Transcript Drug resources - Florida State University College of Medicine

Drug Resources
Nancy Clark, MEd, Director Medical Informatics Education
Mark Strickland, MD, Informatics Curriculum Director, TLH
Regional Campus
FLORIDA STATE UNIVERSITY
The College of Medicine
Objectives
• Find the Drug Reference Library web page
• Locate basic prescription, OTC and herbal
drug information (dosage, indication, etc.)
online and on the PDA
• Calculate a drug dosage using an electronic
resource
• Identify if a drug is on a particular formulary
and locate alternatives
• Identify a pill from it’s imprint or description
• Perform a drug interaction check
• Use an infectious disease/antibiotics guide
• Use an immunization schedule tool
FLORIDA STATE UNIVERSITY
The College of Medicine
Handouts
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Evaluations
Drug References Handout
Worksheet
Instructions for email alerts
Top 200 Drugs Prescribed 2008 www.rxlist.com
FLORIDA STATE UNIVERSITY
The College of Medicine
Using the green Worksheet
as we go thru the workshop,
identify drug questions you can
use with students.
FLORIDA STATE UNIVERSITY
The College of Medicine
New Library Webpage
(Fall 2010)
FLORIDA STATE UNIVERSITY
Summer 2010
The College of Medicine
7
Library Web Site
FLORIDA STATE UNIVERSITY
The College of Medicine
Subscription Drug Resources
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Epocrates Online or Essentials (web and PDA)
Facts and Comparisons (web)
PEPID (web and PDA)
Access Medicine’s Drugs (Lexi Drug) (web)
Harrison’s Practice (Lexi Drug) (web and PDA)
MDConsult (Clinical Pharmacology) (web)
Natural Medicines Database (web and in Epocrates
PDA)
• Pediatric Care Online
• Journals, News and periodical databases
– Prescriber’s Letter
– Medical Letter (Handout
how
to get alerts)
FLORIDA on
STATE
UNIVERSITY
The College of Medicine
PDA Drug Resources
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Epocrates Essentials
PEPID
Harrison’s Practice
Pediatric Care Online
Dynamed
FLORIDA STATE UNIVERSITY
free to
TheAvailable
College of Medicine
all faculty
Student Issues
• Taught generic names
• Preceptors/clerkship faculty use brand
names
• Don’t learn dosing in Pharmacology
• Do not understand abbreviations (PO,
PRN, …)
• When do they learn how to write a
prescription? 1st Clerkship
FLORIDA STATE UNIVERSITY
The College of Medicine
Who Has What?
FLORIDA STATE UNIVERSITY
The College of Medicine
EPOCRATES
ESSENTIALS
FLORIDA STATE
P
P
P
P
P
P
P
P
P
U P
Rx Monographs
OTC Monographs
Alt Meds Monographs
Drug Interaction Tool
Drug Costs
Dosage Calculator
Formulary Tool
Pill Identifier
Antibiotics Guide
Immunizations
NIVERSITY
The College of Medicine
Epocrates Essentials iPhone/iPod
Get Back
Formulary
Add to Favorites
FLORIDA STATE UNIVERSITY
Theand
College
Medicine
Prescription, Alt Meds
OTCofare
combined in same list.
Epocrates Essentials Rx
• Search by drug or
class
– Rx
– Alt
– OTC
• Compare subcategories of each
type
FLORIDA STATE UNIVERSITY
The College of Medicine
Comparing Sub Categories
Rx
Alt Meds
Add to Favorites
FLORIDA STATE UNIVERSITY
The College of Medicine
OTC
Dosage Calculator in Epocrates iPhone
• Online Dosage Calculator
FLORIDA STATE UNIVERSITY
– http://www.medcalc.com/pedidose.html
The College of Medicine
Exercises for Practice
Using Epocrates PDA
• A little boy who is eight years old just ate a bottle of Children’s
Tylenol tablets his mother had in the medicine cabinet. She
thinks he ate forty or fifty of them. You search the Tables >
Toxicology > Antidotes 1 and find that acetylcysteine is
indicated for acetaminophen toxicity. Calculate the dosage of
acetylcysteine for the child. He weighs 50 lbs.
FLORIDA STATE UNIVERSITY
The College of Medicine
Epocrates PDA MultiCheck
4. Repeat until all drugs in list
5. Click View Interactions
FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• Epocrates PDA: lisinopril, metformin, and
hydrochlorothiazide
• Peds example: isoniazid, rifampin,
ethambutol, acetaminophen
FLORIDA STATE UNIVERSITY
The College of Medicine
Epocrates Formularies
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Go to Epocrates.com
Manage My Account
Pick Formularies
Sync/update to add
FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• Using Formulary Tools on Epocrates online or PDA
• I have a patient with H. Pylori who has BCBS of Florida 3
Tier who needs a low copay. Which of the treatments
are covered by BCBS low copay?
Look up drugs by class> gastrointestinal> H. Pylori.
• I have a depressed patient with no health insurance who
is indigent. Which SSRI can they get for $4 at Target?
FLORIDA STATE UNIVERSITY
The College of Medicine
Epocrates iPhone Pill Identifier
FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• What is this pill?
