Drug information involves providing clinically relevant information about drug use to patients or healthcare professionals. A drug information center specializes in answering questions about medicines and provides unbiased information to support rational drug use and patient care. When answering drug information queries, pharmacists follow a systematic process of understanding the request, researching resources, evaluating evidence, formulating a response, and documenting outcomes.

1. -DRUG INFORMATION-
Definition-
Drug information means providing clinically relevant information on any aspect of drug use
relating to individual patients, or general information on how best to use drugs for
populations.
• Drug information service can be applied to any activity where information about drug
use is transferred, and includes patient related aspects of pharmaceutical care.
• A Drug information center is an area where pharmacists (or other health care
professionals) specialise in providing information to health professionals or public.
• The drug information centre provides authenticate, unbiased information to healthcare
professionals, provide tailor-made counselling and health information to
patients/consumer as well as monitor and document adverse drug reactions.
DRUG INFORMATION:
• The first drug information centre was opened in 1962 at the university of Kentucky
medical centre and was intended to be utilised as a source of selected, comprehensive
drug information.
• A drug information centre can also contribute to pharmacovigilance (adverse drug
reaction reporting), drug use reviews, health education programmes and clinical
research.
The objectives of DIC are:
• To provide an organized database of specialized information on medicines and
therapeutics to meet the drug information needs of practitioners.
• To educate pharmacy students to serve as effective providers of medicines
information.
• To provide accurate and unbiased medicines information service to the pharmacists,
physicians and other health care professionals in the hospital and community.
• To promote patient care through rational use of medicines.

2. DRUG INFORMATION RESOURCES:
• Textbooks, newsletters, journals,
• Newsletters, microfiche reader,
• Optical discs,
• Computer systems
• Tertiary resources >>>Secondary resources >>>Primary resources
Primary resources:
• Primary literature describes unique experiences which change the world in terms of
available knowledge.
• They are the foundation on which all other drug information is based. These include
journal publications on drug-related subjects, such as reports of clinical drug trials,
case reports, and pharmacological research. Evaluating primary literature is difficult.
• The most reliable evidence comes from reports on randomized controlled trials.
Proper evaluation of these trials requires considerable experience, and systematic
reviews of combined trials (meta-analyses) may be necessary.
• Sources:
• ¾ Medical and therapeutics Journal:
• annals of internal medicine.
• British medical journal.
• Journal of the medical association.
• New England Journal of Medicine.
• ¾ Pharmacy journals:
• American Journal of Hospital Pharmacy.
• Clinical Pharmacy.
• DICP-Annals of pharmacotherapy.
• Journal of Clinical and Hospital Pharmacy.
• ¾ Drug and Toxicology Information and Pharmacology Journal.
• British Journal of Clinical Pharmacology.
• Human and Experimental Toxicology.

3. Secondary sources:
Secondary sources consist of reviews of primary reports. These provide a personal
perspective of the literature and can include comments on how the author might apply the
information in practice.
• Medline
• International Pharmaceutical Abstracts
• Chemical Abstracts
• IOWA drug Information Service
• DRUGDEX
• Martindale
• POISINDEX
Tertiary resources:
Tertiary resources are summaries of the primary and secondary published literature. Printed
textbooks are the main example and these are characterised by a slow rate of revision
compared to secondary sources.
• AHFS-Drug information Book: Australian Medicine
• Handbook; Meylersside effect of drugs
• Avery’s Drug Treatment
• Basic skills in interpreting Lab data
• Drug information handbook
• Drug interactions Stockley/ Facts and comparison
• Handbook of injectables
• Harrison Principles of Internal Medicine
• Martindale, Pharmacopoeias, Physician’s desk ref
• Merck index, Merck manual,
• BNF, USP, Australian formulary
Alternative other resources-
• Local drug lists
• National formulary
• Hospital formulary

4. • Phone calls to manufacturer, medical shops, government and national organisations,
drug information centres
• Internet, Medscape
• Cochrane meta-analysis
Examples of specific sites include:
• National institute for health and clinical excellence, UK (WWW.nice.org.uk)
• National prescribing centre, UK (WWW.npc.org.au)
• Canadian agency for drugs and technologies in health (WWW.cadth.ca)
ANSWERING DRUG INFORMATION QUERIES-
• Approach to answering drug information queries:
• Analyse the type of drug information
• Understand the background of the question
• Understand the real need of the physician
• Follow systematic approach
THE BASIC STEPS TO APPROACHING DRUG INFORMATION ENQUIRIES ARE:
1. Secure demographic details of the requester:
Identify the enquirer and obtain sufficient details the requestor’s profession. (Physician,
pharmacist, nurse, layperson)-to know education, experience and knowledge base.
2. Obtain background information.
General questions for obtaining background information includes
• The resources that the requestor already consulted
• Whether the request is patient specific or academic
• The patient’ diagnosis, medications and pertinent medical information
• The urgency of the request
3. Refine and categorise the ultimate question:
Classification of the request helps in developing a more effective search strategy and in
determining the resources that should be used.

