Drug Information Lecture
Introduction to Basic References (2)
Shawn Hsiang-Yin Chen, Pharm.D.
台北醫學大學藥學系教授 陳香吟
Shawn@tmu.edu.tw
Outline for basic reference lecture (2)
Know which tertiary references to look into when you answer a question
about:
a. Pediatric dosing.
b. Drug therapy in pregnancy and lactation
c. Infectious diseases or antibiotics
d. Laboratory data and drug interaction
e. IV compatibility and stability
Using electronic resources to allocate the general tertiary references
Pediatrics resources (1)
Harriet Lane Handbook- a manual for pediatric house officers
1.
2.
3.
4.
1.
Publisher: Mosby
Yearly updated
Provide the knowledge for pediatric care
Part I - Acute care
Part II – Disease & therapeutic information
Part III – Formulary
Well-referenced
Pediatrics resources (2)
Pediatric dosage handbook
1.
2.
3.
4.
5.
Publisher: Mosby
Irregularly updated
Specific source of pediatric drug information
Well-referenced
Good to have to confirm the information from Harriet Lane
Pediatrics resources (3)
Pediatric dosage handbook
1.
2.
3.
4.
5.
Publisher: Apha (American Pharmaceutical Association)
Commonly used by pharmacists
Alphabetically list of monographs
Not referenced
With some errors, have to double check with other references
Pregnancy, Lactation, teratogenicity resources (1)
Drugs in pregnancy and lactation
1.
2.
3.
4.
5.
6.
Published by Williams & Wilkins
Provide drug monograph with fetal risk and breast feeding summary
Neutral risk category
Collaborative perinatal project
Human data
Updated every 4 years; with every 3 month update
Pregnancy, Lactation, teratogenicity resources (2)
Pregnancy
Definitions
category
Adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester of pregnancy and
A
there is no evidence of risk in later trimesters
Animal studies have not demonstrated a risk to the fetus but there are no adequate studies in pregnant women or
B
Animal studies have shown an adverse effect, but adequate studies in pregnant women have not demonstrated a risk to the
fetus during the first trimester of pregnancy and there is no evidence of risk in later trimesters
C
Animal studies have shown an adverse effect on the fetus but there are no adequate studies in humans; the benefits from
the use of the drug in pregnant women may be acceptable despite its potential risks or
There are no animal reproduction studies and no adequate studies in humans
D
There is evidence of human fetal risk, but the potential benefits from the use of the drug in pregnant women may be
acceptable despite its potential risks
Studies in animal or humans demonstrate fetal abnormalities or adverse reaction reports indicate evidence of fetal risk.
The risk of use in a pregnant woman clearly outweights any possible benefit
X
Pregnancy, Lactation, teratogenicity resources (3)
Catalog of teratogenic agents (Author: Shepard)
Author: Shepard
2. Provide a short description of teratogenicity for a medication or chemical agent
3. Human and animal data
4. Updated every 3-4 years
1.
Infectious disease resources (1)
Principles and practice of infectious diseases
Author: Mandell
2. Covered all topics of infection deeply, including clinical syndrome, specific organism,
diagnosis, management and host characteristic
3. Textbook format with keyword index and extensive references
4. Updated every 3-4 years
1.
Infectious disease resources (2)
熱病 (Sanford’s guide to antimicrobial therapy)
Published by Antimicrobial Therapy Co.
2. Rapid reference for
1.
a.
b.
c.
d.
e.
f.
g.
Empirical initial therapy by diagnosis
Antimicrobial spectrum
Antibiotic side effect
Prophylactic therapy
Pediatric dosage
Dosage in renal failure
Antifungal agents, antituberculous agents, Antiparasitic agents, Antiviral agents
Updated every year
4. Most useful handbook for infectious disease
3.
Table of Content in Sanford’s guide
Useful tables in Sanford’s guide
Table 1: Clinical approach to initial choices of antimicrobial therapy
Table 2: Recommended antimicrobial agents against selected bacteria
Table 3: Suggested duration of antibiotics therapy in immunocompetent patients
Table 4
A: Anti-bacterial activity spectrum
B. Anti-fugal activity spectrum
C. Anti-viral activity spectrum
Table 5A: Treatment option for systemic infection due to multiple drug resistant
gram (+) bacteria
Table 5B: Treatment option for systemic infection due to multiple drug resistant
gram (-) bacteria
Useful tables in Sanford’s guide
Table 6: Suggested management of suspected or culture positive community
associated MRSR infection
Table 7: Antibiotics hypersensitivity reaction and drug desensitization method
Table 8: Pregnancy risk and safety in lactation
Table 9
9A: Selected pharmacologic features of antimicrobial agents
9B: PK of antimicrobial
9C: Enzyme and transporter medicated interaction of antimicrobial
Table 10: Antibiotic dosage and side effect
Table 11: Treatment of fugal infections
Table 14: Antiviral therapy
Table 1: Clinical approach to initial choices of
antimicrobial therapy (Empiric therapy)
Table 4 A: Recommended antimicrobial agents
against selected bacteria
Table 11 B: Treatment of Fugal Infections
Laboratory tests (1)
Basic skills in interpreting laboratory data
1. Publisher: ASHP
2. Provide fundamental knowledge of interpreting clinical lab tests for
pharmacy students
3. First reading to start
4. Chaptered by organ/disease
Laboratory tests (2)
Interpretation of diagnostic tests
1. Publisher: Little Brown
2. Not full text but real life questions
3. Not well referenced
Laboratory tests (3)
Clinical laboratory medicine
1. Publisher: Mosby
2. For more advanced knowledge, not for answering questions
3. Provide enough technical and chemical information about each
laboratory procedure
4. Provide useful tables with normal range and conversion
Laboratory tests (4)
Clinical guide to laboratory tests
1. Publisher: Saunders
2. Easy to read and locate information
3. Tablized information, not in details
4. Four sections:
a) General clinical test
b) Molecular pathology
c) Therapeutic drugs
d) Microbiology
Intravenous Administration (1)
King’s Guide to Parenteral Admixtures
Current literature
Office files
The lastest edition of the Handbook on Injectable Drugs
(Edited by Lawrence Trissel, published by American Society of Hospital
Pharmacists)
Trissel’s: Use of the Four Compatibility Tables
Y-site
compatibility
Two diluted
solutions
IV bag additive
compatibility
Syringe
compatibility
1 diluted solution +
2 concentrated sol’n
1 concentrated additive
Try more questions by yourself on these references!
shawn@tmu.edu.tw
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