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Answering Drug Information Questions. Presented by: Andrew Hamilton . Date: November 7, 2008 . Answering Drug Information Questions. Subtitle. Drug Information questions can be broken down into the following elements: Nomenclature & Identification Therapeutic Usage Adverse Effects

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answering drug information questions

Answering Drug Information Questions

Presented by: Andrew Hamilton

Date: November 7, 2008

answering drug information questions1
Answering Drug Information Questions

Subtitle

  • Drug Information questions can be broken down into the following elements:
    • Nomenclature & Identification
    • Therapeutic Usage
    • Adverse Effects
    • Business & Economics
    • Governmental Regulation
answering drug information questions2
Answering Drug Information Questions
  • Nomenclature & Identification
    • Identifying the name of a drug
    • Finding synonymous names & codes for a drug
    • Determining the chemical composition and physical properties of a drug
    • Identifying other drugs that possess a similar chemical structure or mode of action
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Answering Drug Information Questions
  • Therapeutic usage
    • Determining which diseases are approved to be treated by a drug
    • Discovering how a drug works to achieve its therapeutic activity
    • Finding the recommended dosage and route administration of a drug
    • Learning how a drug is absorbed, distributed, metabolized, and excreted
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Answering Drug Information Questions
  • Adverse Effects
    • Side effects
    • Interactions
      • Drug/Drug
      • Drug/Food
      • Drug/Herb
    • Toxic potential
    • Contraindications
    • Teratogenicity
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Answering Drug Information Questions
  • Business & Economics
    • Drug prices
    • Drug sales
    • Drug companies
      • Drug Manufacturers
      • Drug Stores
    • Most commonly prescribed drugs
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Answering Drug Information Questions
  • Government regulation
    • Drug approval process
    • Identifying which countries have approved the usage of a specific drug
    • The restriction or prohibition of the usage of specific drugs (controlled substances)
    • Policies and codes regulating the manufacture, distribution, and sales of pharmaceutical agents
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Answering Drug Information Questions
  • Names & Classifications of Drugs
    • Drugs can be referred to by a number of synonymous names and codes.
    • These terms fall into three basic categories
      • Names
      • Codes
      • Classifications
  • Using Nitroglycerin as an example, we’ll examine the different terms that refer to it
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Answering Drug Information Questions
  • Names
    • Chemical
      • 1,2,3-Propanetriol trinitrate
      • Glycerol trinitrate
      • Nitroglycerin
    • Approved Name (USAN,INN,BAN,JAN)
      • Nitroglycerin
    • CAS#
      • 55-63-0
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Answering Drug Information Questions
  • Names
    • Trade Names
      • +200 proprietary names for Nitroglycerin are listed in ChemIDplus
    • NDC
      • 177 different NDC codes exist for Nitroglycerin formaulations
    • Molecular formula
      • C3H5N3O9
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Answering Drug Information Questions
  • Names
    • Structural formula
    • Where are the five hydrogen atoms?
      • H atoms are often not shown in structural formulas
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Answering Drug Information Questions
  • Classifications
    • Classifications serve to organize drugs into groups. In pharmacology, they fall into three categories based on the following criteria:
      • Chemical structure
      • Pharmacologic action
      • Therapeutic use
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Answering Drug Information Questions
  • Classifications
    • Nitroglycerin is classified in the following ways
      • Chemical
        • Nitrate
      • Pharmacologic action
        • Vasodiltor
      • Therapeutic use
        • Anti-anginal agent
    • Nitroglycerin is also industrially classified as an explosive agent
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Answering Drug Information Questions
  • What is the difference between pharmacologic action & therapeutic use?
    • Pharmacologic action refers to what the drug does
      • Beta adrenergic blocker, Serotonin uptake inhibitor
    • Therapeutic use refers to the condition that the drug is treating
      • Antihypertensive, Anti-depressive agent
