Drug Information Center: School of Pharmacy and Health Professions, Creighton University Medical Center

You should arrive at 10 am on the first morning of clerkship. You will need your laptop, lab coat and name tag. The first day will consist of orientation to the clerkship, computer set up, literature searching refresher course.

The first 2-3 afternoons of this rotation will involve a training class through the library. This takes place from 330pm until 5pm. This is a very helpful class to re-familiarize you with searching the literature.

Drug information questions come in at all times, so be prepared to start answering questions on the first day.

What we do and do NOT do <Back to top>

We do…

Take questions from health professionals primarily regarding drugs and drug therapy.
Receive requests primarily from phone calls, but also through email and fax.
Receive questions on a very broad range of topics including dietary supplements, lab test monitoring, disease management, manufacturer information, etc.
Provide support to CUMC P&T committee.

We do NOT…

Take calls from the general public.
Work on assignments for pharmacy or other health professions students. If a student asks you to help with a project, contact your preceptor before doing so.
Serve as an article retrieval or copy service. If callers just want a copy of an article, refer them to the library reference desk.

Hours of Operation & Rules of the Center <Back to top>

The Center is open every business day Monday thru Friday from 830 am to 430 pm.

Although the start time is 10 am on the first day, everyday thereafter the start time will be at 830 am.

Dress: professional dress (minimum of business casual) is required.
Visitors: Visitors are permitted, but be courteous to your fellow classmates. If you are going to have an extended conversation with a visitor, please go outside the Center.
Food and drink: Permitted within reason.

Contact information <Back to top>

Voice: 280-5100 or 280-5101

Toll-Free: 800-561-3728

Fax: 280-5149

Primary Preceptors <Back to top>

Amy Wilson, PharmD, Director, Center for Drug Information & Evidence-Based Practice

Office: 280-3269

Pager: 978-1574

Philip Gregory, PharmD, Coordinator, Drug Information Residency

Office: 280-5118

Pager: 978-0081

Anne Bruckner, BS, PharmD, Drug Information Specialist

Office: 280-5158

Pager: 978-1223

Zara Risoldi, PharmD, Drug Information Resident (2008-2009)
Office: 280-5161

Pager: 978-0149

Syllabus & Grading <Back to top>

To review the syllabus and grading, click here.

Student Responsibilities <Back to top>

Your primary responsibility while on drug information clerkship is answering drug information questions. Answering these questions should come before any other projects or assignments. Therefore, if you have any pending question to answer, please complete that question before working on a project.

In addition to questions, you will have various projects as described in this manual.

You are expected to approach this work with a professional attitude and make every attempt to produce high-quality work. Everything done in the Center will be used on a professional level. Remember that there is a patient on the other end of everything you do.

As a courtesy to your colleagues, please be on time. If the phone rings, answer it. Do not wait for your colleagues to answer it for you.

The Center is sometimes very busy. Other times it can be slow. If it is slow and you are caught up on your assignments, be professional and ask your colleague if you can help them out. Alternatively, ask a preceptor if there are any other projects you can help out with.

Playing computer games, reading leisure books, chit-chatting, inappropriate web surfing, or otherwise wasting time is unprofessional and should be avoided.

We encourage you and expect you to make the most of your experience while you are here.

Getting set up <Back to top>

You will need to set up your laptop to print and to get access to the Drug Information Question Database. We will help you set this up on the first. Here are some instructions to get started:

Installing the printer:

Left click on start, select run, in the box type \\spahpprint , click OK, it will search and then show a list of printers, select the DICsavin2522 and double click on it, once the printer has been installed set it as the default.

Accessing the DI database:

http://creightondruginformation.creighton.edu

An instruction manual for the this database will be provided.

Introduction to receiving & answering questions <Back to top>

We receive questions most often by phone, but also by email and fax.

How to answer the phone

“Creighton Drug Information Service, this is xxxxxxx” or something similar. Please always state your name so the caller knows who they are talking to.

