Drug information by million N

By Million N( B pharm, pediatric
clinical pharmacist) 2015.
@ milla, AAU, Black lion

Objectives
After completing this chapter, the reader will be able to;-
1. Define the term drug information, ( INTRODUCTION).
2. Describe the importance of drug information centers in the evolution of
pharmacy practice.
3. Identify the services provided by drug information centers.
4. Identify medication information functions performed by individual
pharmacists.
5. Describe the skills needed by pharmacists to perform medication
information functions.
6. Identify major factors that have influenced the ability of pharmacists to
provide medication information.
7. Describe practice opportunities for a medication information specialist.

Course out lines
 Chapter -1
 Introduction to the Concept of Medication Information
 Chapter -2


Introduction
 The provision of medication information is among the most
fundamental responsibilities of pharmacists.
 The information may be either patient specific, as an integral
part of pharmaceutical care, or relative to a group of patients,
 The pharmacist can serve as;-
 a resource for issues regarding cost-effective medication selection and
use,
 medication policy decisions (drug benefits),
 medication information resource selection, or practice-related issues

 The pharmacist can serve as a resource for issues
regarding cost-effective medication selection and
use, medication policy decisions (drug benefits),
medication information resource selection, or
practice-related issues.
 Medication information opportunities are developing
and expanding with changes in the health care
environment.

 With national efforts to expand access to care while reducing
health care cost, the advent of consumerism, and the
integration of new technologies, medication information
opportunities are growing in several areas including;
 managed care organizations,
 pharmaceutical industry,
 medical and specialty care clinics,
 scientific writing and medical communication companies,
 and the insurance industry.

Beginning
 The term drug information developed in the early 1960s when
used in conjunction with the words center and specialist.
 In 1962, the first drug information center was opened at
the University of Kentucky Medical Center.
 From that date on;- An area separated from the pharmacy was
dedicated to provide drug information.

DRUG INFORMATION
 Drug literature is growing rapidly in size.
 It is also increasingly complex, i.e., interdisciplinary and
interprofessional in nature.
 Thus, drug information ‘sprawls
across’ many professional journals of the most varied
types.
 Its effective use by the practitioner offers many
difficulties.”
 Competent evaluation of masses of drug information is
particularly necessary.

The center was to be;
 a source of selected, comprehensive drug information,
 Place for staff physicians and dentists to evaluate and compare
drugs,
 to provide for the drug information needs of nurses,
 Place for education of health professional students including
medicine, dentistry, nursing, and pharmacy.
 A stated goal was to influence pharmacy students in developing their
role as drug consultants.

 Several other drug information centers were established shortly
thereafter,
 Different approaches to provide drug information services included ;-
 decentralizing pharmacists in the hospital,
 offering a clinical consultation service, and providing services for
ageographic area through a regional center.
 The individual responsible for operation of the center was called the
drug information specialist.

DIC
 The term drug information may have different meanings to
different people depending on the context in which it is used.
 If asked to define this term, one could describe it as printed
information in a reference or verbalized by an individual that
pertains to medications.
 which include the following;- personnels are;-
• Specialist/practitioner/pharmacist/provider
• Center/service/practice
• Functions/skills

Definition
 It is an academic-based drug information center,
a unit operated under the faculty of medicine
within the therapeutic committee.
 The provision of medication information is among
the most fundamental responsibilities of
pharmacists.

 the term medication information is used in place of drug
information to convey the management and use of information on
medication therapy and to signify the broader role that all
pharmacists take in information provision.
 Drug informatics is another term used to describe the evolving roles
of the medication information specialist.
 Drug informatics emphasizes the use of technology as an integral
tool
in effectively organizing, analyzing, and managing information on
medication use in patients.

DIC personnel's
 Drug information pharmacists working in centers appear
to be better trained than those in the past and a larger
percentage have a doctor of pharmacy degree.
 More are clinically trained
 They are top class academically
 Computer training was the center of services
 Always ready for change educationally
 Member of therapy committee

 All pharmacists must be effective medication information providers
regardless of their practice.
 an effective provider;-
 perceives, assesses, and evaluates medication information needs
and
 retrieves, evaluates, communicates, and applies data from the
published literature and other sources as an integral component of
patient care.
 Developing the skills of an effective medication information provider
is the
foundation for the pharmacist to be a lifelong learner and problem
solver.

