What does your search strategy depend on..
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
What are the 6 general tertiary reference sources?.
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-
What are secondary sources?
Micromedex
Medline
Embase
IDIS
Plumbed
International pharmaceutical abstract
What are primary reference sources?
Current literature Journal articles Clinical trials Case studies Cohort studies
Why are other info sources?
Pharmaceutical society
Poisons service
CARM
Internet
Drug companies
Specialise colleagues
What are some advantages of using the pharmaceutical industry?
Accuses to full text references
In house data
Can provide better information for some enquiries than other things
What are some disadvantages to using pharmaceutical industry as a source
Specific MI service not always available
Potential for biased/ skewed data