When you receive a question

· Make sure you get adequate background information in order to determine the ultimate question. If you don’t get the background information initially, you might have to call the requester back to clarify.

· Fill out the information request form and immediately log the question on the log sheet. Then “Create a new request” using the online DI database.

· Think about and write down your search methodology.

· Consult with the preceptor to let them know you have received a new question BEFORE starting to research your question.

Before you answer a question

· Discuss your response with the preceptor. The preceptor must “sign off” on your response before you give ANY answer. This applies even to simple tablet identification questions. Failure to check with the preceptor BEFORE responding to any question is grounds for failure of this rotation.

· If your response is written, ask your preceptor to read it first and provide feedback.

· EVERYTHING must be documented in the DI database. We need to know all of the background of the question (even if you think it is unimportant), where you looked (even if you didn't find anything there), and details of your proposed response, whether it is to be written or discussed verbally.

Written Responses to Questions (i.e., Formal Response)

· All written responses must be in the proper memo format. You can see an example of this format by reviewing previous written responses in the DI database.

See memo template

See sample formal response

· All responses must be properly formatted including an introduction, methodology, results, and conclusion. All responses must be written clearly, concisely, and appropriately to answer the question. This means good grammar, no misspellings, etc. Do not ask your preceptor to review a document that you have not already thoroughly proofed and corrected for spelling and grammar.

· All responses must be properly referenced using the reference format from the literature evaluation course (i.e., AMA style).

See quick reference guide to referencing

· If you have any questions, ask a preceptor BEFORE your start.

Document your responses

· All responses, written and verbal must be documented in the Drug Information Database. This must occur before the question is sent out. All responses must be documented using the standard format described in the template (intro, methodology, results, conclusion). This must be done for both written and verbal respnses.

Emails

· Any email communications with users of the DI service, must be courteous and in written in a letter-like format. This means that you address the email (e.g., start with Dr. Abc) and signed (e.g., Sincerely, Ed Pharmacist, PharmD Candidate).

· All emails should have a subject line include.

Phone Calls/Fax

· A special code is needed to make long-distance phone calls. Just ask the preceptor to enter the code when you need to make a long-distance call.

· Personal calls using the phones or fax in the DIC are not permitted. You can take personal calls on your own cell phone, just be courteous to your fellow classmates.

Confidentiality

The questions you receive are considered confidential. Do not share with others outside of the drug information clerkship. This is private information to be shared only between you, the caller, and the preceptor.

Lawyers and Media

Occasionally we get calls from lawyers or media or other people wanting quotes or research for legal cases, etc. In the event that you receive a call like this, find your preceptor or take a message and the preceptor will call the person back.

Monographs & Class Reviews for P&T <Back to top>

At least 2 students in each clerkship period will develop at least one monograph or class review for the CUMC P&T committee.

Monographs and class reviews follow a similar format, but monographs only cover one drug in a class. Class reviews compare and contrast all drugs in a class.

This format may be modified for specific reasons. Ask your preceptor before making any formatting changes.

Students completing a monograph or class review will usually present their monograph or class review at the P&T committee. Your preceptor will let you know the day and time.

See Appendix 1 for a sample monograph and class review.

DUEs for P&T <Back to top>

Information to follow

Evidence-based clinical reviews <Back to top>

Students who are not assigned a monograph or class review will be assigned an evidence-based clinical review. These reviews will cover and important, practical clinical topic. Each review will be published on the Center's website, in the Center's newsletter or submitted for publication in a medical or pharmacy journal.

Clinical review topics will be assigned by the preceptor. If you have a topic of special interested that you would rather pursue, please discuss with your preceptor. In some cases, but not all, topics may be switched.

In addition to publishing reviews in print, you will present your completed topic to your colleagues and faculty at the School of Pharmacy & Health Professions. Your presentation time will be on Tuesday at 12 pm during either the second or third week of the rotation.

See Appendix 3 for more information on how to develop an evidence-based clinical review article.

Journal Club <Back to top>

Each student will be responsible for one journal club article presentation during the drug information clerkship experience. See Appendix 4 for details.

