Phin Prelims Lec 1

PHARMACY INFORMATICS
SECOND SEMESTER – PRELIMS / LECTURE
TOPIC 1: INTRODUCTION TO PHARMACY APPLICATIONS OF HEALTH INFORMATICS IN THE

INFORMATICS PROCESS OF CARE?
WHAT IS PHARMACY INFORMATICS? 1. Hospital administration, billing and accounting

2. Resource management
• Deals with the application of pharmacy-related 3. Medical documentation
health data for a variety of purposes. 4. Diagnostics and therapy
• According to ASHP, it is “the use and integration of 5. Imaging
data, information, knowledge, technology, and 6. Communication
automation in the medication-use process for the 7. Information management
purpose of improving health outcomes.” 8. Clinical decision support
PHARMACY INFORMATICS INFORMATION TECHNOLOGY
• Deals with the subset of informatics relevant to the • The use of hardware, software, services, and
practice of pharmacy. supporting infrastructure to manage and deliver
• An important subset of medical informatics in which information using voice, data, and video
the pharmacists use their knowledge of information • The science and activity of using computers and
systems and medication-use processes to improve other electronic equipment to store and send
patient care by ensuring that new technologies lead information
to safer and more effective medication use (ASHP).
• A scientific field that focuses on medication-related Examples of Information Technology
data and knowledge within the continuum of
1. Telephone and radio equipment and switches used
healthcare systems -including its acquisition,
for voice communications.
storage, analysis, use and dissemination - in the
2. Traditional computer applications that include data
delivery of optimal medication-related patient care
storage and programs to input, process, and output
and health outcomes. (HIMSS October 2006).
the data.
• It is the use of electronic health data to support safe
3. Software and support for office automation systems
and effective medication use.
such as word processing and spreadsheets, as well
It can include various aspects of medication as the computer to run them.
management: 4. Users' PCs and software.
5. Server hardware and software used to support
➢ from a drug utilization review, applications such as electronic mail/groupware, file
➢ to the use of barcoding technology during and print services, database, application/ web
product dispensing, servers, storage systems, and other hosting services.
➢ to the development of alert systems to improve 6. Peripherals directly connected to computer
prescribing and dispensing of medications. information systems used to collect or transmit
• Pharmacy informatics involves broad collaboration audio, video or graphic information, such as
between pharmacists, pharmacy technicians, scanners and digitizers.
physicians, nurses, information technology 7. Voice response systems that interact with a
personnel, and other health care professionals. computer database or application.
Examples: IVR systems
AMERICAN SOCIETY OF HEALTH SYSTEM
8. The state radio communications network.
PHARMACIST (ASHP)
Examples: DZMM
• National professional organization members include 9. Computers and network systems used by teachers,
pharmacists, student pharmacists, and pharmacy trainers, and students for educational purposes
technicians who serve as patient care providers on Examples: School Automate & CANVAS
healthcare teams in acute and ambulatory settings. 10. "Open/integrated" computer systems that monitor or
automate mechanical or chemical processes and
also store information used by computer
applications for analysis and decision-making, such
as a building management system.
Examples: CISCO & Honeywell
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WHAT ARE THE OTHER TERMS RELATED TO

INFORMATICS
• The study and application of information

technology to the arts, science and professions, and
to its use in organizations and society at large1
• The study of the best practices in information
accrual, handling, dissmination, and comprehension
using appropriate technology2
HOW DOES INFORMATICS IMPACT HEALTH?
• Construct computer health information systems by

studying the needs of doctors, nurses, patients, and
health care organizations.
DATA
• Create health networks that allow doctors and
nurses to share knowledge and best practices. • Simply discrete and objective facts about subject or
• Create new methods of information delivery that an event
motivate patients to follow treatment • Easy to capture and store in media such as
recommendations. databases and files
MEDICAL INFORMATICS EXAMPLE:
• is most simply defined as computer applications in Patient laboratory values, drug orders, patient’s weight
medical care.
INFORMATION
• comprises the theoretical and practical aspects of
information processing and communication based • Data that has relevance and purpose
on knowledge and experience derived from • Has meaning because it is contextualized,
processes inmedicine and health care categorized, calculated, corrected, or condensed
Health informatics EXAMPLE:
• The development and assessment of methods and Knowing particular lab result was high or low from
systems for the acquisition, processing and reference value
interpretation of patient data with the help of
knowledge from scientific research KNOWLEDGE
• It covers all aspects of the generation, handling,
• Broader, deeper, and richer than data and
communication, storage, retrieval, management,
information
analysis, discovery and synthesis of data,
information and knowledge in the entire scope of ALERT
healthcare.
• a patient- and context-sensitive warning presented to
the ordering provider at the time an order is being
entered. Used to inform the provider of a clinical
concern relevant to the patient and order being
placed.
CLINICAL REMINDER
• A context-sensitive electronic prompt to the provider

to perform an intervention or procedure, based on the
patient’s specific clinical data as applied to a set of
logical conditions.
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NOTIFICATION
• It is a patient- and context-sensitive prompt to the

ordering provider, attending physician,primary
provider, or care team to alert them of new
information (i.e.,abnormal lab result) or tasks in need
of completion (i.e.,unsigned order or note).
TELEHEALTH
• It is the "delivery of health care services, where

patients and providers are separated by distance.
• It uses technology for the exchange of information for
the diagnosis and treatment of diseases and injuries,
research and evaluation, and for the continuing
education of health professionals.
TELEMEDICINE
• It refers to the practice of caring for patients remotely

when the provider and patient are not physically
present with each other.
• It must be compliant based on DPA
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TOPIC 2: INTRODUCTION TO PHARMACY 2. KNOWLEDGE DELIVERY

