F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S TATE U NIVERSITY The College of...
If you can't read please download the document
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S TATE U NIVERSITY The College of Medicine Drug Resources Nancy Clark, MEd, Director Medical
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Drug Resources Nancy
Clark, MEd, Director Medical Informatics Education Mark Strickland,
MD, Informatics Curriculum Director, TLH Regional Campus
Slide 2
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Objectives Find the Drug
Reference Library web page Locate basic prescription, OTC and
herbal drug information (dosage, indication, etc.) online and on
the PDA Calculate a drug dosage using an electronic resource
Identify if a drug is on a particular formulary and locate
alternatives Identify a pill from its imprint or description
Perform a drug interaction check Use an infectious
disease/antibiotics guide Use an immunization schedule tool
Slide 3
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Not Covering Patient
Education Handouts on drugs Drug News: recalls, dosing and delivery
changes, safety issues, FDA approvals, etc. Research articles on
clinical trials, drug toxicology, etc.
Slide 4
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Handouts Evaluations Drug
References Handout Worksheet Instructions for email alerts Top 200
Drugs Prescribed 2008 www.rxlist.comwww.rxlist.com
Slide 5
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Medication Errors Adverse
Drug Events (ADEs) rash drop dead ADEs due to inappropriate
prescribing & pt noncompliance = 3-28% hospitalizations 30% of
pts who suffer ADEs die or are disabled for > 6 months IOM:
98,000 deaths per year from medication errors in hospitals Cost of
drug related morbidity and mortality in US estimated $1.56-$5.6
billion/yr
Slide 6
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Using the green Worksheet
as we go thru the workshop, identify drug questions you can use
with students.
Slide 7
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine New Library Webpage (Fall
2010) Summer 20107
Slide 8
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Library Web Site
Slide 9
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Subscription Drug
Resources Epocrates Online or Essentials (web and PDA) Facts and
Comparisons (web) PEPID (web and PDA) Access Medicines Drugs (Lexi
Drug) (web) Harrisons Practice (Lexi Drug) (web and PDA) MDConsult
(Clinical Pharmacology) (web) Natural Medicines Database (web and
in Epocrates PDA) Pediatric Care Online Journals, News and
periodical databases Prescribers Letter Medical Letter (Handout on
how to get alerts)
Slide 10
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine PDA Drug Resources
Epocrates Essentials PEPID Harrisons Practice Pediatric Care Online
Dynamed Available free to all faculty
Slide 11
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Free Drug Resources Johns
Hopkins Antibiotic Guide (Web) http://hopkins-abxguide.org
http://hopkins-abxguide.org Shots (immunization schedules) (Web and
PDA) http://www.immunizationed.org http://www.immunizationed.org
CDC Travelers' Health http://wwwn.cdc.gov/travel/
http://wwwn.cdc.gov/travel/ Medscape (iPhone) Merck Medicus (PDR
Library) (web and PDA) http://www.merckmedicus.com
http://www.merckmedicus.com Drugs.com http://www.drugs.com/
http://www.drugs.com/ Toxnet (poisons and toxic agents)
http://toxnet.nlm.nih.gov/ http://toxnet.nlm.nih.gov/
Slide 12
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Student Issues Taught
generic names Preceptors/clerkship faculty use brand names Dont
learn dosing in Pharmacology Do not understand abbreviations (PO,
PRN, ) When do they learn how to write a prescription? 1 st
Clerkship
Slide 13
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Who Has What?