Headlines <Back to top>

Headlines are brief “news clips” of current drug information that will be posted on our website. Each topic should include a 2-3 sentence summary, with a link to additional information. Each student will be responsible for scanning the news and submitting headlines for any pertinent information for a one week time period. See Appendix 5 for details.

Newsletter <Back to top>

Each student will be responsible for creating a newsletter article during the rotation, based on the schedule provided in orientation. Students will work together to publish an electronic newsletter, suitable for distribution, containing all the articles. Topics for newsletter articles will be determined the preceptor. Newsletter articles should be focused for a professional audience, and must be fully referenced. See Appendix 5 for details.

Appendix 1. Monograph & Class Review Instructions and Examples <Back to top>

Monograph template, click here.

Sample monographs: Micafungin, Daptomycin

Appendix 2. DUE instructions and examples <Back to top>

To see a sample of DUE criteria/Data collection sheet, click here.

To see a sample of a completed DUE, click here.

Appendix 3. Evidence-based clinical review instructions and examples <Back to top>

The purpose of the evidence-based clinical review is to provide the clerkship student the experience of developing a scholarly manuscript. It is also an opportunity for the student to gain an in-depth knowledge of an important clinical practice topic. Secondarily, by presenting this topic to colleagues and faculty, it serves as a learning opportunity for all participants.

How is an evidence-based clinical review conducted and written? We follow guidelines similar to those put forth by the American Academy of Family Physicians. To learn about these guidelines, read the following article:

How to write and evidence-based clinical review article

To learn more about the Strength of Recommendation Taxonomy or SORT, review the following:

Strength of Recommendation Taxonomy (SORT): A patient-centered approach to grading evidence in the medical literature

Here is an example of a good evidence-based clinical review article written by a student:

>>>Evidence-Based Clinical Review: Recent concerns regarding erythropoiesis-stimulating agents

To see several examples of evidence-based clinical reviews, see these articles published in the journal American Family Physician:

Ginger: An overview

Iron deficiency anemia

Treatment of the common cold

Treatment options for Atopic Dermatitis

Appropriate prescribing of medications: An eight-step approach

Appendix 4. Journal club <Back to top>

Purpose

There are at least three goals of journal club during this clerkship:

Keep up-to-date with current literature on drug therapy.
Gain experience in literature evaluation.
Practice presentation skills

Overview

Each student will be responsible for one journal club article presentation during the drug information clerkship experience.

Responsibilities of the Presenter

· Select an appropriate journal article to review (see below)

o Provide a copy of your article to each student and faculty member at least 2 days before your presentation day.

· Critically evaluate your article. Use this evaluation tool and provide a copy as part of your presentation.

· Summarize your evaluation of the article in written form (see example below). Distribute this document the day of your presentation.

· Present your article and your critical evaluation orally during your selected time.

· DO NOT read your hand out as your presentation.

· Discuss the article with your colleagues.

Responsibilities of the Participants

· Review and critically evaluate the article selected by the presenter.

· Listen to the evaluation of the presenter.

· Ask relevant questions.

· Discuss your evaluation of the article with your colleagues.

Criteria for Choosing your Article

· Current – preferably something within the last 3 months; nothing older than 12 months.

· Relevant – choose articles most relevant to our profession (i.e., drug therapy). Avoid articles that focus just on diagnostics or disease state epidemiology, etc. Ask yourself: “Will this study impact or change my practice in any way?” If the answer is ‘yes’ then you have a good article.

· High impact – look for articles in known journals first (e.g., JAMA, NEJM, Circulation, Chest, etc). Avoid articles in relatively unknown or obscure journals.

· Interesting – ideally, pick a topic you think participants will find interesting and important to them. This makes the whole process much more fun.

Evaluating Your Article

· Review your notes on literature evaluation.

· Utilize the evaluation tool from PHA458.

Journal Club Presentation Format <Back to top>

Question: State the research question or hypothesis of the study. What is the question the authors intended to answer by conducting the study?