FROM CENTERS TO PRACTITIONERS
 Among deficiencies in the health care system, one is the
unavailability of adequate information for those who consume,
prescribe, dispense and administer drugs.
 This deficiency has resulted in inappropriate drug use and an
unacceptable frequency of drug-induced disease.
 Pharmacists are seen as health professionals who could make an
important contribution to the health care system of the future by
providing information about drugs to consumers and health
professionals.
 Education and training of pharmacists now and in the future must be
developed to meet these important responsibilities.

 Pharmacists involved in patient care areas (e.g.,
hospitals, clinics, long-term care, and home health
care) now frequently answer drug information
questions.
 Over time, the activity of the pharmacist as a
medication expert for patients has gained
acceptance in a variety of practice settings including
community pharmacies, nursing
homes, and primary and specialty practices in
medicine.

Missionfunctions of DI
 Toincrease the community knowledge and
awareness about drug and drug usage.
 Promote rational drug use at individual
level,

Role
 DIC is a service that answers questions
for healthcare professionals who take
care of patients, including referring
physicians…..

 For poison control
 For pharmaceutical industry( scope)
 For academia( curriculum set)
 For scientific writing and medical communication

Types of DIstions ?
Drug availability
Drug identification
Drug therapy and efficacy
Investigational drugs
Side effects and adverse effects
Drug dosage and administration
Drug interactions

Cont.
Drug use during pregnancy and while breastfeeding
IV compatibility and stability
Pharmacokinetics
Toxicology
Alternative medications and natural products

Services
1
• Provision of drug information and supporting
documentation to questions posed by health care
practitioners
2
• Provision of consultative services in various areas
3
• Participation in pharmacology-related research

EDUCATING FOR THE NEED
 The education of pharmacists continues to evolve in scope and
depth.
 Many areas identified as needed by the drug (medication)
information specialist are now incorporated into pharmacy curricula
and taught to all pharmacists.
 There were several key concepts that were developed;-
I. drug information should be a required component of the
pharmacy curriculum,
II. drug information concepts and skills should be spread throughout
the curriculum, beginning the day students enter pharmacy school,
III. problem solving should be a major technique in drug information
education,

Ethical considerations in DIC
 All pharmacists provide drug information and must
address the ethical dilemmas that arise
in the course of providing this service. Such
dilemmas may arise in a wide variety of settings
and circumstances where pharmacy is practiced.

Legal Issues
 Negligence
 Confidentiality
 Data protection Act 1998
 Human Rights Act 1998
 Freedom of Information Act 2000
 Consent
 Unlicensed medicines (Medicines Act 1968)
 Copyright

Ethical Principles
 Autonomy
 Beneficence
 Non-maleficence( do harm)
 Justice

Diallemas
1. The community pharmacist requested by a patient at the counter to
critique another
health care provider’s recommendations.
2. The hospital practitioner asked to provide information that might be used
to speed the ending of a terminal patient’s life.
3. The drug information specialist confronted by a physician, or an
administrator, pressuring for a certain formulary recommendation .
4. without such legal requirements omits all safety information for
reimbursement of insurance.
5. who finds workload demands to be an impossible( barrier) to providing
more than the minimum, legally required information.
6. The pharmacist working in industry, who is asked to prepare two versions
of a consumer product promotion

What we need for DIC
DIC
TEAM
PLACE
HARDWARESOURCES
CONTACT

Residents
The team
Chief
Director
Vice
Director Expert pharmacist

Place & Hardware
‘The place should be
fixed and full filled
with suitable
hardware’

Sources
‘The information should be properly updated
and maintained.’

I- Primary Source

II- Secondary Source

III- Tertiary Source

Other Sources
Information from the public and hospitals about the
Adverse effects of any drug.
Local drug lists
National Formularies
Hospital Formularies
Internet

Contact
Internet (request form - Email)
Phone
Fill request form in center

Request form

Chapter 2
Approach to Answering Questions
Pharmacists are asked to provide responses to a variety of
drug information questions everyday.
While the type of requestor, query, and setting can vary,
the process of formulating responses remains constant.