INFORMATICS
• The informatics pharmacist drive the delivery of
WHO ARE INFORMATICS PHARMACISTS? medication-related information and knowledge
throughout the clinical knowledge lifecycle.
Is considered a dual specialist:
• Knowledgeable about both pharmacy practice and

informatics
• Has the ability to look at both the “big picture” and the
individual details and processes.
ROLES OF AN INFORMATICS PHARMACIST
• Ensure patient safety 3. DATA ANALYSIS

• Provide guidance and leadership for all technology
• In order to improve healthcare, data must be
initiatives that support medication use
reviewed and the insights gained from this data must
• Customize and tailor health information systems and
be applied
technology to the needs of practice
• Serve as a liaison between pharmacy and other 4. CLINICAL INFORMATICS
departments
• It promotes the understanding, integration and
o Information Technology
application of information technology in healthcare
o Nurses
settings.
o Physicians
o Vendors • It focuses on an individual patient.
• Provide education to healthcare professionals and
managers
• Serve as a resource for hospital staff
• Provide recommendations regarding vendor
selection
AREAS OF RESPONSIBILITY
1. Inormation management
2. Knowledge delivery 5.CHANGE MANAGEMENT
3. Data analysis • When dealing with knowledge to guide healthcare
4. Clinical informatics
delivery, the only constant is change.
5. Change management
• Treatments come and go, diagnostic tools evolve,
1. INFORMATION MANAGEMENT clinical practice changes.
• Informatics Pharmacist must generate and share WHAT DOES AN INFORMATICS PHARMACIST DO?
this information with various healthcare
• Maintain databases of medication management
professionals to ensure patient safety while also
systems
measuring the usage and effectiveness of this
• Liaison between information technology (IT) and
information throughout the clinical process.
pharmacy
➢ Understanding system capabilities and
limitations
• Identify solutions to and resolve system problems
• Work with interdisciplinary teams to implement new
technology
➢ Barcode Medication Administration
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• Leadership • Also called as medication information, or drug

➢ Involvement in committees and professional informatics.
organizations Education • This is the discovery, use, and management of
information in the use of medications. Drug
IMPORTANCE OF PHARMACY INFORMATICS IN THE
information covers the gamut from identification,
SOCIETY
cost, and pharmacokinetics to dosage and adverse
1. In health care field, effects. You may also need information about the
• its ability to cater to the needs of the patients from body, health, or diseases in order to better utilize the
any place at any given time. drug information.
• This is highly beneficial for occupational medicine. • Drug information sources have been traditionally
• Telemedicine help to formulate an efficient and classified in three different categories: primary,
reliable healthcare plan secondary, and tertiary.
• Thus, pharmacists need to know how to access
2. In rural area, computerized medical information in various
• Help rural providers deliver better health care by databases and to understand the underpinnings of
connecting rural providers and their patients to these databases to use them most effectively.
services at distant sites and promoting patient- • Information and technology skills should help the
centered health pharmacist clearly see the complex picture of
medication management for each individual patient
3. In urban area and make the best possible decisions for his or her
• It has made waves in less by bringing providers and care
experts to patients, which also decreases healthcare WHAT ARE THE IMPORTANCE OF PHARMACY
and travel costs INFORMATICS IN THE SOCIETY
PHARMACY INFORMATICS ON THE IMPROVEMENT OF TELEMEDICINE
HEALTH OUTCOMES
ANCIENT TIMES
• Information about drugs includes primary literature
and electronic information resources, hospital and • Uses fire, smoke signals, drums, horns, etc.
pharmacy information systems, pharmacokinetics,
EARLY TELEMEDICINE
and pharmacogenomics.
• Patient-related issues include medication safety, • It was kicked off by the inventions of the electrical
electronic health records, decision support systems, telegraph and the telephone.
and the practice of evidence-based medicine. • The telegraph and telephone brought long distance
communication into the mainstream, where almost
anyone could send a telegraph message or make a
phone call.
• Major city hospitals and doctor offices installed
telephones. Within a few years, many city residents
also had telephones in their homes
Late 1800’s – Capital Avenue Drugstore was connected

to 21 different local physicians via the early version of
telephone
• The skills needed to implement this knowledge in April 1924

patient-centered care include effective literature and • The first idea of telemedicine was introduced
Web search skills, an understanding of databases,
• Depicting the use of television and microphone for a
and the controlled vocabularies needed for
patient to communicate with a doctor, including use
interoperability between systems and for optimal
of heartbeat and temperature indicators
searching of some databases
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1925
• The concept “Teledactyl” was introduced by Hugo

