Systematic Approach to Answering Drug Information Questions and Formulating an Effective Response (Week 1)

Question 1

Steps

Answer 1

1. Identify the requestor and establish a timeframe
2. Obtain background information and define informational need
3. Categorize the ultimate question
4. Develop and conduct an efficient search strategy
5. Evaluate, analyze, and synthesize relevant literature into a response
6. Communicate response
7. Conduct follow-up

Question 2

Step 1: Identify requestor and establish a timeframe

Answer 2

• Requestor: Healthcare professional vs Consumer (information should be appropriate for requestors level of understanding)
• Timeframe for response: Urgency of request, determine how to deliver response

Question 3

Step 2: Obtain background information and define informational need

Answer 3

• Establish context (General Information vs. Patient-Specific)
• Determine why the question is being asked (gather as much info as possible, sufficient background is defined by the situation)
• Clear understanding of the situation
• The “real”/ultimate question being asked may be buried in the original question

Question 4

What questions should be considered when gathering context to a patient specific question?

Answer 4

• Patient demographics (age, gender, weight, height, race/ethnicity)
• Health problems or conditions: primary diagnosis
• End-organ function (liver and kidney)
• Allergy history
• Prescription and OTC medications

Question 5

Questions to ask depending on the request: (Drug Information/Identification of Product)

Answer 5

 Where the patient is from?
 Has there been an ingestion?
 Who wants this information and why do they want the information?
 Where did they get the product?
 What does the patient believe they are taking it for?
 What is the dosage form, color markings, size, etc?

Question 6

Questions to ask depending on the request: (Pharmacokinetics/Dosing)

Answer 6

 Patient compliance
 Patient’s age and gender
 Patient’s weight (fluid overload vs obesity)
 Patient’s end-organ function
 Concomitant medications/disease states
 Nutritional status – What are the patient’s dietary (and alcohol) habits?
 Patient’s condition
 Previous drug concentrations and timing of the concentrations
 Route of administration, dose of the drug, and administration schedule

Question 7

Questions to ask depending on the request: (Adverse Drug Reaction)

Answer 7

 Route of administration, dose of drug, diluent, duration of therapy, and administration schedule
 A list of all other medications which the patient has taken during the previous 2 weeks
 Onset, duration, severity of reaction
 Changes in soaps, lotions, perfumes
 Changes in diet
 Concomitant diseases and other health conditions
 Known allergies and their manifestations

Question 8

Questions to ask depending on the request: (Stability or Compatibility)

Answer 8

	Number of peripheral lines, central lines, etc.
	Y-sites, IV piggyback, in-line filters
	Diluents of each medication 
	Type of tubing
	Suspected contact time of the agents

Question 9

Questions to ask depending on the request: (Drug-Drug Interactions)

Answer 9

 Description of the interaction – What event(s) suggest that an interaction occurred?
 All current medications including dose, route, duration, and sequence of administration
 Has the patient received this combination or similar combination in the past?
 Any over the counter (OTC) medications?
 What is the temporal relationship between the drugs in question?
 Patient’s condition and other health problems

Question 10

Step 3: Categorize the ultimate question

Answer 10

• Serves to refine and understand the request
• Also serves to define the scope of the search needed
• Example classifications below (this is NOT a comprehensive list

Question 11

Adverse Drug Reaction

Answer 11

unwanted effect of a drug

Question 12

Availability/Cost

Answer 12

Cost of drug and how available the drug is

Question 13

Compounding / Stability / Formulation

Answer 13

putting 2 or more drugs together / activity of a drug in a given environment / how a drug is supplied (ex. tablet, suspension, etc.)

Question 14

Dosing / Administration

Answer 14

amount of medication/ how given

Question 15

Drug Interactions

Answer 15

effect of giving two or more drugs together

Question 16

Formulary

Answer 16

list of drugs readily avalible within an institution

Question 17

Herbal/Natural Products

Answer 17

non-prescription drugs made from plant or natural products

Question 18

Identification

Answer 18

ID of drug

Question 19

IV Compatibility and Stability

Answer 19

two intravenous drugs combined in one apparatus (ex. bag, syringe, tubing, etc.) and if they are still active in that environment

Question 20

Patient Education

Answer 20

information about drugs and/or disease states using non-medical terminology

Question 21

Pediatrics

Answer 21

patients from birth to 18 years old

Question 22

Pharmacoeconomics

Answer 22

Describes the costs of drug therapy to healthcare systems and society

Question 23

Pharmacokinetics

Answer 23

Absorption, distribution, metabolism and excretion of drugs

Question 24

Pharmacology

Answer 24

how substances/drugs interact with the body

Question 25

Pregnancy/Lactation

Answer 25

time when a woman is pregnant (is there risk to the mother and/or fetus)/ dealing with breast feeling

Question 26

Reference Search

Answer 26

looking for a particular reference article and/or performing a background reference search

Question 27

Therapeutic Consult

Answer 27

Reviewing literature to provide a well-balanced recommendation to a question

Question 28

Toxicology

Answer 28

harmful effects of chemicals/substances/drugs on people