Design: State the research design of the study, e.g. randomization, controls, blinding.

Setting: Identify the basic location for the study: hospital, community, number of centers, primary care, referral centers, US or non-US locations.

Patients: Describe the patients involved in the study. What is the primary disease condition in the study, what are the demographics of the population, the severity of illness, presence of risk factors, inclusion and exclusion criteria, the number of subjects involved.

Intervention: How were the subjects treated, drug(s), doses, duration of treatment? Include any co-therapy, and important non-drug therapy that was used. If there are any important parts of usual recommended treatment that are not included in the trial it is worth noting. In most studies there will be an investigational or “new”, treatment and a control treatment. The control may be active therapy or may be placebo. In some studies there will be more than two groups, just be clear in the description of how each group is treated.

Outcome measures: How were the results of the treatment measured, i.e. how was it determined if treatment was successful. There will usually be one primary outcome and often a number of secondary outcomes. Make sure you focus first on the primary outcome in this section and in the results. Are the outcomes clinically important, the ones you would think of in terms of the goals of treatment of the condition under study? Are they sensitive, specific, precise in measurement? Are they “patient oriented evidence that matters” ( POEMs)? If there are significant limitations in the outcomes of the study, it should be noted.

Main results: What were the results for the primary outcomes for each group treated? Provide the specific results of the trial, often a table is a good way to do this. Also include any of the secondary outcomes that you believe are important to making a judgment about the success or lack of success of each of the treatments. Also give some information about any side effects reported and if possible give the specific incidence and some measure of severity for each important side effect. Always give clear quantitative measures of the results, make sure it is clear if there is statistical significance in the results between groups, and a range (perhaps the 95% CI) for the size of the difference between groups. Be sure for all of the comparative data presented that it is clear what outcome you are talking about, and what the comparison groups are, i.e. intervention compared to control, end of study result compared to baseline, or whatever is appropriate. Also note if the analysis is by intent to treat or per protocol. The completeness of follow-up, and degree of compliance with the treatments should also be presented.

Be sure to give RR, AR, and NNT is relevant for the type of data.

Conclusion: What is the primary conclusion of the study? This should be an answer to the research question. In this section you are presenting the author’s conclusion, not necessarily your own conclusion. Your comments, and your bottom line on the study will be in the commentary.

Commentary: Here is where you should note the major advantages, and major disadvantages to the design and success in conducting (did they follow the intended protocol) the study. Some points may have been mentioned in the individual sections above, but those sections are mostly for factually presenting what was done, and the commentary is for the evaluation points. Make sure you give a clear recommendation for how the information in this study may be used for decision making in practice. Are the results internally valid, and if they are, to what types of patients should the results apply? Are there any special cautions or warnings about the use of the new treatment? If the new treatment has an advantage be specific about what it is, and once again, be quantitative if possible. If it is better, how much better, and better at achieving what outcome?

Sample Presentation <Back to top>

Article: Boureau F, Kappos L, Schoenen J, et al A clinical comparison of sumatriptan nasal spray and dihydroergotamine nasal spray in the acute treatment of migraine. Int J Clin Pract 2000;54:281-286

Question: In patients with acute migraine is headache relief with intranasal sumatriptan 20mg better than intranasal dihydroergotamine 1mg plus an optional 1 mg.

Design: Randomized, double blind, double dummy, crossover of patients treating 2 migraine attacks

Setting: 498 patients were recruited from 52 centers in Belgium, France, Portugal, and Switzerland.

Patients: Eligible patients had a migraine history of a least one year, and on overage, over the last 12 months, had experienced between one and six attacks per month or severe or moderately sever migraine, with or without aura, according to International Headache Society Criteria.

Intervention: Patients were instructed to treat two attacks and were randomly assigned to one of the following to treat the first attack: sumatriptan nasal spray 20mg (plus placebo DHE), or DHE nasal spray 1mg (plus placebo sumatriptan). Patients crossed over to the alternative therapy for the second migraine attack. DHE was give as two separate sprays of 0.5 mg into each nostril and sumatriptan was given as a single dose of 20mg into one nostril. Patients taking active treatment with DHE had the option of taking a second dose 30 minutes after the first if insufficient relief was obtained. To maintain blinding patients receiving active sumatriptan took a second dose of placebo nasal spray at 30 minutes if insufficient relief was obtained.