Gernsback
The first uses of telemedicine is to transmit video, images,

and complex medical data occurred in the late 1950s and
early 1960s.
1959
• used interactive telemedicine to transmit

neurological examinations, which is widely
considered the first case of a real-time video
telemedicine consultation.
• The rise of the Internet in the 1990s also brought with

it the information explosion. The Internet protocols
allowed support for practically all information and
traffic needed for telemedicine
❖ Some of the affordable measurement devices that

are commonly used with telemedicine include:
➢ Smartphone cameras
➢ Digital stethoscopes
New Normal
ONLINE PHARMACY:
• MedExpress Drugstore
• AideApp
• Dima
• MedGrocer
• Mercury Drugstore
• Rose Pharmacy
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TOPIC 2: SOURCES OF DRUG INFORMATION PART 1 MEDICATION INFORMATION
DRUG INFORMATION • Used to convey the MANAGEMENT and USE of

information on MEDICATION THERAPY and to signify
• A PRINTED information in a particular reference or
the broader role that all pharmacists take in
VERBALIZED by an individual that pertains to
information provision.
medications.
• In many cases individuals use this term in different POPULATION
contexts by associating it with other words, which
• Frequently used to refer to an aggregation or group of
include the following:
individuals defined by a set of common
➢ Specialist/practitioner/pharmacist/provider
characteristics.
➢ Center/service/practice
➢ Function/skills DRUG INFORMATICS
CONSIDERED DRUG INFORMATION PROVIDERS • It is used to describe the evolving roles of the
➢ Pharmacists medication information specialist.
➢ Doctors HISTORY OF DRUG INFORMATICS
➢ Nurses
➢ Medical Researches • Developed in the early 1960s when it was used in
➢ Other health care professionals conjunction with the words center and specialist.
• In 1962, the first drug information center was opened
MISLEADING INFORMATION at the University of Kentucky Medical Center.
➢ News Media DRUG INFORMATION CENTER
➢ Biased/Wrong
➢ Information • To be “a source of selected, comprehensive drug
➢ Incomplete Research information for staff physicians and dentists to
evaluate and compare drugs” as well as to provide
the drug information needs of nurses.
• To take an active role in the education of health
professional students including medicine, dentistry,
nursing, and pharmacy.
APPROACHES IN PROVIDING DRUG INFORMATION

SERVICES:
• Decentralizing pharmacists in the hospital.

• Offering a clinical consultation service.
• Providing services for a geographic area through a
PURPOSE OF DRUG INFORMATION regional center. Drug Information It should be stored
in the center and retrieved, selected, evaluated, and
To improve the level of patient care by ensuring SAFE and
disseminated by the specialist.
EFFECTIVE use of medicines.
Drug Information
WHAT ARE SOME TERMS TO DRUG INFORMATION?
INFORMATION • It should be stored in the center abd retrieved,

selected, evaluated and disseminated by specialist
• It is the knowledge obtained from investigation,
Drug Information Specialist
study, or instruction.
• It is to describe it as one or more statements or facts • The individual responsible for operation of the
that are received by a human and that have some center
form of worth to the recipient.
• knowledge communicated or received concerning a
particular
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WHAT ARE SOME MEDICATION? Example of Secondary Sources:
• Support for clinical services ➢ Computerized Indexing Systems

• Answering questions ➢ Abstracting Publications
• Pharmacy and therapeutics committee activity
Primary Sources
WHAT ARE SOME MEDICATION INFORMATION
• Often provides the most recent and in-depth
SERVICES?
information about a topic, and allows the reader to
• Education - in services for health professionals, analyze and critique the study methodology to
students, consumers. determine if the conclusions are valid.
• Medication usage evaluation/medication use • Most specific.
evaluation. • Most current.
• Investigational medication control.
Example of Primary Sources:
➢ Institutional Review Board activities - approve,
monitor, and review biomedical and behavioral ➢ Original Research
research involving humans. ➢ Case Studies
• Coordination of reporting programs. e.g. adverse ➢ Manufacturer’s Monograph
drug reactions
Other Sources
• Poison information
• Overseeing clinical trials • Manufacturers
• Expert in the field
WHAT ARE THE DRUG INFORMATION RESOURCES
USED IN PHARMACY? • Internet Websites
• Generally, the best method to find information WHAT ARE PRIMARY RESOURCES?
includes a stepwise approach moving first through: • Original published or unpublished works that
Tertiary > secondary > primary introduce new knowledge or enhance existing
Tertiary Sources knowledge on a subject.
• Include research results and case reports as well as
• Provide the practitioner with general information evaluative and descriptive studies.
needed to familiarize the reader with the topic. • These are the foundation for the secondary and
• Provide rapid access to information tertiary literature
• General source • Provide the most accurate information because they
• Excellent first-line resources contain the original communication of ideas
• Rapid access to information
Advantages
Example of Tertiary Sources:
• Access to detailed information about a topic and the
➢ Textbooks ability to personally assess the utility and validity of
➢ Drug Compendia study results.
➢ Review Articles in journals • More recent than tertiary or secondary literature.
➢ Full text computer/ handheld databases • Peer-reviewed
➢ Internet
Disadvantages
Secondary Sources
• Misleading conclusions based on only one trial
• If the information from the tertiary sources is not without the context of other researches.
recent or comprehensive enough, it may be • There is a need to have good skills in medical
employed to direct the reader to review primary literature evaluation.
articles that might more insight on the literature • Longer time needed to evaluate the large volume of
provide topic. literature available.
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WHAT ARE SECONDARY
• Refers to references that either index or abstract the

primary literature with the goal of directing the user
to primary literature
Indexing
• Consists of providing bibliographic citation

information (e.g., title, author, and citation of the
article)
Abstracting
• Also includes a brief description (or abstract) of the

information provided by the article or resource cited.
• Frequently used to access the primary literature and
usually consist of bibliographic citations.
• Most sources identify citation through computer or
“online” searching process, some exist in print form.
• Can be used for multiple purposes; one can be to
help keep a practitioner of recently published
information
• Find more recent or detailed information on
specified treatment or disease
• Frequently used to access the primary literature and
usually consists of bibliographic citations.
• Available as abstracting services, citations, indexes
with or without full text, and directories.
• Less current than the primary literature.
Advantages
• Saves time
• Cheaper than journal
• On-line easy to search
• Updated information can be sent to you periodically
Disadvantages
• Time lag
The time lag for most secondary sources is 4-8
weeks after primary resource publication
WHAT ARE USEFUL SECONDARY RESOURCES FOR

