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DRUG INFORMATION
RESOURCES
PHCL 312
Jamilah Alsaidan, MSC
DRUG INFORMATION RESOURCES
Learning Objectives:
 The student should differentiate between
primary, secondary, and tertiary sources of
information.
 Select resources relevant to different pharmacy
practice areas.
 Identify the most appropriate resource for a
specific drug information request.
 Describe the role of the internet and PDA
resources in the provision of drug information.
 Critique tertiary resources to determine
appropriateness of information.

DRUG INFORMATION RESOURCES
Learning Objectives cont.:
 Describe appropriate search strategy for use with
computerized secondary databases.
 Recognize alternative resources for provision of
drug information.

DRUG INFORMATION RESOURCES
Introduction:
 The quantity of medical information and
literature is growing at an outstanding rate.
 The technology with which this information can
be accessed is also improving.
 Its not about simply selecting the easiest, most
familiar resource to find information, its about
using the best resource to answer the query at
hand.
 Generally, the best method to find information
includes a stepwise approach moving first
through tertiary, then secondary, finally primary.

DRUG INFORMATION RESOURCES
Introduction cont.:
 Often, a search for information will not employ
all of these steps or require the use of all three
types of resources.
 The type of requestor may also substantially
influence the resources used to respond to a
question.
 Generally, a request from a consumer or patient
could be answered more appropriately from
available tertiary resources rather than a stack
of clinical trials.

DRUG INFORMATION RESOURCES
Tertiary
Secondary
Primary
DRUG INFORMATION RESOURCES
Tertiary Resources:
 Consist of:
 textbooks
 compendia (Balanced Summary of a larger body
of information)
 review articles in journals
 general information found for example online
 These references may often serve as an initial
place to identify information due to the fact that
they provide a fairly complete and concise
overview of information available

DRUG INFORMATION RESOURCES
Tertiary Resources
Advantages:
Provide a fairly
complete and concise
overview of
information available
on a specific topic.
 Excellent to use first
line
 Convenient
 Easy to use
 Familiar

Tertiary Resources
Disadvantages:






Lag time associated
with publication
Less current
information
Possible its out of date
even before its
published
Possible its incomplete
Errors in transcription
Human bias
DRUG INFORMATION RESOURCES
When selecting a tertiary reference for use:
 Differences in practice setting, available funding,
patients seen, and types of information most
commonly needed all have an impact on which
tertiary resources are available at a specific
practice site.
 Selection according to the type of information
needed for a specific request or situation.
 Consider the categories of requests received in a
practice setting to ensure that the appropriate
texts are available.
 References for PDAS or on CD are available

DRUG INFORMATION RESOURCES
Evaluation of Tertiary Literature:
 Does the author have appropriate
experience/expertise to publish in this area?
 Is the information likely to be timely based on
publication date?
 Is the information supported by appropriate
citations?
 Does the resource contain relevant information?
 Does the resource appear to be free from bias or
blatant errors?

DRUG INFORMATION RESOURCES
USEFUL RESOURCES FOR COMMON
CATEGORIES OF DRUG INFORMATION
Type of Request



General Product
information
Adverse Effects
Availability of Dosage
Forms
Useful Tertiary Source

Handbook of Clinical Drug
Data, Handbook of
Nonprescription drugs
AHFS DI/ USP DI/
Drugdex
 Lexi-comp Reference
Handbook, Drug
Information
Handbook

DRUG INFORMATION RESOURCES
Type of Request
Useful Tertiary Source

Dosage recommendations


Drug-Drug interactions


Drug- food interactions

Drug Identification
Toxicology information
IV or IM incompatibilities






Drugdex/ USP DI/ AHFS DI
USP DI Vol. I, AHFS DI,
Drugdex
USP DI Vol. II
Identidex
Poisondex
Handbook of Injectable Drugs
DRUG INFORMATION RESOURCES
Type of Request
Pediatric dosage
recommendation
 Drug use in Pregnant
or lactating female
 Drug Laboratory
Interference


Pharmacokinetics
Useful Tertiary Source
The Harriet Lane
Handbook
 Drugs in Pregnancy or
Lactation
 Basic skills in
interpreting
Laboratory data
 Clinical
Pharmacokinetics

DRUG INFORMATION RESOURCES
Tertiary
Secondary
Primary
DRUG INFORMATION RESOURCES
Secondary Resources:
 Are used to locate primary literature and
generally include indexing and/or abstracting
services
 Indexing: providing bibliographic citation
information (e.g. title, author, and citation of the
article)
 Abstracting: provides a brief description
(abstract) of the resource cited.