5. This information may help to refine the question and to estimate the time required to achieve
an acceptable response, example of question classification:
• Adverse drug reaction/ contraindications
• Availability
• Dose
• Drug compatibility/ stability
• Drug interaction
• Drug therapy
• Drug identification.
4.Develop a strategy and conduct a search:
The pharmacist should select and prioritize resources based on the probability of locating the
desired information.
Conduct a systematic search:
• Be familiar with the three types of information sources in the literature hierarchy
• Begin with the established knowledge located within the tertiary literature (e.g.,
textbooks) due to the condensed, easy-to-use format of the information presented
• Progress through the secondary literature (e.g., PubMed, International Pharmaceutical
Abstracts [IPA]) to the primary literature (e.g., controlled clinical trials, letters to the
editor)
5.Perform evaluation, analysis and synthesis:
• The pharmacist should confirm information with other references to assure
consistency between various resources and whether clinical research is relevant to
your population or specific patient.
• The pharmacist should apply his or her techniques and skills for literature evaluation
and clinical application for statistical analysis

6. 6.Formulate and provide a response:
• Answers should be derived only after critically analysing information obtained from a
comprehensive search.
• Provide a formulated response to the enquirer in a timely manner.
• Present the competing viewpoints along with the reference.
• All responses should be documented with the minimum detail necessary to justify the
response.
7.Conduct follow-up and document the outcome:
• Determine the consequence of your advice and any patient outcomes.
• Advise provided should be recorded in at least in mode of documentation (log book,
paper worksheet, computer database).
QUESTION-
A young, adult male patient recently arrived from Japan and presented to the
physician sparse medical records indicating he is suffering from tsutsugamushi
disease. Because of the language difficulties, little is known about the patient, other
than he is taking drug X for the illness. Physical examination reveals a patient in some
discomfort with elevated temperature, swollen lymph glands, and red rash. All other
findings appear to be normal.The physician has little information on the disease and
would like to know if that drug X is the most appropriate treatment.
ANSWER-
Tsutsugamushi disease is an acute infectious disease seen in harvesters of hemp in
Japan. It is caused by Rickettsia tsutsugamushi. Common symptoms of the disease
include fever, painful swelling of the lymph glands, a small black scab in the genital
region, neck or axilla, and large dark-red papules. The disease is known by a number
of other names, including akamushi disease, flood fever, inundation fever, island
disease, Japanese river fever, and scrub typhus. The standard treatment of the disease
includes either drug X or drug Y, although there are several other less effective
treatments.5-7 In the remainder of this paper, a comparison of the two major drugs
will be presented. (Note: Clear objective for paper is presented.)

7. A thorough search of the available literature was conducted. Unfortunately, there
were few textbooks available on this disease. A search of MEDLINE® (1966 to
present) and EMBASE’s Drugs and Pharmacology (1980 to present) produced a
number of articles that were obtained and are reviewed below. (Note: This documents
the type of search and acts as a lead-in to the remainder of the body of the paper.)
Smith and Jones performed a double-blind, randomized comparison of the effects of
drug X and drug Y in patients with tsutsugamushi fever. Patients were required to be
between 18 and 70 years old, and could not have any concurrent infection or disorder
that would affect the immune response to the disease (e.g., neutropenia, AIDS).
Twenty patients received 10 mg of drug X three times a day for 15 days. Eighteen
patients received 250 mg of drug Y twice a day for 10 days. The two groups were
comparable, except that the patients receiving drug X were an average of 5 years
younger (p < 0.05). Drug X was shown to produce a cure, both in terms of symptoms
and cultures in 85% of patients, whereas drug Y only produced a cure in 55.5% of
patients. The difference was statistically significant (p < 0.01). No significant adverse
effects were seen in either group. Although it appears that drug X was the better
agent, it should be noted that drug Y was given at its minimally effective dose, and
may have performed better in a somewhat higher dose or longer regimen.
Based on the literature found, it appears that drug Y is generally accepted as the better
agent, except in those patients with severe renal insufficiency. Because this patient
does not appear to be suffering from that problem, it is recommended that he receive a
3-week course of drug Y at a dose of 500 mg three times a day. Renal function should
be monitored weekly. The patient should receive an additional week of therapy, if the
symptoms have not been gone for the final week of therapy.
Reference-
https://webstor.srmist.edu.in/web_assets/srm_mainsite/files/downloads/drugs_and_poison_in
formation.pdf