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Drug Resources

Drug Resources. Nancy Clark , MEd , Director Medical Informatics Education Mark Strickland , MD, Informatics Curriculum Director, TLH Regional Campus . Objectives. Find the Drug Reference Library web page

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Drug Resources

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  1. Drug Resources Nancy Clark, MEd, Director Medical Informatics Education Mark Strickland, MD, Informatics Curriculum Director, TLH Regional Campus

  2. 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

  3. Handouts • Evaluations • Drug References Handout • Worksheet • Instructions for email alerts Top 200 Drugs Prescribed 2008 www.rxlist.com

  4. Using the green Worksheetas we go thru the workshop,identify drug questions you can use with students.

  5. New Library Webpage (Fall 2010)

  6. Library Web Site

  7. Subscription Drug Resources • 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 on how to get alerts)

  8. PDA Drug Resources • Epocrates Essentials • PEPID • Harrison’s Practice • Pediatric Care Online • Dynamed Available free to all faculty

  9. 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

  10. Who Has What?

  11. Epocrates Essentials

  12. Epocrates Essentials iPhone/iPod Get Back Formulary Add to Favorites Prescription, Alt Meds and OTC are combined in same list.

  13. Epocrates Essentials Rx • Search by drug or class • Rx • Alt • OTC • Compare sub-categories of each type

  14. Alt Meds Comparing Sub Categories Rx OTC Add to Favorites

  15. Dosage Calculator in Epocrates iPhone • Online Dosage Calculator • http://www.medcalc.com/pedidose.html

  16. 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 acetylcysteineis indicated for acetaminophen toxicity. Calculate the dosage of acetylcysteine for the child. He weighs 50 lbs.

  17. Epocrates PDA MultiCheck 1. Type 2. Pick drug 3. Click + 6. Tap Interaction 4. Repeat until all drugs in list 5. Click View Interactions

  18. Exercises for Practice • Epocrates PDA: lisinopril, metformin, and hydrochlorothiazide • Peds example: isoniazid, rifampin, ethambutol, acetaminophen

  19. Epocrates Formularies • Go to Epocrates.com • Manage My Account • Pick Formularies • Sync/update to add

  20. 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?

  21. Epocrates iPhone Pill Identifier

  22. Exercises for Practice What is this pill?

  23. Epocrates PDA ID Tool

  24. 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)

  25. Tables

  26. Rx, OTC and Alt Meds Epocrates online

  27. Browsing Epocrates ONLINE 1. Pick a letter 2. Pick drug

  28. Search for a Drug 1. Type 2. Pick drug

  29. Using Classes 2. Pick sub category 1. Pick category 3. Pick drug

  30. Prescription Drug Monographs 1. Pick category

  31. Dosage Calculator

  32. Alt Meds Monographs 1. Pick category

  33. OTC Monographs

  34. 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)

  35. Epocrates ONLINE Formulary 1. Pick formulary 2. Click to see meaning

  36. Epocrates ONLINE Formulary 1. Click Code 2. Under View Alternatives, click class Alternatives

  37. Finding Substitutes Codes

  38. 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

  39. Another Formulary Option

  40. Epocrates ONLINE MultiCheck Tool 1. Type 2. Click drug Interactions appear as found Repeat until all drugs in list

  41. Exercises for Practice • Check for Interactions: digoxin, furosemide, lisinopril • Peds example: isoniazid, rifampin, ethambutol, acetaminophen

  42. Epocrates ONLINE Pill Identifier Scroll through results until you find your pill. Click name to go to monograph. Pick shape, color, etc. If imprint readable, type it in and click Identify Pills

  43. Epocrates Online Tables

  44. Epocrates Vaccinations

  45. 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?

  46. PEPID

  47. PEPID Drug Information 1. Click on Dose

  48. PEPID Drugs iPhone 1. Pick CRC

  49. 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?

  50. PEPID Interaction Tool

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