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DRUG INFORMATION
SERVICES
By:- Dr. Manish Pal Singh,
Associate Professor
1
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
❑ Drug information is a fundamental responsibility of all pharmacist
irrespective of the practice setting.
❑ 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 population.
❑ Drug information can be challenging but also exciting.
❑ WHO developed DIC (Drug Information Center) to promote rational use of
drugs.
❑ The term ‘drug information service’ can be applied to any activity where
information about drug use is transferred, and includes patient-related
aspects of pharmaceutical care.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
2
Drug Information Center (DIC)
➢ Provides in-depth, unbiased source of crucial drug information to meet
needs of the practicing physicians, pharmacists and other health care
professionals.
➢ Or “ A DIC is an area where pharmacists (other health professionals)
specialize in providing information to health professionals or the public.
➢ The first drug information center was established in the university of
Kentucky in U.S.A. (1962).
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
3
Source*- https%3A%2F%2Fwww.istockphoto.com
Note:-* Medicines Information-
Which are limited to problems relating
to drugs of abuse.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
4
INDIAN SCENARIO*
Haryana (Sirsa)
Chhattisgarh(Raipur)
Rajasthan
(Jaipur)
Assam
(Dibrugarh)
Goa(Panaji) WHO-Indian
Country Office
(5- DIC)
* Chauhan N:Indian aspects of drug information resources & impact of DIC on community, J. Adv. Pharm. Tech. Res
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
5
DIC
Poison
Information
Center*
Drug
Information
Services
Note*- Poison Information
Services-
▪Poison Information services
can be co-located with drug
information services, but
specific training and
resources are required to
provide poison information
to health professional & the
public.
Drug Information Resources
➢ Information about drugs is available in a wide range of formats, media types
and levels of quality.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
6
Primary
resources
• There are original reports
• Ex- Patents, Scientific Abstracts, Case reports, thesis, etc.
Secondary
resources
• In consist of reviews of primary resources
• Ex- Drugdex (Micromedex, USA), IPA, Indexing services etc.
Tertiary
Resources
• Are the summarization of primary & secondary published literature.
• Ex- Printed Textbooks
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
7
Primary resources Secondary resources
Tertiary resources
https%3A%2F%2Fwww.amazon.in%2FGoodman-Gilmans-Pharmacological-Basis-Therapeutics
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
8
Resources for a basic drug information service
Martindale: The complete Drug Reference (Pharmaceutical Press. UK)
Goodman & Gilman’s (McGraw-Hill, USA)
Drugs in Pregnancy & Lactation (Lippincott, USA)
Source*-
▪https%3A%2F%2Fwww.amazon.com%2FMartindale-Complete-
Reference-Extra-Pharmacopoeia
▪https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.amaz
on.com%2FDrugs-Pregnancy-Lactation-PDA-
Reference%2Fdp%2F078175674X&psig=AOvVaw2mredofyST55_riBOYq
bxS&ust=1602309370204000&source=images&cd=vfe&ved=2ahUKEwir
5fXX6absAhXz6HMBHcjODlQQr4kDegQIARBa
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
9
Searching Strategies Computerized Databases
Step-1 (Using Specific
Keywords)
Step-2 (Search For Group
related terms)- Tree-
Branches-Explosion
Step-3 (Determine &
Categorized the actual
question)
Step-4 (Develop the
search strategy conduct
the research )
Step-5 (Perform
Evaluation , Analysis &
Synthesis)
Step-6 (Formulate &
provide a response)
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
10
Information
about drugs
Patient
education
service
Assistance on
drug usage in
patients
Drug related
information to
hospital staff
Reporting and
investigating
ADR
DIC- offered following services:-
Poison Information Center (PIC)
➢ A wide variety of chemicals are designed for diverse uses in day today life.
➢ Acute poisoning is one of the commonest emergencies throughout the world.
➢ To ensure chemical safety, a framework for prevention and management of
eventualities if any, is provided by the Poisons Control Programme of which
Poisons Information Centre is an integral part.