FLORIDA STATE UNIVERSITY
The College of Medicine
Epocrates PDA ID Tool
FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• Using Epocrates ID
• Which antibiotics should be used for a 17 year
old outpatient female with PID, etiology
unknown?
• The DNA probe comes back with Chlamydia in
the same patient. What antibiotic should I use?
Using the PDA, find the antibiotic.
• What other treatment recommendations for this
patient are found in ID? (choose the “Info” tab
across the top)
FLORIDA STATE UNIVERSITY
The College of Medicine
Tables
FLORIDA STATE UNIVERSITY
The College of Medicine
Rx, OTC and Alt Meds
EPOCRATES
ONLINE
FLORIDA STATE
P
P
P
P
P
P
P
P
P
U P
Rx Monographs
OTC Monographs
Alt Meds Monographs
Drug Interaction Tool
Drug Costs
Dosage Calculator
Formulary Tool
Pill Identifier
Antibiotics Guide
Immunizations
NIVERSITY
The College of Medicine
Browsing Epocrates ONLINE
FLORIDA STATE UNIVERSITY
The College of Medicine
Search for a Drug
FLORIDA STATE UNIVERSITY
The College of Medicine
Using Classes
FLORIDA STATE UNIVERSITY
The College of Medicine
Prescription Drug Monographs
FLORIDA STATE UNIVERSITY
The College of Medicine
Dosage Calculator
FLORIDA STATE UNIVERSITY
The College of Medicine
Alt Meds Monographs
FLORIDA STATE UNIVERSITY
The College of Medicine
OTC Monographs
FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• Using Epocrates Online
• What is the starting dose of lisinopril to
treat HTN if the patient is not on a
diuretic? (dose)
• How much does one month supply of
Cymbalta 30 mg cost?
• What is the off label indication for Ativan?
( indicates off label)
FLORIDA STATE UNIVERSITY
The College of Medicine
Epocrates ONLINE Formulary
2. Click to see meaning
FLORIDA STATE UNIVERSITY
The College of Medicine
Epocrates ONLINE Formulary
FLORIDA STATE UNIVERSITY
Alternatives The College of Medicine
Finding Substitutes
FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• A 65 yr old female with osteoporosis is on
Boniva. She has recently changed to
AARP Medicare Complete MA. Can she
continue taking Boniva? Are there lower
cost choices?
• Another formulary resource:
– http://www.fingertipformulary.com/
– Can’t vouch for accuracy
FLORIDA STATE UNIVERSITY
The College of Medicine
Another Formulary Option
FLORIDA STATE UNIVERSITY
The College of Medicine
Epocrates ONLINE MultiCheck Tool
2. Click drug
Interactions appear as found
Repeat until all drugs in list
FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• Check for Interactions: digoxin,
furosemide, lisinopril
• Peds example: isoniazid, rifampin,
ethambutol, acetaminophen
FLORIDA STATE UNIVERSITY
The College of Medicine
Epocrates ONLINE Pill Identifier
Scroll through results
Pick shape, color, etc. If
until you find your pill.
imprint readable,FLORIDA
type S
itTATE
in UNIVERSITY
Click name to go to
and click Identify
Pills of Medicine monograph.
The College
Epocrates Online Tables
FLORIDA STATE UNIVERSITY
The College of Medicine
Epocrates Vaccinations
FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• Using any of the Immunizations tools:
• Patient has planned a mission trip to Central
America. What immunizations does she need?
• The news of a meningitis outbreak brings in a 53
yr old man with a history of TB but otherwise
healthy who is worried that he might be
exposed. Should we give him Menactra?
FLORIDA STATE UNIVERSITY
The College of Medicine
P
P
P
P
P
P
Rx Monographs
OTC Monographs
Alt Meds Monographs
Drug Interaction Tool
Drug Costs
Dosage Calculator
Formulary Tool
PEPID
Pill Identifier
Antibiotics Guide
P
Immunizations
FLORIDA STATE UNIVERSITY
The College of Medicine
PEPID Drug Information
FLORIDA STATE UNIVERSITY
The College of Medicine
PEPID Drugs iPhone
1. Pick CRC
FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• Using PEPID online or PDA
• You have a child with otitis media for
whom you need to give PO amoxicillin.
The child weighs 62 Lbs. How many ml of
250 mg/5 ml should you prescribe per
dose?
