problems and situations in searching the literature
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Problems and Situations in Searching the Literature
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Objectives
To be aware of the practical approaches to specific situations and problems in providing drug information services
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Use of Textbooks
Drug identification Drug availability Pharmaceutical compatibility Poisoning Drug dosing Patient related questions
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Use of abstracts
Should be never used The reason for this is that abstracts may contain out
of context statements and may not always provide enough information to indicate the true content of the original article
abstracts can be used in one situation; when an article is published in foreign language and a translation is not readily available
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Use Of The Earlier Literature
A search in the past 10-12 years is sufficient to provide an adequate response to many questions
If a drug or a therapeutic procedure has not been mentioned in the last 10-15 years there is a possibility that it has been proved to be ineffective
E.g. the use penicillinase in the treatment of allergic reactions to penicillins
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Use Of The Most Current Literature
It is necessary for provision up to date drug information
The lag period for most secondary literature sources
Can vary from short as three months to as long a year more.
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Use Of The Most Current Literature
InPharma •weekly publication• presenting abstracts from 1700 journal•Abstracts covering All major areas of drugs•Bibliographies on various subjects or specific drugs from the recent literature are also published•Lag period 2wks-3months
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Use Of The Most Current Literature
MEDLINE and TOXLINEOnlineIndex Medicus data base (2500 journals)Index to Drug Literature International Nursing IndexLag period 1-3monthsTOXLINE Covers all reports on adverse effects fee
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Use Of The Most Current Literature
Current Contents-Clinical Practice
Lists the table of contents for over 725 medical and related journals on weekly basis
Lag period 3-6months
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When Data Cannot be Found in the Literature
“There have been no reports in the literature” Extrapolate with closely related drugs in same situations Unpublished data? (symposium) Error in searching
– Improper use of indexing and terms and synonyms– Misspelling of terms and names
e.g. foreign or investigational drugs and uncommon disease states
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The Complete Search
Complete Search: every possible information source has been covered
Depends on the type of question and the access to the drug literature
Poison cases do not need a complete search due to the response should be immediate
See Reference pg.148-149
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Utilizing Other Information Sources
Use of Specialists
1. To provide any recent drug therapy information in specific patient –related questions that may not be published in the literature
2. To verify documented literature findings Use of Agencies
FDA,CDC and Public Health Service
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Utilizing Other Information Sources
Use of Drug Manufacture– Ask about the availability of a drug
product– Use unpublished available clinical data– Drug recalls
Physcian Desk Reference (PDR)
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Investigational Drugs and non-FDA approved indications
The pharmacist should present complete information depending on the literature.
He should not hesitate in presenting unlabeled use and the final decision must be the physician’s
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Formulating A Response
Majority of questions are answered verbally
Only a small percentage of the questions are prepared in a written responses
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Written responses
Depend on documenting the fact and the personnel clinical expertise
The pharmacist should feel an equal responsibility to the patient as to the individual requesting
They are valuable in evaluating the effect of the service on patient care
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Written Responces
written responses are prepared for following reasons: to avoid duplication of work especially if the search took
a considerable time If the information was difficult to obtain or involved
personnel communications If the inquirer requests a written copy of the answer If the pharmacist has been asked to place the response
in the patients chart in the form of the consult
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Use of Tables and Graphs
When the response involves a large amount of data They enable one to organize data available for
presentation over the phone more adequately Allows the data to be presented in a logical format Enables the inquirer to receive a summary of the
subject in an easy to read fashion Graphs (pharmacokinetic data)
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Conflicting Reports in the Literature
Common Depends on pharmacists skills to evaluate the
studies in the literature and discriminate between a well designed studies and poorly designed studies
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Disease stat Background Knowledge
The pharmacist must have a fundamental knowledge
Of the disease state in question before attempting to provide a response
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Specific Problems
Problems with Synonyms, Indexing and Medical Terminology
The news media Teratogenicity