➢ Poison Information (PI)- “is a specialiased area of drug information which
includes information about the toxic effects of chemicals and pesticides,
household products, therapeutic medicines, plants , animal toxins, snacks bites
& other venomous creatures”.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
11
➢ A poison information services deals with the risk assessment , diagnosis,
management & prevention of exposure to any poison in patient of any type
(intentionally & accidental) & route of exposure.
➢ In 1930’s – Louis Gdalman established the framework for the first poison
control center at Rus presbyterian-St. Luke’s hospital.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
12
American Association
of Poison Control
Centers
The National
Poison Prevention
Week Council
NPIC-AIIMS
(New Delhi)
Source*- https://rushinperson.rush.edu/2018/08/13/life-saving-
poison-control-centers-have-origins-at-rush/
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
13
To provide comprehensive,
accurate and timely
information to their clients
To enhance the
medical care of
patients
PIC
GOALS
To provide rapid access
to information valuable
in assessing
and treating poisonings
To assist with poison
prevention.
Reasons for
PIC
Establishment
Comparison Between DIC & PIC
DIC
✓ 9-10% calls are placed by
public, but mostly by health
care professionals.
✓ Fewer than 7 calls per day
✓ Operates 9AM-5PM
✓ They rely on pharmacists
✓ Sponsored by hospitals or
medical centers
PIC
✓ 88% poison center calls are placed by
public.
✓ 103 calls per day, it ranges from 33 to
213 calls per day. Depending upon
service population size, poison center
awareness in that area, poisoning rates.
✓ Operates 24hrs a day year round.
✓ They use a wider variety of health care
professionals
✓ Public funding
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
14
Indian Scenario Regarding PIC:
➢ The first ‘National Poison Information Center (NPIC)’- was established in
December-1994 at the AIIMS, New Delhi.
➢ The other centers were subsequently established at the –
➢ National Institute of Occupational Health, Ahmadabad
➢ Government General Hospital, Chennai
➢ Amrita Institute of Medical Sciences and Research, Cochin
➢ In India, management of acute poisoning cases is difficult for physician
working in emergency departments because typically very little information is
available regarding the nature & amount of the substance ingested at the time of
presentation.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
15
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
16
▪Poison Information centers can
play a vital role in the prevention &
management of poisoning cases
through the provision to healthcare
professional.
▪As 2010, there were only 4-
WHO- recognized centers in
India.
▪Considering the incidence rate of
poisoning cases in India, these
centers may not ne able to meet the
demand for poison information.
▪India, the need for establishing
several such centers with well-
equipped & well trained personnel
is greater.
Source*-
https%3A%2F%2Fsagarmediainc.com;
https%3A%2F%2Fwww.getmyuni.com;
https%3A%2F%2Fwww.mouthshut.com
PIC- Organization:
❖ PIC can operate effectively with various types of organizational structures.
❖ PIC should be based on the anticipated ‘ideal human exposure call volume’.
❖ Poison center expenses and potential revenues are directly tied to call volume.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
17
Organisation Setup of- PIC
CHIEF-Medical Director
Poison
information
specialists
Manager or
Supervisor
FACULTY INCHARGE
1.---ROSTER DUTY
2.----OBSERVERS
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
18
Source*- https%3A%2F%2Fwww.mdpi.com
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
19
FUNCTIONING OF PIC
When a telephonic call
is received at PIC
The caller has
to provide
the following
information
THE FOLLOWING INFORMATIONIS PROVIDED
➢ The diagnosis
➢ How to proceed for emergency management
➢The possible antidote
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
20
PIC- Information Resources:
Primary
Resources
• Include Journals of Medicine & toxicology
• Ex- “Toxicology” {Published by Elsevier}
Secondary
Resources
• Like- “POISINDEX; TOXINZ; HyperTox” for update
information
• “MEDLINE; Index medicus”
Tertiary
Resources
• The standard textbooks of toxicology& medical
dictionaries are essential.