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Answering Drug Information Questions
  • Adverse Drug Reactions (ADR)
    • ADRs are the greatest cause of patient non-compliance with therapeutic interventions
    • At least 1.5 million Americans are sickened, injured or killed each year by ADRs
    • ADRs are 4th leading cause of death in the United States
    • Estimated annual cost of ADRs is $136 billion
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Answering Drug Information Questions
  • Adverse Drug Reaction
    • Refers to any harmful/undesired/irrelevant effect of a drug
    • Categories of ADR include
      • Side effect
      • Interaction
      • Toxicity
      • Teratogenicity
      • Contraindication
      • Precautions
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Answering Drug Information Questions
  • Side Effect
    • Secondary effect of a drug that sometimes accompany the desired therapeutic effect
    • Side effects are seen when the drug is being given at the normal therapeutic dose
    • Side effects are not necessarily harmful
      • Both Rogaine & Viagra started off being used as Anti-hypertensives
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Answering Drug Information Questions
  • Drug interaction
    • An alteration in the properties of a drug that manifests itself only in the presence of a another drug (or class of drugs)
    • Interactions involve a precipitant drug affecting the effects of the object drug
    • Effects can range from being life-threatening to clinically insignificant
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Answering Drug Information Questions
  • Interactions – Nitroglycerin
    • Aspirin increases serum levels of NG which results in the increase of its effect relative to the administered dosage
    • NG causes a decrease in the activity of a common anti-coagulant, Heparin
    • Interactions are common when two drugs compete to be metabolized via the same enzymatic pathway
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Answering Drug Information Questions
  • Other interactions
    • Drug/Test
      • NG interferes with the reaction used in the lab test that measures serum cholesterol resulting in the underestimation of a patients cholesterol level
    • Drug/Food & drink
      • Alcohol potentiates the effect of NG, possibly triggering a hypotensive crisis and cardiovascular collapse
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Answering Drug Information Questions
  • Other interactions
    • Drug/Equipment
      • NG is actively absorbed by PVC tubing with the degree of absorption determined by:
        • The rate of flow
        • The concentration of NG
        • The length of the tube
      • Only glass bottles & non-PVC tubing can be used to deliver NG intravenously
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Answering Drug Information Questions
  • Toxicity
    • Describes effects seen when a drug is administered at a dosage greater than that normally used for therapy or has been used for an extended period of time
      • Acetaminophen – unintentional ingestion of more than recommended maximum daily dose may result in liver injury & abdominal pain.
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Answering Drug Information Questions
  • Poisoning
    • Refers to the administration or ingestion of a life-threatening dose of drug
      • Acetaminophen – normal dose is 650-1000mg, but permanent liver failure can occur at 10x the normal dose
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Answering Drug Information Questions
  • Contraindication
    • A circumstance or condition that causes the administration of the drug to become inadvisable or inappropriate
      • Xanax is contraindicated in patients with narrow angle glaucoma
      • Morphine is contraindicated in patients with severe asthma
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Answering Drug Information Questions
  • Precaution
    • Indicates situation where greater caution must be exercised with the use of the drug
      • Propranolol must be used with caution in diabetics due to its ability to mask hypoglycemia and in patients w/ impaired liver function due to their reduction of the ability to metabolize it
    • A precaution does not preclude the use of the drug in indicated cases but does require greater vigilance to monitor the patient
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Answering Drug Information Questions
  • Teratogen
    • A drug capable of producing developmental abnormalities in an embryo, fetus, or postnatal individual
      • Thalidomide – When introduced as a sleep aid in the early 1960’s it caused a number of limb deformities due to its teratogenic properties
      • Accutain – Used to treat acne, it carries a high risk of causing deformities if a developing embryo/fetus is exposed to it