COMMON CATEGORIES OF DRUG INFORMATION?
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WHAT ARE USEFUL TERTIARY RESOURCES FOR

COMMON CATEGORIES OF DRUG FORMATION?
EXAMPLE OF TERTIARY SOURCES
A. PHARMACOLOGY AND DRUG INFORMATION

SOURCES
Goodman and Gillman's Pharmacological Basis of

Therapeutics
• contains general principles of action, absorption,

distribution and metabolism.
• It is a "gold standard"
Basic & Clinical Pharmacology by Katzung
• is a complete and comprehensive general

• pharmacology text which is utilized nationally as
primary reference for many pharmacology courses
American Hospital Formulary Service (AHFS)

WHAT ARE THE ADVANTAGES AND DISADVANTAGES
OF USING TERTIARY SOURCES • FDA approved and non- labeled uses; extensive
dosage and usage section
TERTIARY SOURCES
• Published annually with quarterly
ADVANTAGES
Handbook on Injectable Drugs
• Convenient and easy to use
• Covers parenteral infusions, drug stability and
• Well accepted in medical practice
compatibility;
DISADVANTAGES • published approximately every two years with an
annual supplement
• Lag time associated with publication
• Medical information changes, may be out of date Micromendex
before it is even published
• an online pharmacology database which has a vast
• Incomplete information
array of information dealing
• Errors ins transcription
• with pharmacology, therapeutics, poison
• Human bias interpretation
information, etc.
• Incorrect information
• Lack of expertise by authors Clinical Pharmacology
• Impossible to compile a comprehensive list of
• an online pharmacology database that consists of
tertiary resources that are useful in all areas of
extensive, peer-reviewed, current, accurate drug
pharmacy practice.
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information for health care providers. Contains full C. INFORMATION ON DRUG SIDE EFFECTS
text information on
Meyler's Side Effects of Drugs
• generic, brand, herbal or investigational drugs
• Side effects of Drugs Annual
Drug Facts and Comparisons
• lists and discusses side effects associated with drug
• FDA approved drugs and investigational and orphan therapy; comprehensive index referenced by drug
agents; legend and OTC listings; and adverse drug reaction
• good quick-source • published approximately
Drug Information Handbook D. OTHER INFORMATION RESOURCES
• alphabetical listing of drugs by generic name; many Remington: The Science and Practice of Pharmacy
charts, algorithms, and tables with information; not
• information concerning the practice of pharmacy
referenced
and pharmaceutical sciences
• published annually
• republished approximately every
Martindale: The Complete Drug Reference
• foreign drug information including selected US

drugs; great resource for obscure information and
for names of drugs in other countries; well
referenced; published by the Royal Pharmaceutical
Society of Great Britain
• published approximately every four years
Physician's DeskReference (PDR)
• FDA approved product information; usage and

• dosage information only as approved by the FDA.
Not useful for finding critical drug information
• updated annually
American Drug Index
• listing of products available in US and cross-

referenced by trade, generic, and chemical names;
various pharmacy type information
• updated editions blihd ll
B. DRUG INTERACTION RESOURCES
Drug Interaction Facts
• Mechanism of drug/drug and drug/food interaction

listed as well as clinical significance; well reference
• updated quarterly for placement binders or available
annually in a text version
Hansten and Horn's Drug Interaction Analysis and

Management
• similar to Drug Interaction Facts; an introductory

chapter provides an excellent discussion regarding
mechanisms of drug interactions
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TOPIC 3: SOURCES OF DRUG INFORMATION PART 2 DRUG FACTS AND COMPARISONS

WHAT ARE TERTIARY SOURCES USED FOR GENERAL
PRODUCT INFORMATION? WolterKluwer Health, Inc.
ASHP DRUG INFORMATION (ASHP DI) • [www.factsandcomparisons.com]
• Organized by DRUG CLASS
American Society of Health - System Pharmacists • Information is provided about specific agents,
(ASHP) including inactive ingredients in commercial
• [www.ashp.org] preparations.
• Organized by MONOGRAPHS
• Containing information on: DRUG INFORMATION HANDBOOK
➢ Food and Drug Administration (FDA) approved Lexi-Comp
medications
• [www.lexi.com]
➢ off-label uses of medications.
• Organized in BRIEF PRODUCT MONOGRAPH
• Information is presented regarding clinical use,
safety , and monitoring for a variety of drugs.
• Contains:
➢ FDA-approved medications
➢ off-label use of medications.
• There is a limited table identification section as part
of the electronic format
HANDBOOK OF CLINICAL
• Organized into MONOGRAPHS and COMPARATIVE

