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Drug Information
Drug Information
The newer drugs are generally more potent & selective, and
formulations becoming increasingly complex
The literature on drugs has also expanded and covers a wide range of
information
Primary Source:
Information is presented by authors without any evaluation by a second party.
Provides must current information about drugs.
Examples; articles published in journals(eg British Medical Journal), thesis etc.
Secondary source
The original source has been evaluated by second party other than the publisher.
Modified and rearranged form
Examples; review articles like lexis-nexis, Medline etc
Tertiary source
Information obtained from primary and secondary source and arranged in a
manner to represent a composite of the available information.
Examples; Representative form Pharmacopeias - BP, USP, IP, BNF etc., Encyclopedia
Dictionaries Guides, text books
Other Sources:
The DIC also receives information from
The public and hospitals about the Adverse effects of any drug
Local drug lists
National Formularies
Hospital Formularies
Internet
Phone calls to Manufacturers
Government and Non-government organizations
and also to other DIC’s.
Drug informer should understand the nature of the question and should ask
all the needed questions to get the ultimate question
once it has been determined, the next step is to categorize the question.
Knowing the limitations of any study can help in evaluating the usability of
its data
Drug information specialists will often use some standard questions to help
in this process
Role of Pharmacist:
Must be a part of DIC,should be “ready to go” for information
all the time.
‘The Drug-Information Pharmacist’ is at interface of vast
amount knowledge on onside and the persons needing the
knowledge on other.
Should provide proper information irrespective of the
Drug Information Centers in Nepal
Four organizations in Kathmandu were initially identified as potential sites for
drug information centers:
The bulletin normally publishes the latest development in the medical sciences,
the newly introduced drugs, new indications for certain drugs, newer drug delivery
systems, updates on drug interactions and ADRs.
Medical team
Toxicologists specializing in medical toxicology are
Supporting team
People trained in library science with computer
knowledge
◦ Assess and treatment recommendations during
poisoning via 24-hour emergency telephone services
◦ Provide public and professional educational programs
◦ To collect data on poisonings
◦ To perform research
◦ Assist the public and health care providers during
hazardous material spills
My daughter is 2 years old and just swallowed ½
a bottle of PCM…
Recommendations to Client
Complete Coding & Documentation
Poison; Any substance that can harm the body by altering
cell structure or functions
Absorption
Injections
Ingestion
Acids and Alkalis
Burns on or around the lips
Burning in mouth, throat, and abdomen
Vomiting
Food Poisoning
Various types of signs and symptoms
Abdominal pain
Nausea and vomiting
Diarrhea
Fever
Insecticides
Slow pulse
Excessive salivation and sweating
Nausea, vomiting, and diarrhea
Breathing difficulties
Constricted pupils
Petroleum Products
Characteristic odor of breath, clothing, and vomitus
Coughing and difficulty breathing
Range of signs and symptoms
Important questions to consider asking
patient
What substance?
When did you ingest/become exposed?
If an ingestion, how much did you ingest?
Over what time period?
What Interventions?
How much do you weigh?
[What effects are you experiencing from the
ingestion?]
Poisons that are swallowed:
◦ Household and industrial chemicals
◦ Medications
◦ Improperly prepared food
◦ Plant materials
◦ Petroleum products
◦ Agricultural products
Ingested Poisons
Signs and Symptoms
Nausea,Vomiting,Diarrhea,Altered mental status,
Abdominal pain,Chemical burns around the mouth,
Different breath odors
G G
A A
S S
Fire suppression and
motor vehicle exhaust
Prevents oxygen
binding with red
blood cells
Inhaled Poison
Signs and Symptoms
Difficulty breathing ,Chest
pain,Cough,Hoarseness,Dizziness,
Headache,Confusion,Seizures,Altered mental status
Transport
Perform an initial assessment.
Provide oxygen and assist ventilations, if needed.
Treat for shock.
Perform rapid trauma assessment.
Identify and treat life-threatening problems.
Do focused history and physical exam.
Assess baseline vital signs.
Consult Medical Direction.
Transport with all containers, bottles, and labels.
Perform ongoing assessment. (cont.)
Indications:
◦ Poisoning by mouth
Contraindications:
◦ Altered mental status
◦ Ingestion of acids or alkalis
◦ Inability to swallow
Medication form
◦ Pre-mixed in plastic bottle (12.5 grams)
◦ Powdered form
Dosage
◦ Adults and children: 1 gram/kg
Adult dose: 25–50 grams
Pediatric dose: 12.5–25 grams
Actions:
◦ Binds to certain poisons
◦ Reduces absorption
Side effects:
◦ Black stools
◦ Vomiting (cont.)
Syrup of Ipecac
◦ Not so used
◦ Reason for removal;
It is said that it takes too long to cause vomiting and it does
not remove enough of the poison from the stomach.
◦ Indications - poisoning by mouth
Antidotes
Drugs Antidotes
Morphine Naloxone
Benzodiazepines Flumazenil
Barbiturates Tacrine
Acetlycholine Atropine
Warfarin Vitamin K
Isoniazid Vitamin B6
Insulin Dextrose or Glucagon
Paracetamol Acetylcysteine
Heparin Protamine Sulphate