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • IDENTIFICATION – US DRUG NAMES
      • USP Dictionary of USAN and International Drug Names.
      • American Drug Index.
      • Merck Index.
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • IDENTIFICATION – FOREIGN DRUG NAMES
      • Index Nominum
      • International Nonproprietary Names (INN) for pharmaceutical substances
      • Martindale: the complete drug reference (Warning: – Does not provide an A-Z name index)
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • THERAPEUTIC USAGE – ARRANGED BY DRUG CLASS
      • AHFS Drug Information
      • Drug Facts and Comparisons
      • Martindale: the complete drug reference
    • THERAPEUTIC USAGE – ARRANGED BY NAME
      • USP DI Volumes I-II
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • THERAPEUTIC USAGE – ARRANGED BY DISEASE
      • Harrison’s Principles of Internal Medicine
      • Applied Therapeutics: The Clinical use of Drugs. Author: Mary Anne Koda-Kimble
    • THERAPEUTIC USAGE – ARRANGED BY MANUFACTURER
      • Physicians‘ Desk Reference : PDR.
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • THERAPEUTICS – NONAPPROVED INDICATIONS
      • Drug Facts & Comparisons
      • Martindale: The complete drug reference
    • THERAPEUTIC USAGE – PEDIATRICS
      • The Harriet Lane Handbook : a manual for pediatric house officers.
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • ADVERSE EFFECTS
      • Meyler's Side Effects of Drugs/Dukes Annual.
      • AHFS Drug Information
      • Facts & Comparisons
    • ADVERSE EFFECTS – INTERACTIONS
      • Drug Interactions : Analysis and Management. Authors: Philip D. Hansten & John R. Horn.
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • ADVERSE EFFECTS – DERMATOLOGIC
      • Litt’s Drug Eruption Reference Manual. Author: Jerome Z. Litt
    • ADVERSE EFFECTS – TERATOLOGY
      • Drugs in Pregnancy and Lactation. Author: Gerald Briggs.
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • ADVERSE EFFECTS – IN VITRO COMPATIBILITY
      • Handbook on Injectable Drugs. Author: Lawrence A. Trissel.
    • OTC DRUG INFORMATION
      • Handbook of Non-prescription Drugs.
    • PHARMACOLOGY (HOW DRUGS WORK)
      • Goodman & Gilman's the Pharmacological Basis of Therapeutics.
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • BUSINESS & ECONOMICS
      • Red book : Pharmacy's Fundamental Reference.
      • Remington : the Science and Practice of Pharmacy.
    • REGULATORY INFORMATION
      • USP DI Vol III.
      • Remington : the Science and Practice of Pharmacy.
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • INFORMATION FOR THE PATIENT
      • USP DI Vol II.
      • Essential Guide to Prescription Drugs. Author: James Rybacki
      • Complete Guide to Prescription & Nonprescription drugs. Author: H. Winter Griffith, Updated by Stephen Moore.
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • TOXICOLOGY
      • Patty’s Toxicology
      • Sax's Dangerous Properties of Industrial Materials
      • Disposition of Toxic Drugs and Chemicals in Man. Author: Randall C. Baselt
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Answering Drug Information Questions
  • Printed Drug Reference Sources
    • SUBJECT GUIDES
      • Drug Information. Author: Bonnie Snow
      • Using the Pharmaceutical Literature. Author: Sharon Srodin
      • Information Resources in Toxicology. Editor: Philip Wexler
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Answering Drug Information Questions
  • Online Drug Reference Sources
    • Comprehensive resources
      • AHFS Drug Information
      • Facts & Comparison
      • Micromedex
      • Gold Standard Clinical Pharmacology
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Answering Drug Information Questions
  • Online Drug Reference Sources
    • Name Identification
      • Rxlist.com (fuzzy logic spellchecker)
      • ChemIDPlus.gov
      • Drugs@fda.gov
      • Drugs.com (phonetic search)
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Answering Drug Information Questions
  • Online Drug Reference Sources
    • Pill Identification
      • Drugs.com
      • Rxlist.com
      • Drugdigest.com
      • WebMD.com
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Answering Drug Information Questions
  • Online Drug Reference Sources
    • New Drugs
      • Drugs@fda.gov
      • Centerwatch.com
      • Drugs.com
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Answering Drug Information Questions
  • Online Drug Reference Resources
    • Manufacturers
      • Druginfonet.com
      • Medilexicon.com
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Answering Drug Information Questions
  • Online Drug Reference Sources
    • Toxicology
      • TOXNET.gov
        • Includes HSDB, LactMed, Household products databank
    • Consumer Health
      • MedlinePlus
      • NOAH