CHARTS.
• Contains information on:
➢ Dosing
➢ Dosing adjustments for special populations
➢ Adverse events
CLINICAL PHARMACOLOGY ➢ Pharmacology
➢ Pharmacokinetic data.
• Gold Standard • Serves as a quick reference rather than an in-
• [http://cp.gsm.com/] depth review
• Has monographs of prescription and non-
prescription products as well as some dietary HANDBOOK OF NONPRESCRIPTION DRUGS: AN
• supplements. INTERACTIVE APROACH TO SELF CARE
• This can also screen drug interactions, create
comparison tables for prescription drugs, determine American Pharmacists Association (APA)
intravenous (IV)compatibility, and search for tablets • [www.aphanet.org]
by description or imprint codes. • Organized by BODY SYSTEM
• Patient education section is also available • focusing on those disease states for which self care
may be appropriate.
DRUGDEX SYSTEM • Contains information on:
➢ Comparative efficacy of various over -the
Thompson MICROMEDEX counter (OTC) agents
• [www.thomsonhc.com] ➢ Contraindications for self-treatment
• This electronic resource is a database within the ➢ Drug interactions
MICROMEDEX system. ➢ Other safety information
• Contains: • Use of treatment algorithms and patient care
➢ FDA-approved indications cases make this resource especially helpful for
➢ off-label uses students and new practitioners.
➢ pharmacokinetic data
➢ safety information
➢ pharmacology
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PHYSICIAN’S DESK REFERENCE (PDR) ➢ Chemical structure

➢ Molecular weight
Thomson Healthcare ➢ Chemical Abstracts Service (CAS) registry
• [www.thomsonhc.com] number
• Compilation of PRODUCT PACKAGE INSERTS. ➢ Pronunciation guide
• Contains additional information:
➢ Contact information for manufacturers ADVERSE EFFECTS
➢ List of poison control centers MEYLER’S SIDE EFFECTS OF DRUGS
➢ Limited tablet identification.
• Available: electronic online package from Thomson Elsevier Publishing
and via MICROMEDEX, as well as in a PDA format. • [www.elsevier.com]
• Specially texts PDR: • Published every 4 years with annual updates
➢ PDR for herbal medicines • Provides a critical review of international literature
➢ PDR for Nutritional supplements in the area of adverse events.
➢ PDR for Ophthalmic medicines • Chapters - Organized by DRUG CLASSIFICATION
• Adverse events - Organized by drug name and then
USP DI VOLUMES I, II, AND III by organ system within
• Information from the United States Pharmacopoeia AVAILABILITY OF DOSAGE FORMS

(USP) Drug Information(DI) resources is also AMERICAN DRUG INDEX
included in MICROMEDEX healthcare Series.
Facts and Comparisons
VOLUME I: • Contains brief entries, indexed by product and
• Contains information for the health care generic name
professional • Contains information on:
• Organized into MONOGRAPHS based on ➢ Product use
nonproprietary names. ➢ Available dosage forms and sizes
• Information included: ➢ Charts are also available, including:
➢ Indications ✓ Look-alike/sound-alike medications
➢ Pharmacology ✓ Pregnancy categories
➢ Pharmacokinetics
RED BOOK
VOLUMES II:
Thomson Healthcare
• Contains advice for the lay person
• Contains information on:
• Material intended to supplement counseling by a
➢ Prescription
health care professional
➢ OTC product availability and pricing
VOLUME III: • Include a number of tables listing information
such as sugar-free, lactose-free, or alcoholic-free
• Information about therapeutic equivalence
preparations.
and USP/National Formulary (NF) requirements
for labeling, storing and packaging drugs. • Additional information:
• Information about regulations and statutes ➢ National Drug Coded(NDC) numbers
➢ Routes of administration
impacting pharmacy.
➢ Dosage form size and strength
• ORANGE BOOK - first portion of this volume and
contains the same information that is available
COMPOUNDING
through the FDA
ALLEN’S COMPOUNDED INFORMATION
USP DICTIONARY OF USAN AND INTERNATIONAL
DRUG American Pharmacists Association
• [www.aphanet.org]
U.S. Pharmacopoeia • A collection of U.S. Pharmacist columns that have
• [www.usp.org] been printed as text.
• Official resource for determining generic and
• Provides method of
chemical names of drugs, as well as the
➢ Preparation
international nonproprietary name.
➢ Stability
• Contains additional information:
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➢ Discussion of utility of the dosage form. • Contains the official substance and product and
product standards.
EXTERMPORANEOUS FORMULATIONS
• Official preparation instructions are given for a
American Society of Health-System Pharmacists limited number of commonly compounded
• [www.ashp.org] products.
• Compilation of PUBLISHED RECIPES with • Some journals are especially useful for
STABILITY DATA. compounding “recipes” (ex. International Journal of
• Most products are ORAL FORMULATIONS to reflect Pharmacy Compounding, U.S. Pharmacist, or
the unique needs of some pediatric patients. American Druggist)
• Information is also provided about LEGAL and PHARMACOLOGY
TECHNICAL ISSUES in compounding practices.
GOODMAN & GILMAN’S:THE PHARMACOLOGICAL
MERCK INDEX BASIS OF THERAPEUTICS
• Provides descriptions of the chemical and McGraw-Hill
pharmacologic information about a variety of • A Classic pharmacology text that provides
products. information about PHARMACOKINETICS and
• Contains: PHARMACODYNAMICS of a number of drugs.
➢ CAS number • Focused to provide a correlation between
➢ Chemical structure PRINCIPLES OF PHARMACOLOGY AND
➢ Molecular weight CONTEMPORARY CLINICAL PRACTICE
➢ Physical data: solubility, which may be
especially useful in compounding. BASIC & CLINICAL PHARMACOLOGY
• Available: print online and on CDROM
Lange
REMINGTON: THE SCIENCE AND PRACTICE OF • [www.mcgraw-hill.com]
PHARMACY • Organized by THERAPEUTIC CLASS OF AGENTS
• Contains:
Lippincott Williams and Wilkins ➢ General discussion of pharmacology principles
• Contains information about all aspects of ➢ More detailed discussion of specific agents
pharmacy practice. • Figures and tables are used frequently to illustrate
• Discussion: difficult
➢ Social issues impacting pharmacy
➢ Information about the basics of pharmaceutics, PRINCIPLES OF PHARMACOLOGY
manufacturing, pharmacodynamics, and
Lippincott Williams & Wilkins
medicinal chemistry.
• [www.lww.com]
• Information is provided regarding common
• Designed for medical students
compounding
• Offers a good discussion of pharmacology in the
A PRACTICAL GUIDE TO CONTEMPORARY PHARMACY context of a variety of biologic processes.
PRACTICE • The use of cases with accompanying study
questions makes clinical application of these
Lippincott Williams and Wilkins
principles easy.
• [www.lww.com]
• A text resource with CD-ROM DRUG INTERACTIONS
• Organized in an OUTLINE FORMAT to easily find
information. HANSTEN AND HORN’S DRUG INTERACTION
• Discussion: ANALYSIS AND MANAGEMENT
➢ Compounding techniques • Updated quarterly
➢ Explanations of additives used in compounding
• Provides RAPID INFORMATION regarding severity
USP / NF and likelihood of an interaction and actions
needed to minimize this risk based on the case
• Available in both text and CD-ROM format studies and primary literature available.
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• Contains: DRUG THERAPY MONITORING SYSTEM