DRUG INFORMATION RESOURCES
Secondary
Resources
Indexing services
bibliographic citation information
(e.g., title, author, and citation of the
article)
Abstracting Services
a brief description (or abstract) of
the information provided by the
article or resource cited
DRUG INFORMATION RESOURCES



The main purpose is to provide summaries of
primary literature articles in addition to the
citation for that article
They are essential tools for locating and using
the primary literature
Various systems will index or abstract literature
from different journals, meetings, or publications,
therefore, in order to perform a comprehensive
search different databases must be used.
DRUG INFORMATION RESOURCES
Availability
 Hard Copy
 Print (Paper)
 Electronic Format
 CD-ROM
 Online

The vast majority of secondary resources are
utilized primarily in electronic format, although
some may have a print form.
DRUG INFORMATION RESOURCES
Advantages of Printed
Secondary Resource
Less costly than
electronic
 Used to browse for
new information

Disadvantages of
Secondary Resources
Might require more
time than an
electronic listing due
to need to look at
multiple editions and
indexes.
 Can be searched by
only one user at a
time.

DRUG INFORMATION RESOURCES
Advantages of electronic
databases
Faster retrieval
 The more frequent
updating of listings
and information is
very important

Disadvantages of
electronic databases
Require knowledge of
search strategy
suitable for particular
database
 Different database
systems use different
indexing terms
 Costly except for
PubMed

DRUG INFORMATION RESOURCES
In general secondary resources must be updated
frequently on regular basis
 Users must be familiar with their structure,
format, and frequency
 Proficiency in searching skills must also be
developed through practice and experience

DRUG INFORMATION RESOURCES
Efficient Search Strategies:
 Systems do not index all terms in the same
manner therefore it is necessary to determine
what terms a database is using to conduct a
successful search.
 E.g. databases in the NLM index terms by their
Medical Subject Heading (MeSH term), while the
IOWA Drug Information Service (IDIS) uses the
United States Adopted name and International
Classification of Diseases.

DRUG INFORMATION RESOURCES
"Is clonidine effective in the treatment
of attention deficit hyperactivity
disorder (ADHD) in adolescents?"
BOOLEAN OPERATORS

AND

OR

NOT
DRUG INFORMATION RESOURCES
The Boolean Operator AND often used to
combine two terms; it limits retrievals, returning
only citations that contain both these concepts or
terms.
 The Boolean Operator OR often used to broaden
a search; it returns citations where either term is
used.
 Using the Boolean operator NOT will always
decrease the number of retrievals. It eliminates
any references having the term that follows the
NOT operator. Should be used with caution.

AND
 will
combine two terms, returning
only citations containing both of
those concepts or terms.
For example The use of clonidine for
ADHD
 the appropriate search terms
(clonidine AND attention deficit
hyperactivity disorder)
DRUG INFORMATION RESOURCES
Search Term
Number of results
Clonidine
16001
ADHD
19763
Clonidine AND ADHD
224
DRUG INFORMATION RESOURCES
 OR:
 will
have an equal or greater number
of returns since it will include any
citation where either term is used.
 searching for a term with synonyms
)attention deficit disorder OR
ADHD (
 A search using OR will return a
number of results equal to or greater
than a search using the term AND
DRUG INFORMATION RESOURCES
Matching Results
The use of
either
clonidine or
guanfacine for
ADHD
ADHD
guanfacine
Clonidine
DRUG INFORMATION RESOURCES
OR:
Search Term
Number of results
Clonidine
16001
ADHD
19763
Guanfacine
717
Clonidine OR
Guanfacine
16406
ADHD AND Clonidine OR
Guanfacine
897
DRUG INFORMATION RESOURCES
NOT:
 will always decrease the number of responses,
since it eliminates any references having the
term that follows that operator.


therefore it should be used with caution, since it
may eliminate articles that may be appropriate,
simply because the term being eliminated
happens to appear somewhere in the article.
DRUG INFORMATION RESOURCES
 NOT:
 The
operator NOT would be helpful if a
user wants to exclude certain topics, for
example, a specific disease state.
 In
this case, a search might be performed
for ADHD NOT Tourette's disorder .
 Since
the use of the term NOT will exclude
any article mentioning Tourette's disease,
an article focused on treatment of ADHD
with a small section about Tourette's
disease would also be excluded.
DRUG INFORMATION RESOURCES
NOT
Search Term
Number of results
16001
Clonidine
19763
ADHD
224
Clonidine AND ADHD
Clonidine AND ADHD NOT
Tourette’s disease
180
DRUG INFORMATION RESOURCES
Efficient Search Strategies cont.
 Some databases will also use the terms WITH or
NEAR.
 These operators are similar to AND, however,
they require the terms to be within a certain
number of words of each other.
 These terms may be useful when other searches
are identifying a large number of articles where
both terms are mentioned, but not in conjunction
with each other.

