Drug Information Science

Week #1
Systematic Approach to Drug
Information
Types of Resources
 Functions of a Drug Information
Specialist, ie. Pharmacist
• Pharmacists must know how to:
• 1_____________________
• 2_____________________
• 3_____________________
 Functions of a Pharmacist as an
Information Source
• Provide drug information by:
– answering information requests
– writing patient specific consultations
– communicating information that wasn’t
requested, but is necessary
– developing criteria/guidelines for drug use
 Functions...
• Provide drug evaluations
• Develop policies for dept., P&T comm..
Bulletins, newsletters, journal columns,
education for practitioners.
• Be involved with:
– ADR reporting, DUE’s, publishing, developing
protocols, IRB, Poison Control Center
information.
 Information Sources Utilized by
Pharmacists
• ________________________________
• ________________________________
• ________________________________
• ________________________________
 Systematic Approach to Answer
Drug Questions
• 1. Secure demographics of requestor.
• 2. Obtain background information.
• 3. Determine and categorize ultimate question.
• 4. Develop strategy and conduct search.
• 5. Perform evaluation, analysis, and synthesis.
• 6. Formulate and provide response
• 7. Conduct follow-up and documentation
 1. Request Demographics
• Obtain requestor’s knowledge base and
position, training and knowledge of
medicine.
• Obtain telephone #, address, fax, etc for
follow-up later.
• Determine approximate age (elderly,
adolescent, etc.) (usually no need to directly
ask)
 2. Background Information
• Think, “Why is requestor asking for this
information?”
• Weigh time involved to get background info.
• Use tact, politeness and assertiveness
• Background questions should be specific for the
nature of the request.
• Ask, “What sources have already been used?”
• Useful info: age, gender, weight, allergies, other
disease states, other meds, lab values, etc
 3. Determine and Categorize
Ultimate Question
• Find ________________________
• How _________________________
• Use __________________________
• Determine _______________________
___________________________________
 Categories of Questions
• Strength, manuf, availability of product, approval
• Tablet identification, general product information
• Laws/policies/procedures, Cost, Foreign products
• Compatibility, stability, administration rate\
• Drug interactions (drug, lab, disease,food)
• Pharmaceutics (compounding, formulations)
• Pharmacokinetics (ADME/levels)
• Nutrition support
 Categories of Questions...
• Therapy evaluation-- picking drug of choice
• Dosage, regimen, recommendations
• Adverse effects
• Poisoning, toxicology
• Pregnancy, Teratogenicity
• Lactation/ infant risks
4. Develop Strategy and Conduct
Research
• 1.

• 2.

• 3.
 Resources Available: Primary
Literature Resources
• Research studies published in biomedical
journals.
• Provide details of research methodology
and scientific results that lead to therapeutic
conclusions.
• Advantages: Most current resource for
information. Least biased, so most accurate
 Primary Literature Examples:
• New England Journal of Medicine
• Archives of Internal Medicine
• JAMA (Journal of the American Medical
Association)
• CHEST (from the American College of
Chest Physicians)
• Clinical Pharmacy and Therapeutics
• Annals of Pharmacotherapy
• British Medical Journal
 What do we find in Primary
Resources (journals)?
• Advertisements
• Abstracts
• Letters to the Editor, Correspondence
• Review articles (considered tertiary
resource)
• Meta analysis (considered tertiary resource)
 What do we find in Primary
Resources (journals)?
• Primary journal articles: clinical drug trials
– *** These articles are the primary resources we
are talking about ****
• Clinical trial types:
– Intervention types (highly rated)
• Randomized controlled trial
– Parallel
– Crossover
– Before and After (time series)
Primary journal article resources
• Observational (weaker than interventional
studies)
– Cohort (strongest in class)
– Case control
– Cross sectional
– Case series, Case report, descriptive
 Secondary Literature Resources
• Indexing and Abstracting Services
• Indexing service: provides only bibliographic
information that is indexed by topic.
• Abstracting service: also provides a brief
description or “abstract” of information contained
in a specific citation.
• Both provide access to primary literature
• Each can cover different journals, texts, publicat.
• Cost will vary from $150 to $60,000 / year
 Secondary Literature Resources:
• Medline- largest 380,000 ref, 4000 journals
• BIOSIS
• Embase
• Index Medicus
• IDIS (Iowa Drug Information System)
• PUBMED (access to Medline)
 Tertiary Literature Resources
• Textbooks (Goodman and Gilman, Handbook of
Non-Prescription Drugs, etc)
• Drug Encyclopedias (Martindales, Merck Index,
etc)
• Review articles in primary journals, Meta Analysis
articles in primary journals
• Drug Compendia (Facts and Comparisons, AHFS,
PDR
• Full Text Computer Database(Micromedex)
 Tertiary Literature Resources
• Advantages:
– provide rapid access to information
– detailed sufficiently for quick reference
– good general information condensed into easy to
read format
• Disadvantages:
– Outdated quickly, may not reflect current standards
of practice, incomplete, human bias, incorrect
interpretation of research or lack of expertise by
author
 Alternate Sources for Drug
Information
• Internet Sites
• Electronic Bulletin Boards (EBB’s): FIX,
FDA, Helix, Pharmnet, Pharmline
• Local and National Professional
Organizations
• Pharmaceutical Manufacturers
• Drug Information Centers, Poison Control
Centers
 5. Data Evaluation, Analysis,
Synthesis
• 1.

• 2.

• 3.
6. Formulate and Provide
Response
 7. Follow Up and Follow
Through
• Verify the appropriateness, correctness, and
completeness of a response.
• Essential when judgement calls used.
• Essential when new data found or
circumstances changed from original
request.
• Document everything!
Ethical and Moral Responsibility
• How will they use your information?
• Are they asking for lethal dose of drug?
• Are they suicidal or homicidal?
• Are they seeking information for making
illicit drugs?
• Are they trying to forge a prescription?
• Are they in serious need of an ER?
 Ethical and Moral
Responsibility….
• 1.

• 2.

• 3.
 Important Rules for Drug
Information
• Be _______________ with information
• Be _______________ with information
• Be _______________ with information