➢ Summaries,
Medi-Span
➢ Mechanisms,
• [www.medi-span.com]
➢ Management options for reported drug
interactions • CD-ROM resource
• Also includes information regarding severity of • Contains information about
interaction and any risk factors that might ➢ Drug-drug interactions
predispose patients to this event. ➢ Drug-food interactions
➢ Drug-alcohol interactions.
DRUG INTERACTION FACTS • Discussions:
➢ Onset of interaction
• Facts and Comparisons
➢ Severity
• [www.factsandcomparisons.com]
➢ Mechanism
➢ Contains information about:
➢ Management
➢ Drug-drug
➢ Drug-food interactions. STOCKLEY’S DRUG INTERACTIONS
• Discussion:
Pharmaceutical press
➢ Significance of the interaction
• [www.pharmpress.com]
➢ Suggestions for management.
• Available in CD-ROM, Internet, and print formats
• Available in both bound and loose-leaf texts.
• Contains concise summaries of drug interactions
• Available: electronically via CD-ROM and as part of
with supporting primary reference citations.
an online subscription
• The text uses both British (British Approved Name
DRUG-REAX (BAN)) and American (United States Adopted
Name(USAN)) drug names.
Thomson MICROMEDEX
• [www.thomsonhc.com] THERAPY EVALUATION AND DRUG CHOICE
• A database within the MICROMEDEX system.
• Contains information about APPLIED THERAPEUTICS: THE CLINICAL USE OF
➢ Drug-drug interactions DRUGS
➢ Drug-food interactions Lippincott Williams & Wilkins
➢ Drug-supplement interactions • [www.lww.com]
• Discussion:
• Contains information about:
➢ Severity ➢ Disease states
➢ Management
➢ Treatment options
➢ LITERATURE about the interaction.
• Information is presented in the form of CASES WITH
➢ Available: CD-ROM, PDA, and the Internet.
FOLLOW-UP DISCUSSION.
EVALUATION OF DRUG INTERACTIONS • Focused on CLINICAL CASE-BASED presentation of
information.
First databank • Available: Pocket sized handbook designed to
• [www.firstdatabank.com] • accompany the text, PDAversion
• A loose-leaf reference • Updated every 3 - 4 years and comes with a CD _
• Organized by DRUG CLASS, about the ROM.
management of various drug interactions.
• Discussion: CECIL TEXTBOOK OF MEDICINE
➢ Mechanism of drug interaction
Saunders
➢ Recommendations for management
• [us.elsevierhealth.com]
➢ Clinical significance
• Contains:
• Available: format of an electronic database.
➢ Etiology
➢ Manifestations
➢ Diagnosis
➢ Treatment
P a g e 16 | 19
➢ Prognosis ➢ Treatment of diseases states

• Organized by DISEASE STATE and COLOR - CODED ➢ Development of a therapeutic plan
to speed usage. • Sections regarding pathophysiology and clinical
• Available: print, CD_ROM, PDA, and Internet presentation are also provided.
[www.cecelmedicine.com] formats • Available: PDA, CD-ROM, and text versions
HARRISON’S PRINCIPLES OF INTERNAL MEDICINE GERIATRIC DOSAGE RECOMMENDATIONS

