Bài giảng về "Thông tin thuốc"

1. 8/26/14
1
Agenda
• Icebreaker
• Drug
informa1on
references
– Categories
of
drug
informa1on
literature
• Advantages
vs.
Disadvantages
• Examples
– Some
commonly
used
resources
• Poten1al
topics
for
future
webinars
Icebreaker
• Presenters
– Võ
Thị
Hà,
MSPharm.
– Nguyễn
Như
Hồ,
MSPharm.
– Nguyễn
Đức
Như
Khuê,
PharmD/MPH
• ASendees
To
Wiki
or
Not
to
Wiki?
Categories
of
Drug
Informa6on
Literature
• Primary
literature
• Secondary
literature
• Ter1ary
literature
Primary
Literature
• Original
“research”
publica1ons.
• Source
of
informa1on
for
the
development
of
the
secondary
and
ter1ary
literature.
• Containing
a
detailed
descrip1on
of
study
design,
methodology,
and
results.
• Research
studies,
case
reports,
editorials,
disserta1ons,
leSers
to
the
editor,
and
randomized
control
trials
published
or
presented
for
the
first
1me.
• Top
1er
peer
reviewed
journals:
NEJM,
JAMA,
Archives
of
Internal
Medicine,
BMJ,
Pharmacotherapy,
Lancet,
etc…
Primary
Literature
(cont.)
• Advantages:
– Current,
original,
and
"cucng-­‐edge"
informa1on.
– Pa#ent-­‐oriented
&
evidence-­‐based
medicine
that
can
be
directly
u#lized
to
help
care
for
pa#ents.
– Peer
reviewed,
unbiased
sugges1ons,
and
open
to
cri1ques
and
rebuSals.
• Disadvantages:
– Inaccurate
conclusions
d/t
flaws
in
methodology
– Improper
interpreta1on
d/t
lack
of
knowledge
about
scien1fic
methods
and
sta1s1cs
– Time
for
new
informa1on
to
be
widely
accepted

2. 8/26/14
2
Primary
Literature
in
Prac6ce
• Learn
to
be
cau1ous
with
new
informa1on.
• Is
the
ar1cle
from
a
peer-­‐reviewed
journal?
• Understand
study
popula1on,
methods,
sta1s1cal
and
clinical
relevance
to
your
prac1ce
popula1on
before
extrapola1ng
to
your
pa1ent.
• Remember
case
reports
relate
only
to
one
pa1ent,
watch
for
bias,
and
avoid
relying
on
anecdotes.
Secondary
Literature
• Indexing
and
abstrac1ng
services.
• Examples:
– Medline
Database
covers
many
fields
of
medicine
including:
den1stry,
nursing,
veterinary,
pharmacy
and
hard
sciences.
• PubMed
Medline
• OVID
Medline
– Iowa
Drug
Informa6on
Service
indexes
English
(full
text)
ar1cles
relevant
to
drugs
and
treatment
of
disease
from
approximately
200
journals.
– Micromedex:
an
extensive
pharmacology
database
Secondary
Literature
(cont.)
• Advantages:
– Quick
access
to
the
primary
literature.
– Large
scope
of
and/or
concise
informa1on
on
specific
topics
– Generally
from
peer
reviewed
and
high
standard
journal
sources.
• Disadvantages:
– Lag
1me
– Availability
of
specific
journal
– Large
amount
of
informa1on
–
Search
techniques
– Cost
Ter6ary
Literature
• Textbooks
e.g.
Goodman
&
Gilman’s
Pharmacological
Basis
of
Therapeu1cs
• Compendia
(a
vast
array
of
informa1on
about
many
drugs)
e.g.
such
as
Facts
and
Comparisons
• Review
ar1cles
in
journals
that
thoroughly
summarize
a
par1cular
topic
can
also
be
considered
ter1ary
literature
(usually
more
up
to
date
than
text)
Ter6ary
Literature
(cont.)
• Advantages:
– Convenient
and
easy
to
use.
– Divided
into
specific
subjects,
e.g.
drug
interac1ons,
drugs
in
pregnancy.
– Informa1on
generally
well
accepted
• Disadvantages:
– Lag
1me
– Space
limita1on
– Less
thorough
review
– Possible
inappropriate
references
– Flawed
primary
literature
(poorly
done
studies)
Common
Online
Sources
(in
US)
• FDA
approved
drug
products:
www.accessdata.fda.gov/scripts/cder/drugsarda
• Dailymed
@
NLM
(database
of
product
package
inserts)
:
www.dailymed.nlm.nih.gov/dailymed
• Drug
informa1on
portal
@
NLM:
www.druginfo.nlm.nih.gov/drugportal
• Consumer
page
@
FDA:
www.fda.gov/forconsumers
• MedlinePlus
@
NIH:
www.nlm.nih.gov/medlineplus
• FDA
medica1on
guides:
www.fda.gov/drugs/drugsafety/
• MedWatch:
www.fda.gov/safety/medwatch
• Medica1on
safety:
www.ismp.org
• Drug
iden1fica1on:
pillbox.nlm.nih.gov

3. 8/26/14
3
Common
Online
Sources
(in
US)
• Diseases
&
Condi1ons
@
CDC:
www.cdc.gov/diseasescondi1ons
• Travel
medicine:
www.cdc.gov/travel
or
www.iamat.org
• Na1onal
guideline
clearinghouse:
www.guideline.gov
• Clinical
trials:
www.clinicaltrials.gov
• Na1onal
Cancer
Ins1tute:
www.cancer.gov
• Most
of
cancer
guidelines:
www.nccn.org
• DM
guideline:
ADA
2013
(less
commonly
used
AACE)
• HTN:
JNC
8
or
AHA
for
HTN
• An1thrombo1c
therapy:
CHEST
2012
• Dyslipidemia:
AHA/ACC
2013
Cholesterol
(aka
“ATP
4”)
• Be
proac1ve:
look
for
drug
problems.
No
other
healthcare
provider
has
the
unique
opportunity
to
improve
drug
therapy
that
pharmacists
have.
• Dig
deeper:
oxen
1mes
the
ques1on
that
is
originally
asked
is
not
the
ques1on
the
person
was
trying
to
ask.
• Be
skillful:
use
a
systema1c,
logical,
organized
approach.
• Keep
records:
document
your
search
methods
and
answer.
• There
may
be
more
than
one
correct
answer.
• An
acceptable
answer
may
be
“I
will
find
out”.
Drug
Informa1on
Pearls