Rescue medication was permitted if migraine symptoms were not relived within 2 hours of the first dose of study medication. Patients who normally took prophylactic medication for migraine were permitted to continue therapy provided it did not contain ergotamine or DHE and the dosage remained unchanged throughout the study.

Main Outcome Measures: Patients used diary cards to record symptoms just before the dose, then 15, 30, 45, 60, 90, and 120 minutes after. Headache severity was assessed as none (0), mild (1), moderated (2), or severe (3). Headache relief was defined as a change from grade 2 or 3 to grade 0 or 1. The primary efficacy parameter was headache relief at 60 minutes. Other measures included disability on a scale of normal (0) to bed rest (3), severity of nausea (from 0 to 3), presence of vomiting, photophobia, and phonophobia. They also recorded the use of rescue medication and headache recurrence.

Main Results: 405 patients were randomized, 368 treated two attacks, and 327 were analyzed for efficacy:

Percent of patients recording headache relief

	60 min	90 min	120 min
Sumatriptan	53%	60%	63%
DHE	41%	48%	51%
P value	<0.001	0.037	0.003

After 60 minutes 64% of sumatriptan and 40% of DHE treated patients reported relief of nausea, (p= 0.006). The optional second dose of study medication at 30 minutes was taken by 76% of the sumatriptan treated and 81% of DHE treated patients. Rescue medication was taken by 37% of sumatriptan and 35% of DHE treated patients. Headache recurrence occurred in 23% of sumatriptan and 13% of DHE treated patients. There were no differences reported in vomiting (7%), photophobia of phonophobia (47%- 52%).

Conclusion: The authors concluded that sumatriptan nasal spray was superior to DHE nasal spray in relief of acute migraine headache from 45 minutes to 2 hours after dosing and in the relief of nausea. Both treatments were well tolerated.

Commentary: The dose of DHE was not the standard recommended dose. The primary outcome to assess pain relief is not the standard recommended time and favors sumatriptan. 405 subjects were randomized, results reported on efficacy were for only 327. There were no data or analysis reported on possible carryover or period effects in this crossover study. No data were reported on the severity of the second headache before treatment. No data were reported on the use of prophylactic therapy. There was no placebo only group so it is not possible to account for a possible placebo effect, which has been 15-75% in published trials.

Bottom line for practice, there might be a slight advantage for pain relief and nausea relief in the first two hours of treatment for sumatriptan nasal, however DHE nasal has a lower frequency of headache recurrence. Patient factors and preference would be important to consider in the selection of one of these drugs over the other.

Resources for background:

Published clinical practice guidelines:

Neurology 2000;55:754-762

Can Med Assoc J 1997;156:1273-1287

Web sites:

http://www.ama-assn.org/special/migraine/migraine.htm

http://www.ahsnet.org/ http://www.ahsnet.org/guidelines.php

http://www.ninds.nih.gov/

http://www.headaches.org/

http://www.aan.com/public/practiceguidelines/headache_gl.htm

Appendix 5. Headlines and Newsletter Articles <Back to top>

HEADLINES:

To see a sample headlines that are currently on our website, click here.

NEWSLETTER:

To see a sample of a newsletter and newsletter articles that are currently on our website, click here.