McGraw-Hill GERIATRIC DOSAGE HANDBOOK
• [www.mcgraw-hill.com]
• Serves as a fairly comprehensive introduction to Lexi-Comp
clinical medicine. • [www.lexi.com]
• Comprehensive information is presented includes:
• Contain TRADITIONAL SECTIONS of drug
➢ Pathophysiology
information, but FOCUS on dosing
➢ Differential diagnosis
recommendations for geriatric patients.
➢ Disease management
• A special section of each monograph
• Available: text, PDA, and electronic formats.
ADDRESSING CONCERNS SPECIFIC TO THE
THE MERCK MANUAL OF DIAGNOSIS AND THERAPY GERIATRIC POPULATION.
• Limited references to primary literature are
Merck & Co. provided.
• [www.merck.com] • Available: online on CD-ROM, and in PDA
• Provides a quick summary of disease state format.
formation, including symptoms, diagnosis and
treatment THE MERCK MANUAL OF GERIATRICS
• Available: online as free resources at Merck & Co.
[http:.//www.merck.com/mrkshared/mmanual/hom
• [www.merck.com]
e.jsp] and as a CD-ROM and a PDA version
• Available in print and online
PHARMACOTHERAPY: A PATHOPHYSIOLOGIC • Focuses primarily on
APPROACH ➢ Management of diseases
➢ Common conditions in geriatric patients
McGraw-Hill ➢ Appropriate dosing of medications
• [www.mcgraw-hill.com]
• Focused on the management of a variety of PEDIATRIC DOSAGE RECOMMENDATIONS
disease states.
• Accompanying texts:
➢ Pharmacotherapy casebook:
❖ A Patient-Focused Approach
➢ Pharmacotherapy Handbook
❖ Information provided about
• disorders includes:
➢ Epidemiology
➢ Etiology
➢ Presentation of disease
➢ Treatment
➢ Treatment outcomes
• Available: CD-ROM
TEXTBOOK OF THERAPEUTICS

• [www.lww.com]
• Focused:
P a g e 17 | 19
THE HARRIET LANE HANDBOOK VETERENARY MEDICINE
Mosby COMPENDIUM OF VETERINARY PRODUCT (CVP)

• [www.mosby.com]
North American Compendiums
• Assembled by medical residents
• [www.prodvm.com]
• Contains a succinct discussion of
• Similar to the human PDR in terms of information
➢ Common diseases and conditions of newborn
provided and format.
to adolescent patients.
• Contains the product monographs for over 4800
➢ Common side effects and dosage forms of
pharmaceutical, biologic, diagnostic, feed
pediatric medications.
additive, and pesticide products that are
• A significant portion of the book is dedicated to
currently available.
medication dosing, specifically pediatrics.
• The reference contains indices of manufacturers
NEOFAX and distributors, brand names/ingredients, and
product categories
• Contains:
➢ Brief drug monographs specific to neonates FOOD AND DRUG ADMINISTRATION/CENTER FOR
arranged by drug therapeutic class. VETERINARY MEDICINE HOMAPAGE
• Each monograph has information about
Food and Drug Administration (FDA)
➢ dose
• [http://www.fda.gov/cvm/default.html]
➢ monitoring,
• Provides information for pharmacists about:
➢ adverse reactions
➢ LEGAL or REGULATORY ISSUES that affect the
➢ preparation of drug
practice of veterinary pharmacy or veterinary
➢ limited references to primary literature.
medicine.
• Available: print, PDA, and online forms
• Useful for regulatory issues pertaining to ANIMAL
PEDIATRIC DOSAGE HANDBOOK HEALTH.
• The compliance policy guide (CPG 608.400)
Lexi-Comp
Compounding of drugs for Use in Animals and the
• [www.lexi.com]
Animal Medicinal Drug Use Clarification Act
• The monographs in this resource contains (AMDUCA)
➢ Traditional sections of drug information ➢ These documents are considered essential
➢ Common extemporaneous preparations reading for any pharmacist who practices
• Focused on detailed dosing recommendations for veterinary pharmacy
pediatrics. • CVM updates contains- detail the prohibited use of
• Limited references is also available online, on CD- drugs in certain animal populations.
ROM and in PDA-format • Updates on the judicious use producing animals of
FOREIGN DRUG IDENTIFICATION antibiotics in food are posted at this site.
➢ Green Book - Listing of all FDA approved animal
EUROPEAN DRUG INDEX drugs
➢ Patent information
European Society of Clinical Pharmacy
➢ Manufacturer lists
• [www.escpweb.org]
➢ Indications
• Offers information about the identification of
➢ Approval numbers
European medications.
➢ General drug information
• Information is provided about dosage form, strength, ➢ Code of regulations
and name of principle ingredients. ➢ Trade/generic names
• Includes a dictionary translating dosage form terms.
THE 5-MINUTE VETERINARY CONSULTANT: CANINE
AND FELINE
P a g e 18 | 19
• Quick reference textbook on internal medicine in • [www.lww.com]