FLORIDA STATE UNIVERSITY
The College of Medicine
PEPID Interaction Tool
FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• digoxin, furosemide, lisinopril
• lisinopril, metformin, and
hydrochlorothiazide
• Peds example: isoniazid, rifampin,
ethambutol, acetaminophen
FLORIDA STATE UNIVERSITY
The College of Medicine
Immunizationss
FLORIDA STATE UNIVERSITY
The College of Medicine
P
P
P
P
P
Rx Monographs
OTC Monographs
Alt Meds Monographs
Drug Interaction Tool
Drug Costs
Dosage Calculator
Formulary Tool
FACTS AND
COMPARISONS
P
Pill Identifier
Antibiotics Guide
P
Immunizations
FLORIDA STATE UNIVERSITY
The College of Medicine
eFacts and Comparisons
• Detailed
• For pharmacists
• New interface
Browse Resources
FLORIDA STATE UNIVERSITY
The College of Medicine
Search eFacts & Comparisons
FLORIDA STATE UNIVERSITY
The College of Medicine
eFacts & Comparisons Online
• Monograph in
Drug Facts and
Comparisons will
come up
• Expand sections
• Or Show All
• See link to Class
• Breadcrumbs
FLORIDA STATE UNIVERSITY
The College of Medicine
Classifications
FLORIDA STATE UNIVERSITY
The College of Medicine
Tables in Facts and Comparisons
FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• Using Facts and Comparisons Online
• Is it possible that Wellbutrin causes
tinnitus? (hint: CTRL-F)
• Which of the proton pump inhibitors are
used off label for GERD in children?
FLORIDA STATE UNIVERSITY
The College of Medicine
eFacts Drug Interactions
Type in patient’s drugs, add
Check list, add
more if needed
then click
GO>>
FLORIDA STATE UNIVERSITY
The College of Medicine
eFacts Drug Interactions
Click on Interaction
to see monograph FLORIDA STATE UNIVERSITY
The College of Medicine
Exercises for Practice
• digoxin, furosemide, lisinopril
• lisinopril, metformin, and
hydrochlorothiazide
• Peds example: isoniazid, rifampin,
ethambutol, acetaminophen
FLORIDA STATE UNIVERSITY
The College of Medicine
eFacts Pill Identifier
2. Click on underlined
drug name
1. Fill in and click
Go
FLORIDA STATE UNIVERSITY
The College of Medicine
P
P
P
Rx Monographs
OTC Monographs
Alt Meds Monographs
Drug Interaction Tool
DYNAMEDEVIDENCE BASED
P
Drug Costs
Dosage Calculator
Formulary Tool
Pill Identifier
Antibiotics Guide
Immunizations
FLORIDA STATE UNIVERSITY
The College of Medicine
1. Type & choose
2. Choose
FLORIDA STATE UNIVERSITY
The College of Medicine
Choose category
FLORIDA STATE UNIVERSITY
The College of Medicine
Dynamed
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New
1000 drug monographs
Evidence-based
Linked to disease content
FLORIDA STATE UNIVERSITY
The College of Medicine
P
P
P
Rx Monographs
OTC Monographs
Alt Meds Monographs
Drug Interaction Tool
Drug Costs
Dosage Calculator
Formulary Tool
MDCONSULT
Pill Identifier
Antibiotics Guide
Immunizations
FLORIDA STATE UNIVERSITY
The College of Medicine
MDConsult Drug Monographs
• Gold Standard’s Clinical Pharmacology
• Thorough
• By Indication, Contraindication and
Adverse Reactions
FLORIDA STATE UNIVERSITY
The College of Medicine
P
P
Rx Monographs
OTC Monographs
Alt Meds Monographs
Drug Interaction Tool
Drug Costs
Dosage Calculator
Formulary Tool
ACCESS MEDICINE
HARRISON’S PRACTICE
Pill Identifier
Antibiotics Guide
Immunizations
FLORIDA STATE UNIVERSITY
The College of Medicine
LexiDrugs in Access Medicine
• Access Medicine Lexi Drug Content (Rx and OTC)
• Also in Harrison’s Practice online and PDA
FLORIDA STATE UNIVERSITY
The College of Medicine
Rx Monographs
OTC Monographs
P
P
Alt Meds Monographs
Drug Interaction Tool
Drug Costs
Dosage Calculator
Formulary Tool
NATURAL MEDICINES
DATABASE
Pill Identifier
Antibiotics Guide
Immunizations
FLORIDA STATE UNIVERSITY
The College of Medicine
Natural Medicines Database
FLORIDA STATE UNIVERSITY
The College of Medicine
Natural Medicines Effectiveness
FLORIDA STATE UNIVERSITY
The College of Medicine
Interaction Checker
FLORIDA STATE UNIVERSITY
The College of Medicine
Rx Monographs
OTC Monographs
Alt Meds Monographs
Drug Interaction Tool
Drug Costs
Dosage Calculator
Formulary Tool
PEDIATRIC CARE
ONLINE
P
Pill Identifier
Antibiotics Guide
Immunizations
FLORIDA STATE UNIVERSITY
The College of Medicine
Pediatric Care Online
• Antimicrobial Therapy Guide
• Information by
• Diagnosis
• Agent
• Class
FLORIDA STATE UNIVERSITY
The College of Medicine
Pediatric Care Online
FLORIDA
STATE UNIVERSITY
Interactive
Periodicity
Schedule
College of Medicine
includesThe
Childhood
Immunizations
Summary
• Epocrates on PDA different than online.
• PEPID competes well with Epocrates as a onestop shop
• Facts and Comparisons more detailed
monographs and interactions but only online
• Many other resources have good drug
information but without tools (formularies,
interaction tools, dosage calculators…)
FLORIDA STATE UNIVERSITY
The College of Medicine