Appendix 6: Select Tertiary Resources <Back to top>

ADVERSE REACTIONS AND SIDE EFFECTS

Major References

Meyler's Side Effects of Drugs

American Hospital Formulary Service (AHFS) Drug Information

Facts and Comparisons

Martindale's Extra Pharmacopoeia

Physician's Desk Reference (PDR)

Textbook of Adverse Drug Reactions (Davies)

U.S. Pharmacopeial Dispensing Information (USP-DI)

Drugdex

AMA Drug Evaluation

Product labeling

Handbook of Poisoning

Clinical Toxicology of Commercial Products

Drug Effects in Hospitalized Patients (Miller and Greenblatt)

FDA Drug Bulletin

For Antibiotics

The Use of Antibiotics

Minor References

The Pharmacological Basis of Therapeutics (Goodman and Gilman)

Secondary References

Clin Alert

International Pharmaceutical Abstracts (IPA)

Index Medicus/Medline

Poisindex

AVAILABILITY

Major References

U.S. Availability

American Drug Index Manufacturer

Facts and Comparisons PharmIndex

Drug Topics Redbook PDR

Blue Book Physician’s Generex

Drugdex USAN and USP Dictionary

Foreign Availability

Martindale's Extra Pharmacopoeia

Index Nominum

Drugs Available Abroad

Foreign Equivalents of PDR

Minor References

Handbook of Nonprescription Drugs

Medical Letter

Facts and Comparisons Newsletter

Pharmacists Letter

CHEMICAL PROPERTIES

Major References

Merck Index

AHFS Drug Information

Martindale's Extra Pharmacopoeia

Remington's Pharmaceutical Sciences

USP-National Formulary

COST INFORMATION

Major References

Drug Topics Redbook

Blue Book

Manufacturers and wholesalers

Physician's Generix

Minor References

Facts and Comparisons

Medical Letter

DOSING AND ADMINISTRATION

Major References

AHFS Drug Information

AMA Drug Evaluations

PDR

Facts and Comparisons

USP-DI

Martindale's Extra Pharmacopoeia

Drugdex

For Pediatrics

Harriett Lane Handbook

Textbook of Pediatrics (Nelson)

Pediatric Therapy (Shirkey)

Pediatric Dosage Handbook (Taketoma, Hodding, Kraus)

For Renal Patients/Hemodialysis

Bennett's Nomogram

For Geriatrics

Geriatric Dosage Handbook (Semla, Beizer, Higbee)

DRUG INTERACTIONS

Major References

Hansten's Drug Interactions

Evaluations of Drug Interactions (Shinn)

Drug Interactions Facts

Minor References

AHFS Drug Information

Meyler's Side Effects of Drugs

Facts and Comparisons

Drugdex

AMA Drug Evaluations

Note: Also consider additive pharmacologic properties or additive toxicities. May need to use pharmacology, chemistry, stability, or adverse effects references too!

DRUG IDENTIFICATION

Major References

American Drug Index

Facts and Comparisons

Drugdex

Ident-A-Drug

Poisindex

Martindale's Extra Pharmacopoeia

USAN and USP Dictionary

Merck Index

PDR

Drug Topics Redbook

Blue Book

By Imprint Code

Identidex

PDR

Pictures

PDR

USP-DI

PDR Identification Kit

IMMUNIZATION INFORMATION

Major References

Report on the Committee on Infectious Diseases

Morbidity and Mortality Weekly Report (MMWR)

CDC-Health Information for International Travel

AHFS Drug Information

Guide for Adult Immunization (ACP)

INVESTIGATIONAL DRUGS

Major References

Martindale's Extra Pharmacopoeia

Drugdex

NCI Investigational Drugs: Pharmaceutical Data

PharmIndex

Medical Subject Headings--Suppl Chemical Records

NDA Pipeline

Orphan Drugs

Drugdex

Facts and Comparisons

Treatment IND

Facts and Comparisons

AHFS Drug Information

Secondary References

Unlisted Drugs

IPA

Iowa Drug Information Service (IDIS)

Periodicals

Phase III Trials

"Pink Sheet" FDC Reports

LABORATORY INFORMATION

Major References

Interpretation of Diagnostic Tests (Wallach)

Diagnostics

Clinical Interpretation of Laboratory Tests (Wiomann)

Clinical Diagnosis by Laboratory Methods

Clinical Laboratory Medicine (Ravel)

For Lab/Drug Interactions

Effects of Drugs on Clinical Laboratory Tests (Young)

