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PDAs and electronic drug information sources

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Vicki R Kee
PharmD
Assistant Professor (Clinical)

Vernon K Duba
MA
Assistant Professor (Clinical)
University of Iowa College of Pharmacy
Iowa City, IA
USA
E:[email protected]

In the fast-paced world of hospital pharmacy, the provision of accurate and concise drug information delivered promptly is essential. Mobility of sources is one key to being able to answer questions effectively and efficiently.

Personal digital assistants (PDAs) and laptop computers are portable electronic devices that allow pharmacists to access vast amounts of drug information at a moment’s notice, even at the patient’s bedside.

Databases
Since Belgado and colleagues’ results were published nearly a decade ago,(1) drug information database providers have improved accessibility and applicability. Results from the study by Clauson et al demonstrate expanded content to handheld devices without compromising affordability or ease of use.(2)

Clinical Pharmacology
Clinical Pharmacology provides peer-reviewed monographs on prescription drugs, herbal supplements, nutritional and over-the-counter products, new and investigational drugs, as well as intravenous (IV) compatibility and patient educational handouts. The standout feature of the PDA product, CP OnHand, is its wide-range search ability by name, class, indication, contraindication and adverse reaction.

eFacts
The products from eFacts’ newly designed search interface are well integrated for comprehensive retrieval within subsection referencing. Four stand-alone Facts & Comparisons FactCheck products (antidotes, chemotherapy regimens, diabetes care and IV push rates) are available for PDAs. These products easily interface with four other databases also available in the online version (Drug Interaction Facts: Herbal Supplements & Food, A to Z Drug Facts, Drug Interaction Facts and Guide to Popular Natural Products) using technology from Skyscape (see Resources).

Epocrates
The availability of the no-cost Epocrates Rx has pushed this PDA product to the top of the popularity list among students and practitioners. The bundled Epocrates Medtools includes several specialty dosing calculators and compendia, as well as MedMath. Enhanced drug, formulary, disease and diagnostic products are available for purchase separately or in one suite. Epocrates Online is also available for purchase.

Lexi-Comp
Lexi-Comp provides an extensive drug monograph and unique features, including audio drug name pronunciation guides, international brand names and medication safety issues. Tools for drug interactions and product identification are also included. Up to 15 products from the Lexi-Comp series can be purchased for download to the PDA.

MICROMEDEX Healthcare Series
This information powerhouse provides clinically relevant drug information to hospitals. Integrated searching allows easy access to the entire suite of clinical databases within the series.

mobileMICROMEDEX enables portability of information to the handheld device, allowing access to four databases: drug, alternative medicine, acute care and toxicology. Tools for drug interactions and formulary advice can also be added.

Handbooks
Many classic drug information sources trusted by pharmacists have become available on the PDA or the internet. Updated content can be downloaded at the touch of a button, reducing lag time to a minimum and ensuring that pharmacists have access to the most current information available from the publisher.

AHFS Drug Information
Published by the American Society of Health-System Pharmacy, American Hospital Formulary Service (AHFS), Drug Information is a premier resource for hospital pharmacists. A multimedia card is available for PDAs. Content can also be directly loaded to a PDA from the CD-ROM version or from the web-based ASHPaccess.

Drugs in Pregnancy and Lactation
One of the most widely trusted sources of information about the safety of medications in pregnant and lactating patients is also available on PDAs. Monographs include the FDA pregnancy risk factor and summaries of fetal risk during pregnancy and use during breastfeeding, and a customised note can be created.

The Harriet Lane Handbook
Written by senior paediatric residents at The Johns Hopkins Hospital, this is one of the leading paediatric pharmacotherapy handbooks in the world. On PDAs, searches for individual drugs can be carried out using one of several indexes: main, formulary, trade name, class or medication. Diagnostic and therapeutic information can be found from the table of contents or the main index. Using the calculator, you can determine rates of IV infusions, body surface area and catch-up energy needs, among other things.

Johns Hopkins Point of Care Information Technology (POC-IT) Antibiotic (ABX) Guide
This free evidence-based, peer-reviewed resource is produced by the Division of Infectious Diseases at The Johns Hopkins University. RecomĀ­menĀ­ded treatment regimens (including prophylaxis) can be located by searching the database by disease or pathogen. Searching by antibiotic drug class leads to individual drug monographs that include study/clinical trial citations and treatment of major drug interactions. The guide also includes vaccines.

Tarascon Pocket Pharmacopoeia
Tarascon’s popular Pocket Pharmacopoeia is now available on PDAs. Reference tables, a drug interactions tool, Canadian entries, paediatric dosing and medical formula calculators are included.

Additional sources
Ten further resources with valuable drug information are shown in Table 1. The commercial websites listed in the table subscribe to the Health On the Net Code of Conduct (HONcode), which is a means to standardise the reliability of medical information on the internet (see Resources).

[[HPE22_table1_31]]

Conclusion
There are a variety of resources that pharmacists can utilise to make their jobs as drug information providers easier. Twenty PDA and laptop options have been presented here. Although there are many commercial products, a fair number of them are free.

References

  1. Belgado BS, Hatton RC, Doering PL. Evaluation of electronic drug information resources for answering questions received by decentralized pharmacists. Am J Health-Syst Pharm 1997;54:2592-6.
  2. Clauson KA, Seamon MJ, Clauson AS, et al. Evaluation of drug information databases for personal digital assistants. Am J Health-Syst Pharm 2004;61:1015-24.

Resources
Clinical Pharmacology
W:www.gsm.com
eFacts
W:www.factsandcomparisons.com
Skycape
W:www.skyscape.com
Epocrates
W:www.epocrates.com
Lexi-Comp
W:www.lexi.com
MICROMEDEX Healthcare Series
W:www.micromedex.com
AHFS Drug Information
W:www.ashp.org/ahfs
Drugs in Pregnancy and Lactation
W:www.lww.com
The Harriet Lane Handbook
W:www.hopkinschildrens.org/pages/residency/harrietlane.cfm
Johns Hopkins Point of Care Information Technology (POC-IT) Antibiotic (ABX) Guide
W:hopkins-abxguide.org
Tarascon Pocket Pharmacopoeia
W:www.tarascon.com
HONcode
W:www.hon.ch/honcode/conduct.htm






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