DRUG INFORMATION RESOURCES
Efficient Search Strategies cont.
 The same search phrase could be indexed under a
variety of search terms, and in order to provide a
comprehensive search it is important to address
all of those.
 For example, ginkgo
"ginkgo", "ginkgo biloba", the Latin name
"Ginkgoaceae", as well as the misspelled word
"gingko".
 This same principle holds true when considering
disease states whose names may have changed
over time.
DRUG INFORMATION RESOURCES
Limits:
Some databases allow searches to be limited by a
variety of factors, including:
 Language of publication
 Year of Publication
 Type of article (e.g. case review)
 Type of journal
 This is most helpful when the initial search terms
return a large number of possible matches.
 Using too many limits with the initial search may
eliminate articles or citations that might be
helpful.
DRUG INFORMATION RESOURCES
SEARCH STRATEGY STEPS
Identify the
key words
Understand
the indexing
terminology
MeSh,
thesaurus
Use Limits
Use Boolean
Operators
DRUG INFORMATION RESOURCES
Questions to ask before choosing a
database:
 Does it allow you to have a Boolean Operators to
connect terms when searching?
 Does it assist you in locating Mesh terms to use
in searching?
 Does it allow you to apply specific limits?
 Does it provide links to full texts?
 Does it allow manipulation of the search results?

DRUG INFORMATION RESOURCES
Questions to ask before choosing a
database:
 Does it contain a journal index that can be
browsed to determine the exact way in which a
journal can be abbreviated
 Does it provide detailed online help?
 Does it cost anything to access?
 Does it allow for an easy way to identify
additional articles related to a particular
citation?

DRUG INFORMATION RESOURCES
Examples of Secondary Resources:
 IOWA drug information services (IDIS)
 PubMed
 International Pharmaceutical Abstracts (IPA)
 OVID

DRUG INFORMATION RESOURCES
Medline®:
 National Library of Medicine
 http://www.nlm.nih.gov.
 Coverage includes basic and clinical sciences as
well as nursing, dentistry, veterinary medicine,
and many other health care disciplines.
 Information comes from more than 3900 journals
in 40 different languages.
 This database is available through a variety of
services including PubMed

DRUG INFORMATION RESOURCES
Pubmed:
 PubMed comprises approximately 20 million
citations for biomedical literature from
MEDLINE, life science journals, and online
books.
 PubMed is a FREE resource that is developed
and maintained by the National Center for
Biotechnology Information (NCBI), at the U.S.
National Library of Medicine (NLM), located at
the National Institutes of Health (NIH).
 Publishers of journals can submit their citations
to NCBI and then provide access to the full-text
of articles.

DRUG INFORMATION RESOURCES
IOWA DRUG INFORMATION SERVICE
 Division of Drug Information Service, University
of Iowa, http://itsnt14.its.uiowa.edu/.
 This is an indexing service that allows retrieval
of complete articles from a variety of biomedical
publications.
 Articles from 1966 to present
 The data base is updated monthly With about
1700 articles added /month
 Useful
 Self-contained

DRUG INFORMATION RESOURCES
The articles focus on drug therapy in humans.
 CD-ROM format and web version.
 It is unique in that it provides full articles, in
either PDF form or, for older articles, microfiche.
 Term index by the United States Adopted Name
and the International Classification of Diseases

Descriptors >150
Either the name or
1-3 digit
DRUG INFORMATION RESOURCES
International Pharmaceutical Abstracts
IPA
 American Society of Health-System Pharmacists,
http://www.ashp.org.
 Coverage includes drug-related information,
including drug use and development.
 This database also abstracts a variety of meeting
presentations.
 The main focus of this database is pharmacy
information, including pharmacy administration
and clinical services, making it the most
comprehensive database for pharmacyspecific information.

DRUG INFORMATION RESOURCES
International Pharmaceutical Abstracts
IPA cont.:
 It abstracts more than 750 journal
 Since 1988,abstracts from all ASHP’s meeting
have been included
 Updated monthly online
 Biweekly in print

DRUG INFORMATION RESOURCES












Adverse Drug Reactions

Biopharmaceutics

Drug Analysis

Drug Evaluations

Drug Interactions
Drug Metabolism and Body 
Distribution

Drug Stability

History

Information Processing and 
Literature
Institutional Pharmacy

Practice
Investigational Drugs
Legislation, Laws, and
Regulations
Methodology and Drug
Testing
Pharmaceutical Chemistry
Pharmaceutical Technology
Pharmaceutics
Pharmacoeconomics
Pharmacognosy
Pharmacy Practice
Pharmacology
Sociology, Economics, and
Ethics
Toxicity
IPA
DRUG INFORMATION RESOURCES
Drawbacks of IPA:
 Requires significant practice and experience
 Lag time(months to 1 yr) between when the
article is published and when it is available on
IPA
 Time consuming to identifying all the
appropriate descriptors to use
 Non full text journal ,difficult to locate some
journals

DRUG INFORMATION RESOURCES
OVID DATABASES:
 Ovid offers more than 90 databases collectively
known as Databases@Ovid, many of which are in
the areas of the health and life sciences.

