Drug Information Science
Week #1
Systematic Approach to Drug
Types of Resources
Functions of a Drug Information
Specialist, ie. Pharmacist
Pharmacists must know how to:
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
• 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 Sources Utilized by
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
• Obtain telephone #, address, fax, etc for
follow-up later.
• Determine approximate age (elderly,
adolescent, etc.) (usually no need to directly
2. Background Information
• Think, “Why is requestor asking for this
• 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
• 1.
• 2.
• 3.
Resources Available: Primary
Literature Resources
• Research studies published in biomedical
• Provide details of research methodology
and scientific results that lead to therapeutic
• 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
• 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)?
Letters to the Editor, Correspondence
Review articles (considered tertiary
• 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
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
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,
• Review articles in primary journals, Meta Analysis
articles in primary journals
• Drug Compendia (Facts and Comparisons, AHFS,
• 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
Alternate Sources for Drug
• Internet Sites
• Electronic Bulletin Boards (EBB’s): FIX,
FDA, Helix, Pharmnet, Pharmline
• Local and National Professional
• Pharmaceutical Manufacturers
• Drug Information Centers, Poison Control
5. Data Evaluation, Analysis,
• 1.
• 2.
• 3.
6. Formulate and Provide
7. Follow Up and Follow
• Verify the appropriateness, correctness, and
completeness of a response.
• Essential when judgement calls used.
• Essential when new data found or
circumstances changed from original
• 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
• 1.
• 2.
• 3.
Important Rules for Drug
• Be _______________ with information
• Be _______________ with information
• Be _______________ with information