• Ex- Formulary manuals:- “Indian Pharmacopeia”
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
21
Ideal Location for PIC
PIC
Emergency
department
Next to a large
medical library
Hospital pharmacies
DIC
Future Trends of PIC
➢ The poison information system is rapidly changing. Since its inception 40yrs
ago, pharmacy has provided unique leadership and expertise.
➢ As long as medications top the list of substances responsible for poisoning,
pharmacy will always be an integral part of the poison information system.
➢ Skilled pharmacists can play an important role as poison information specialists.
➢ Experienced pharmacist may also serve as advisors to analytical toxicology
laboratories, as expert witness in legal proceedings.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
22
Source*- https%3A%2F%2Fpoisoncontrol.utah.edu
Storage and Retrieval Information
✓ The storage, retrieval, and dissemination of information constitutes a major
function of any drug information service.
✓ In the past, DIR forms which contain the requests, answers, references, and
demographic information had been stored in loose leaf binders and filed
chronologically.
✓ DIRs that are received and responded to at the present are being added to the
computer file.
✓ This indexing system was developed by adapting an existing DSM-
I1{Diagnostic and Statistical Manual} Version 2@ MUMPS{Massachusetts
General Hospital Utility Multi-Programming System}-based system, originally
part of the pathology department’s clinical laboratory information system.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
23
✓ Information Retrieval (IR)- “is a branch of computer science that is
concerned with the processing of collections of documents containing “free
text.” Examples of such collections are a set of hospital discharge summaries,
radiology reports, or surgery notes, or (in a non-medical context) the full text
of the complete works of Shakespeare or the Bible”.
✓ Search engines rely on pre-processing a document collection for subsequent
fast retrieval based on keywords. This pre-processing step is termed indexing.
✓ Information retrieval technology is the hidden workhorse that underlies the
powerful Web-searching facilities that all of us take for granted today. Just as
relational database packages have become progressively easier to use and
administer, it is possible that future versions of microcomputer database
packages will include IR components.
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
24
AGRA PUBLIC PHARMACY COLLEGE,
ARTONI, AGRA, UP, INDIA
25
General features in Big Data Management in Health Care
Source*-https%3A%2F%2Fjournalofbigdata.springeropen.comI

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Drug information services

  • 1. DRUG INFORMATION SERVICES By:- Dr. Manish Pal Singh, Associate Professor 1 AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA
  • 2. ❑ Drug information is a fundamental responsibility of all pharmacist irrespective of the practice setting. ❑ 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 population. ❑ Drug information can be challenging but also exciting. ❑ WHO developed DIC (Drug Information Center) to promote rational use of drugs. ❑ The term ‘drug information service’ can be applied to any activity where information about drug use is transferred, and includes patient-related aspects of pharmaceutical care. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 2
  • 3. Drug Information Center (DIC) ➢ Provides in-depth, unbiased source of crucial drug information to meet needs of the practicing physicians, pharmacists and other health care professionals. ➢ Or “ A DIC is an area where pharmacists (other health professionals) specialize in providing information to health professionals or the public. ➢ The first drug information center was established in the university of Kentucky in U.S.A. (1962). AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 3 Source*- https%3A%2F%2Fwww.istockphoto.com Note:-* Medicines Information- Which are limited to problems relating to drugs of abuse.
  • 4. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 4 INDIAN SCENARIO* Haryana (Sirsa) Chhattisgarh(Raipur) Rajasthan (Jaipur) Assam (Dibrugarh) Goa(Panaji) WHO-Indian Country Office (5- DIC) * Chauhan N:Indian aspects of drug information resources & impact of DIC on community, J. Adv. Pharm. Tech. Res
  • 5. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 5 DIC Poison Information Center* Drug Information Services Note*- Poison Information Services- ▪Poison Information services can be co-located with drug information services, but specific training and resources are required to provide poison information to health professional & the public.