canine and feline health. • Often referred to as Brigg’s
• Focuses: • Focused on the use of medications is pregnant or
➢ Signs and symptoms lactating women.
➢ Drug indications • Contains summaries of the literature available
➢ Laboratory interpretations. regarding fetal exposure in utero or exposure through
• Good appendices are provided on conversion breastmilk
tables, lab vales, drug formularies, and toxicology • In caseswhere human literature is lacking,Animal
Literature is provided
TEXTBOOK OF VETERINARY INTERNAL MEDICINE:
• Additional information about recommendations by
DISEASES OF THE DOG AND CAT
organizations such as the American Academy of
W.B. Saunders Company pediatrics is provided.
• [www.us.elsevierhealth.com/Veterinary]
INCOMPATIBILITY AND STABILITY
• Practical, useful, and informative TWO-VOLUME
RESOURCE. HANDBOOK OF INJECTABLE DRUGS
• Focused on internal medicine topics in canines
American Society of Health System Pharmacists
and felines.
• [www.ashp.org]
• Provides extensive coverage of pathophysiology,
diagnosis, and treatment of diseases affecting • Commonly called Trissel’s
dogs • Contains:
➢ Compatibility, and
VETERENARY DRUG HANDBOOK ➢ Stability of various parenteral
➢ Commercially available strengths.
Blackwell Publishing
• Information is provided in the form of CHARTS and
• [www.blackwellprofessional.com]
TABLES, making finding information relatively quick.
• Written by a pharmacist.
• Available: pocket sized handbook and a CD-ROM
• Consideredone of the most useful references for:
version
➢ Off-label drug dosages
➢ Indications KING GUIDE TO PARENTERAL ADMIXTURE
➢ Specific drug information on human
➢ Indications veterinary-label pharmaceutical ed King Guide publications
• Monographs are listed in alphabetical order an • [www.kingguide.com]
categorize drugs chemistry,pharmacology, • Contains over 400 IV drug monographs
indication dosages, contraindications, and • Focused on COMPATIBILITY INFORMATION.
interactions into an easily identifiable format. • Limited information about stability is available .
• Pharmacists should also be aware that more • Available: loose-leaf, bound copy, CD-ROM, as an
resources are becoming available in a variety of Internet resource, and for PDAs.
formats.
TRISSEL’S STABILITY OF COMPOUNDED
• Available: client information booklet, CD-ROM, the
FORMULATIONS
Internet, or via PDA.
• Electronic resources are often preferred because: American Pharmacists Association
➢ Easier to use • [www.aphanet.org]
➢ Allow quicker access to information • Information is provided on nearly 300
➢ Allow multiple searches to be performed compounded oral, enteral, ophthalmic, and
simultaneously topical formulations, organized by drug name.
➢ Often contain the most recent information • Provides extensive citations of the stability and
available regarding a topic formulation studies.
• Has limited discussion of compatibility with other
TERATOGENICITY / LACTATION
drug products
DRUGS IN PREGNANCY AND LACTATION

P a g e 19 | 19

Phin Prelims Lec 1

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PHARMACY INFORMATICS

SECOND SEMESTER – PRELIMS / LECTURE

TOPIC 1: INTRODUCTION TO PHARMACY APPLICATIONS OF HEALTH INFORMATICS IN THE

WHAT IS PHARMACY INFORMATICS? 1. Hospital administration, billing and accounting

WHAT ARE THE OTHER TERMS RELATED TO

• The study and application of information

HOW DOES INFORMATICS IMPACT HEALTH?

• Construct computer health information systems by

MEDICAL INFORMATICS EXAMPLE:

• A context-sensitive electronic prompt to the provider

• It is a patient- and context-sensitive prompt to the

• It is the "delivery of health care services, where

• It refers to the practice of caring for patients remotely

TOPIC 2: INTRODUCTION TO PHARMACY 2. KNOWLEDGE DELIVERY

• Knowledgeable about both pharmacy practice and

ROLES OF AN INFORMATICS PHARMACIST

• Ensure patient safety 3. DATA ANALYSIS

• Leadership • Also called as medication information, or drug

Late 1800’s – Capital Avenue Drugstore was connected

• The skills needed to implement this knowledge in April 1924

• The concept “Teledactyl” was introduced by Hugo

The first uses of telemedicine is to transmit video, images,

• used interactive telemedicine to transmit

• The rise of the Internet in the 1990s also brought with

❖ Some of the affordable measurement devices that

TOPIC 2: SOURCES OF DRUG INFORMATION PART 1 MEDICATION INFORMATION

DRUG INFORMATION • Used to convey the MANAGEMENT and USE of

APPROACHES IN PROVIDING DRUG INFORMATION

• Decentralizing pharmacists in the hospital.

INFORMATION • It should be stored in the center abd retrieved,

WHAT ARE SOME MEDICATION? Example of Secondary Sources:

• Support for clinical services ➢ Computerized Indexing Systems

WHAT ARE SECONDARY

• Refers to references that either index or abstract the

• Consists of providing bibliographic citation

• Also includes a brief description (or abstract) of the

WHAT ARE USEFUL SECONDARY RESOURCES FOR

WHAT ARE USEFUL TERTIARY RESOURCES FOR

EXAMPLE OF TERTIARY SOURCES

A. PHARMACOLOGY AND DRUG INFORMATION

Goodman and Gillman's Pharmacological Basis of

• contains general principles of action, absorption,

Basic & Clinical Pharmacology by Katzung

• is a complete and comprehensive general

American Hospital Formulary Service (AHFS)

Drug Information Handbook D. OTHER INFORMATION RESOURCES

• foreign drug information including selected US

Physician's DeskReference (PDR)

• FDA approved product information; usage and

American Drug Index

• listing of products available in US and cross-

B. DRUG INTERACTION RESOURCES

Drug Interaction Facts

• Mechanism of drug/drug and drug/food interaction

Hansten and Horn's Drug Interaction Analysis and

• similar to Drug Interaction Facts; an introductory

TOPIC 3: SOURCES OF DRUG INFORMATION PART 2 DRUG FACTS AND COMPARISONS

• Organized into MONOGRAPHS and COMPARATIVE

PHYSICIAN’S DESK REFERENCE (PDR) ➢ Chemical structure

• Information from the United States Pharmacopoeia AVAILABILITY OF DOSAGE FORMS

• Contains: DRUG THERAPY MONITORING SYSTEM

➢ Prognosis ➢ Treatment of diseases states

HARRISON’S PRINCIPLES OF INTERNAL MEDICINE GERIATRIC DOSAGE RECOMMENDATIONS