 An essential component within pharmacy practice is the
ability to effectively answer questions posed by health
care professionals and the lay public.
 presented a systematic approach for responding to drug
information requests.

The systematic approach comprised of five steps,

SYSTEMATIC APPROACH (1975)
 Step I. Classification of the request
Step II. Obtaining background information
Step III. Systematic search
Step IV. Response
Step V. Reclassification
 These approaches can be applied in any area while
practicing pharmacy, including;-
 community pharmacy,
 pharmaceutical industry,
 institutional pharmacy management, as well as general application in
any type of professional consultation.

modified systematic approach,
 Step I. Secure demographics of requestor
Step II. Obtain background information
Step III. Determine and categorize ultimate question
Step IV. Develop strategy and conduct search
Step V. Perform evaluation, analysis, and synthesis
Step VI. Formulate and provide response
Step VII. Conduct follow-up and documentation

 accept the initial question and secure requestor demographics.
 Why is the requestor asking for this information?
 By;-
 The requestor’s name
The requestor’s location and/or pager number
The requestor’s affiliation (institution or practice) if a health care professional
The requestor’s frame of reference (i.e., title, profession or occupation, and
rank)
The resources that the requestor already consulted
Whether the request is patient specific or academic
The patient’s diagnosis, other medications, and pertinent medical information
The urgency of the request (i.e., negotiate the time response)

 Formulating a response involves a series of steps that
must be performed completely, objectively, and in a
logical sequence.
 The steps in this process include ;-
 assembling and organizing a patient database,
 gathering information about relevant disease states,
 collecting medication information,
 obtaining pertinent background information, and
 identifying other relevant factors and special
circumstances

FACTORS TO BE CONSIDERED WHEN FORMULATING A RESPONSE
 Patient Factors

Demographics (e.g., name, age, height, weight, gender, race/ethnic group, and
setting)
Primary diagnosis and medical problem list
Allergies/intolerances
End-organ function, immune function, nutritional status
Chief complaint
History of present illness
Past medical history (including surgeries, radiation exposure, immunizations,
psychiatric illnesses,and so forth)
Family history and genetic makeup
Social history (e.g., alcohol intake, smoking, substance abuse, exposure to
environmental or occupational toxins, employment, income, education, religion, travel,
diet, physical activity, stress, risky behavior, and compliance with treatment regimen)
Review of body systems
Medications (prescribed, over-the-counter, and complementary/alternative)
Physical examination
Laboratory tests
Diagnostic studies or procedures

 Disease Factors
Definition
Epidemiology (including incidence and prevalence)
Etiology
Pathophysiology (for infectious diseases, consider site of infection,
organism susceptibility, resistance
patterns, and so forth)
Clinical findings (signs and symptoms, laboratory tests, diagnostic
studies)∗
Diagnosis
Treatment (medical, surgical, radiation, biologic and gene therapies,
other)
Prevention and control
Risk factors
Complications
Prognosis

 Medication Factors
Name of medication or substance (proprietary, nonproprietary, other)
Status and availability (investigational, over-the-counter, prescription,
orphan, foreign,
complementary/alternative)
Physicochemical properties
Pharmacology and pharmacodynamics
Pharmacokinetics (liberation, absorption, distribution, metabolism,
and elimination)
Pharmacogenetics
Uses (Food and Drug Administration [FDA] approved and unlabeled)
Adverse effects
Allergy
Cross-allergenicity or cross-reactivity

Process
First:
All inquiries to the DIC are documented and
responses are indexed and filed.
Second:
When contacting the DIC, the following information
is requested
1) Contact information
2) Actual question and the underlying reason
3) Background information
4) When the verbal/written response is needed

Steps in Answering:
Classification of question
Background Information
Search of literature
Preparation of Response or answer

Steps in Answering:
Step 1: Secure Demographics of Requestor
Step 2: Obtain Background Information
Step 3:Determine and Categorize the Ultimate Question
Step 4:Develop Strategy and Conduct Search
Step 5:Perform Evaluation, Analysis, and Synthesis
Step 6:Formulate and Provide Response
Step 7:Conduct Follow-Up and Documentation

Thank you
for now…

Drug information by million N

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