  • 6. Drug Information Resources ➢ Information about drugs is available in a wide range of formats, media types and levels of quality. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 6 Primary resources • There are original reports • Ex- Patents, Scientific Abstracts, Case reports, thesis, etc. Secondary resources • In consist of reviews of primary resources • Ex- Drugdex (Micromedex, USA), IPA, Indexing services etc. Tertiary Resources • Are the summarization of primary & secondary published literature. • Ex- Printed Textbooks
  • 7. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 7 Primary resources Secondary resources Tertiary resources https%3A%2F%2Fwww.amazon.in%2FGoodman-Gilmans-Pharmacological-Basis-Therapeutics
  • 8. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 8 Resources for a basic drug information service Martindale: The complete Drug Reference (Pharmaceutical Press. UK) Goodman & Gilman’s (McGraw-Hill, USA) Drugs in Pregnancy & Lactation (Lippincott, USA) Source*- ▪https%3A%2F%2Fwww.amazon.com%2FMartindale-Complete- Reference-Extra-Pharmacopoeia ▪https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.amaz on.com%2FDrugs-Pregnancy-Lactation-PDA- Reference%2Fdp%2F078175674X&psig=AOvVaw2mredofyST55_riBOYq bxS&ust=1602309370204000&source=images&cd=vfe&ved=2ahUKEwir 5fXX6absAhXz6HMBHcjODlQQr4kDegQIARBa
  • 9. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 9 Searching Strategies Computerized Databases Step-1 (Using Specific Keywords) Step-2 (Search For Group related terms)- Tree- Branches-Explosion Step-3 (Determine & Categorized the actual question) Step-4 (Develop the search strategy conduct the research ) Step-5 (Perform Evaluation , Analysis & Synthesis) Step-6 (Formulate & provide a response)
  • 10. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 10 Information about drugs Patient education service Assistance on drug usage in patients Drug related information to hospital staff Reporting and investigating ADR DIC- offered following services:-
  • 11. Poison Information Center (PIC) ➢ A wide variety of chemicals are designed for diverse uses in day today life. ➢ Acute poisoning is one of the commonest emergencies throughout the world. ➢ To ensure chemical safety, a framework for prevention and management of eventualities if any, is provided by the Poisons Control Programme of which Poisons Information Centre is an integral part. ➢ Poison Information (PI)- “is a specialiased area of drug information which includes information about the toxic effects of chemicals and pesticides, household products, therapeutic medicines, plants , animal toxins, snacks bites & other venomous creatures”. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 11
  • 12. ➢ A poison information services deals with the risk assessment , diagnosis, management & prevention of exposure to any poison in patient of any type (intentionally & accidental) & route of exposure. ➢ In 1930’s – Louis Gdalman established the framework for the first poison control center at Rus presbyterian-St. Luke’s hospital. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 12 American Association of Poison Control Centers The National Poison Prevention Week Council NPIC-AIIMS (New Delhi) Source*- https://rushinperson.rush.edu/2018/08/13/life-saving- poison-control-centers-have-origins-at-rush/
  • 13. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 13 To provide comprehensive, accurate and timely information to their clients To enhance the medical care of patients PIC GOALS To provide rapid access to information valuable in assessing and treating poisonings To assist with poison prevention. Reasons for PIC Establishment
  • 14. Comparison Between DIC & PIC DIC ✓ 9-10% calls are placed by public, but mostly by health care professionals. ✓ Fewer than 7 calls per day ✓ Operates 9AM-5PM ✓ They rely on pharmacists ✓ Sponsored by hospitals or medical centers PIC ✓ 88% poison center calls are placed by public. ✓ 103 calls per day, it ranges from 33 to 213 calls per day. Depending upon service population size, poison center awareness in that area, poisoning rates. ✓ Operates 24hrs a day year round. ✓ They use a wider variety of health care professionals ✓ Public funding AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 14
  • 15. Indian Scenario Regarding PIC: ➢ The first ‘National Poison Information Center (NPIC)’- was established in December-1994 at the AIIMS, New Delhi. ➢ The other centers were subsequently established at the – ➢ National Institute of Occupational Health, Ahmadabad ➢ Government General Hospital, Chennai ➢ Amrita Institute of Medical Sciences and Research, Cochin ➢ In India, management of acute poisoning cases is difficult for physician working in emergency departments because typically very little information is available regarding the nature & amount of the substance ingested at the time of presentation. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 15