Hansten's Drug Interactions

AMA Drug Evaluations

AHFS Drug Information

For Antibiotics

Use of Antibiotics in Laboratory Medicine (Lorian)

LAWS AND REGULATIONS

Major References

State and Federal Law

State Pharmacy Practice Act

State Board of Pharmacy Regulations

Pharmacy Law Digest

Code of Federal Regulations

Pharmacy Law Texts

Federal Register

MANUFACTURER'S ADDRESSES AND PHONE NUMBERS

Major References

PDR

Facts and Comparisons

Poisindex

Clinical Toxicology of Commercial Products

Martindale's Extra Pharmacopoeia

Minor References

American Drug Index (addresses only)

NATURAL PRODUCTS

Major References

Integrative Medicine Access

Martindale's Extra Pharmacopoeia

Natural Medicines Comprehensive Database

PDR for Herbal Medicines

Poisindex

Professional's Handbook of Complementary and Alternative Medicine

Review of Natural Products

PATIENT INFORMATION

Major References

USP-DI Volume II: Advice for the Patient

Patient Drug Facts

PHARMACOKINETICS

Major References

Applied Pharmacokinetics (Evans, Schentag, Jusko)

Drugdex

AHFS Drug Information

Basic Clinical Pharmacokinetics (Winters)

Applied Clinical Pharmacokinetics (Mungall)

USP DI Volume III

Minor References

Goodman and Gilman

PDR

Handbook of Clinical Drug Data

Martindale's Extra Pharmacopoeia

PHARMACOLOGY

Major References

Goodman and Gilman

Clinical Pharmacology (Melmon and Morrelli)

AHFS Drug Information

Minor References

PDR

POISONING/TOXICOLOGY

Major References

Poisindex

Clinical Toxicology of Commercial Products

Clinical Management of Poisoning and Drug Overdose (Haddad, Winchester)

Handbook of Poisoning (Dreisbach)

Poisoning-Toxicology-Symptoms-Treatments

Montana Poison Control Center 1-800-525-5042

Minor References

AHFS Drug Information

PREGNANCY AND LACTATION

Major References

Drugs in Pregnancy and Lactation (Briggs)

AHFS Drug Information

USP-DI

PDR

Pediatrics 1989;84:924-36

Handbook of Clinical Drug Data

Drugdex

Drug Therapy in Obstetrics and Gynecology (Rayburn)

Drugs and Human Lactation (PN Bennett and WHO Working Group)

Clinical Aspects of Teratogenicity of Drugs (Nishimura, Tanimura)

STABILITY/INCOMPATIBILITY

Major References

Handbook on Injectable Drugs (Trissels)

Guide to Parenteral Admixtures (also called Kings or Cutter Manual)

AHFS Drug Information

Drugdex

Manufacturer

Secondary References

IPA

THERAPEUTIC USE OF DRUGS

Major Medical References

Practical Care for the Ambulatory Patient (Stultz, et al)

Manual of Medical Therapeutics (Washington Manual)

Textbook of Medicine (Cecil)

Harrison's Principles of Internal Medicine

Harvey's The Principles and Practice of Medicine

Current Therapy (Conn)

Merck Manual of Diagnosis and Therapy (Berkow)

The Pathologic Basis of Disease (Robbins)

Pharmacy Therapeutic Texts

Applied Therapeutics for Clinical Pharmacists (Koda-Kimble)

Clinical Pharmacy and Therapeutics (Herfindel, et al)

Pharmacotherapy. A Pathophysiological Approach (DiPiro)

AHFS Drug Information

Martindale's Extra Pharmacopoeia

AMA Drug Evaluations

Drugdex

Handbook of Nonprescription Drugs

For Antibiotics or Infectious Disease

The Use of Antibiotics

A Practical Approach to Infectious Diseases (Reese RE, Betts RF)

Guide to Antimicrobial Therapy (Sanford)

Appendix 7: AHFS on Excel

Students will help with the AHFS classification review process required by JCAHO @ CUMC.