DRUG INFORMATION RESOURCES
OTHER PRODUCTS AND SERVICES:
 Online Books



Online Journals


Journals@Ovid
Decision Support



Books@Ovid
MedWeaver
Cilneguide
Education

MedCases
Evidence-Based Medicine
 Personal Digital Assistants


Ovid@Hand
DRUG INFORMATION RESOURCES
PUBMED VS. OVID
PubMed Advantages






Fast
Free
Growing number of
links from PubMed
citations to online
resources (e.g.,
electronic journals)
Multiple search modes
Multiple document
delivery options.
Ability to store searches
Ovid Advantages




Well-designed search
Multiple-database
searching (with
duplicate deletion)
Excellent phrase and
adjacency search options
Ability to rerun saved
searches automatically
and to receive results
via e-mail
DRUG INFORMATION RESOURCES
DISADVANTAGES OF OVID:
 Web connection sometimes slow but is improving.




Not free; subscription is required.
Only a small percentage of Joumals@Ovid
articles in PDF (changing).
Lacks some of the fancy search features offered
by PubMed (e.g., Clinical Query).
GETTING STARTED
BASIC SEARCH
D
A
B
C
ADVANCED SEARCH SCREEN
A
E
B
C
D
FIND CITATION
DRUG INFORMATION RESOURCES
Basic Tools:
 Boolean Operators And combining searches.
 Truncation and Wild cards.
 Nesting with parentheses.
 Adjacency searching
 Phrase search.

DRUG INFORMATION RESOURCES
PRIMARY LITERATURE:
Tertiary
Secondary
Primary
DRUG INFORMATION RESOURCES
PRIMARY LITERATURE
Primary Literature consists of clinical research
studies and reports, both published and
unpublished.
 NOT ALL literature published in a journal is
classified as primary literature, for example
review articles or editorials are not primary
literature.
 Controlled trials
Are Considered
 Cohort studies
Primary
 Case Series
Literature
 Case Reports

DRUG INFORMATION RESOURCES
PRIMARY LITERATURE
Advantages of the use of
primary literature
Access to detailed
information
 The ability to
personally assess the
utility and validity of
study results
 When groundbreaking
medical information is
first available its
usually in the form of
primary literature.

Disadvantages of the use
of primary literature
alone
Misleading
conclusions based on
only one trial
 The need to have good
literature evaluation
skills
 Time needed to
evaluate the number
of literature available
for a certain topic

DRUG INFORMATION RESOURCES
PRIMARY LITERATURE
The number of journals available is growing
 Each practice setting will require slightly
different primary literature based on the specific
areas that are of greatest importance to that
facility

DRUG INFORMATION RESOURCES
PRIMARY LITERATURE
Obtaining the Primary Literature:
 Once the literature has been identified using a
secondary searching system, the actual article
can be obtained in several ways:
 Library
 Drug Information Center
 Online through publisher websites
 Through NLM
 Articles identified through Pubmed can be easily
ordered from that database through a system
called Loansome Doc.

DRUG INFORMATION RESOURCES
INTERNET RESOURCES:
Sometimes as a starting point a general internet
search can be made
 Especially helpful about:
 unusual diseases
 about marketed over the counter products
 combination dietary supplements.

DRUG INFORMATION RESOURCES
INTERNET RESOURCES:
Different search engines use different techniques
to identify web pages
 No search engine will identify all websites
 Some engines geared toward scholarly content
e.g.
<<scholar.google.com
 Geared toward scientific research e.g. Scirus
<<www.scirus.com

DRUG INFORMATION RESOURCES
INTERNET RESOURCES:
Generally sites maintained by educational
institutions, not for profit information, or a
division of the U.S government are likely to
contain high quality information
 Whereas information maintained by a company
selling or promoting a specific product may be
more questionable.

DRUG INFORMATION RESOURCES
ALTERNATIVE INFORMATION SOURCES
Occasionally, sufficient information can not be
obtained from standard resources requiring the
use of some alternative sources of information.
 E.g. If a question involves a recent news story
about the withdrawal of a medication from the
market, a logical first place to find information
would be to identify the original news story.
 This can be done by searching various newswire
services.

DRUG INFORMATION RESOURCES
ALTERNATIVE INFORMATION SOURCES
Another example of when an alternative
information source might be needed is when
there is so little information published about the
topic.
 It would wise to contact persons:
 performing research in that particular novel
area,
 practioners currently using that therapy
 Experts via medical organizations
 Authors of reputable papers
 Actual manufacturing company of a particular
product

ACKNOWLEDGEMENTS TO LOBNA
ALJUFFALI, MSC