  • 16. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 16 ▪Poison Information centers can play a vital role in the prevention & management of poisoning cases through the provision to healthcare professional. ▪As 2010, there were only 4- WHO- recognized centers in India. ▪Considering the incidence rate of poisoning cases in India, these centers may not ne able to meet the demand for poison information. ▪India, the need for establishing several such centers with well- equipped & well trained personnel is greater. Source*- https%3A%2F%2Fsagarmediainc.com; https%3A%2F%2Fwww.getmyuni.com; https%3A%2F%2Fwww.mouthshut.com
  • 17. PIC- Organization: ❖ PIC can operate effectively with various types of organizational structures. ❖ PIC should be based on the anticipated ‘ideal human exposure call volume’. ❖ Poison center expenses and potential revenues are directly tied to call volume. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 17 Organisation Setup of- PIC CHIEF-Medical Director Poison information specialists Manager or Supervisor FACULTY INCHARGE 1.---ROSTER DUTY 2.----OBSERVERS
  • 18. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 18 Source*- https%3A%2F%2Fwww.mdpi.com
  • 19. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 19 FUNCTIONING OF PIC When a telephonic call is received at PIC The caller has to provide the following information THE FOLLOWING INFORMATIONIS PROVIDED ➢ The diagnosis ➢ How to proceed for emergency management ➢The possible antidote
  • 20. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 20 PIC- Information Resources: Primary Resources • Include Journals of Medicine & toxicology • Ex- “Toxicology” {Published by Elsevier} Secondary Resources • Like- “POISINDEX; TOXINZ; HyperTox” for update information • “MEDLINE; Index medicus” Tertiary Resources • The standard textbooks of toxicology& medical dictionaries are essential. • Ex- Formulary manuals:- “Indian Pharmacopeia”
  • 21. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 21 Ideal Location for PIC PIC Emergency department Next to a large medical library Hospital pharmacies DIC
  • 22. Future Trends of PIC ➢ The poison information system is rapidly changing. Since its inception 40yrs ago, pharmacy has provided unique leadership and expertise. ➢ As long as medications top the list of substances responsible for poisoning, pharmacy will always be an integral part of the poison information system. ➢ Skilled pharmacists can play an important role as poison information specialists. ➢ Experienced pharmacist may also serve as advisors to analytical toxicology laboratories, as expert witness in legal proceedings. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 22 Source*- https%3A%2F%2Fpoisoncontrol.utah.edu
  • 23. Storage and Retrieval Information ✓ The storage, retrieval, and dissemination of information constitutes a major function of any drug information service. ✓ In the past, DIR forms which contain the requests, answers, references, and demographic information had been stored in loose leaf binders and filed chronologically. ✓ DIRs that are received and responded to at the present are being added to the computer file. ✓ This indexing system was developed by adapting an existing DSM- I1{Diagnostic and Statistical Manual} Version 2@ MUMPS{Massachusetts General Hospital Utility Multi-Programming System}-based system, originally part of the pathology department’s clinical laboratory information system. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 23
  • 24. ✓ Information Retrieval (IR)- “is a branch of computer science that is concerned with the processing of collections of documents containing “free text.” Examples of such collections are a set of hospital discharge summaries, radiology reports, or surgery notes, or (in a non-medical context) the full text of the complete works of Shakespeare or the Bible”. ✓ Search engines rely on pre-processing a document collection for subsequent fast retrieval based on keywords. This pre-processing step is termed indexing. ✓ Information retrieval technology is the hidden workhorse that underlies the powerful Web-searching facilities that all of us take for granted today. Just as relational database packages have become progressively easier to use and administer, it is possible that future versions of microcomputer database packages will include IR components. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 24
  • 25. AGRA PUBLIC PHARMACY COLLEGE, ARTONI, AGRA, UP, INDIA 25 General features in Big Data Management in Health Care Source*-https%3A%2F%2Fjournalofbigdata.springeropen.comI