Slide 14
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine EPOCRATES ESSENTIALS Rx
Monographs OTC Monographs Alt Meds Monographs Drug Interaction Tool
Drug Costs Dosage Calculator Formulary Tool Pill Identifier
Antibiotics Guide Immunizations
Slide 15
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates Essentials
iPhone/iPod Prescription, Alt Meds and OTC are combined in same
list. Formulary Get Back Add to Favorites
Slide 16
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates Essentials Rx
Search by drug or class Rx Alt OTC Compare sub- categories of each
type
Slide 17
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Alt Meds OTC Rx Comparing
Sub Categories Add to Favorites
Slide 18
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Dosage Calculator in
Epocrates iPhone Online Dosage Calculator
http://www.medcalc.com/pedidose.htmlhttp://www.medcalc.com/pedidose.html
Slide 19
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
Using Epocrates PDA A little boy who is eight years old just ate a
bottle of Childrens Tylenol tablets his mother had in the medicine
cabinet. She thinks he ate forty or fifty of them. You search the
Tables > Toxicology > Antidotes 1 and find that
acetylcysteine is indicated for acetaminophen toxicity. Calculate
the dosage of acetylcysteine for the child. He weighs 50 lbs.
Slide 20
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates PDA MultiCheck
1. Type 2. Pick drug 3. Click + 4. Repeat until all drugs in list
5. Click View Interactions 6. Tap Interaction
Slide 21
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
Epocrates PDA: lisinopril, metformin, and hydrochlorothiazide Peds
example: isoniazid, rifampin, ethambutol, acetaminophen
Slide 22
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates Formularies Go
to Epocrates.com Manage My Account Pick Formularies Sync/update to
add
Slide 23
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
Using Formulary Tools on Epocrates online or PDA I have a patient
with H. Pylori who has BCBS of Florida 3 Tier who needs a low
copay. Which of the treatments are covered by BCBS low copay? Look
up drugs by class> gastrointestinal> H. Pylori. I have a
depressed patient with no health insurance who is indigent. Which
SSRI can they get for $4 at Target?
Slide 24
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates iPhone Pill
Identifier
Slide 25
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
What is this pill?
Slide 26
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates PDA ID Tool
Slide 27
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
Using Epocrates ID Which antibiotics should be used for a 17 year
old outpatient female with PID, etiology unknown? The DNA probe
comes back with Chlamydia in the same patient. What antibiotic
should I use? Using the PDA, find the antibiotic. What other
treatment recommendations for this patient are found in ID? (choose
the Info tab across the top)
Slide 28
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Tables
Slide 29
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine EPOCRATES ONLINE Rx, OTC
and Alt Meds Rx Monographs OTC Monographs Alt Meds Monographs Drug
Interaction Tool Drug Costs Dosage Calculator Formulary Tool Pill
Identifier Antibiotics Guide Immunizations
Slide 30
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Browsing Epocrates ONLINE
1. Pick a letter 2. Pick drug
Slide 31
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine 2. Pick drug Search for a
Drug 1. Type
Slide 32
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine 1. Pick category 2. Pick
sub category 3. Pick drug Using Classes
Slide 33
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Prescription Drug
Monographs 1. Pick category
Slide 34
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Dosage Calculator
Slide 35
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Alt Meds Monographs 1.
Pick category
Slide 36
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine OTC Monographs
Slide 37
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
Using Epocrates Online What is the starting dose of lisinopril to
treat HTN if the patient is not on a diuretic? (dose) How much does
one month supply of Cymbalta 30 mg cost? What is the off label
indication for Ativan? ( indicates off label)
Slide 38
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates ONLINE Formulary
1. Pick formulary 2. Click to see meaning
Slide 39
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates ONLINE Formulary
1. Click Code 2. Under View Alternatives, click class
Alternatives
Slide 40
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Finding Substitutes
Codes
Slide 41
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine A 65 yr old female with
osteoporosis is on Boniva. She has recently changed to AARP
Medicare Complete MA. Can she continue taking Boniva? Are there
lower cost choices? Another formulary resource:
http://www.fingertipformulary.com/http://www.fingertipformulary.com/
Cant vouch for accuracy Exercises for Practice
Slide 42
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Another Formulary
Option
Slide 43
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates ONLINE
MultiCheck Tool 2. Click drug Repeat until all drugs in list
Interactions appear as found 1. Type
Slide 44
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
Check for Interactions: digoxin, furosemide, lisinopril Peds
example: isoniazid, rifampin, ethambutol, acetaminophen
Slide 45
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates ONLINE Pill
Identifier Pick shape, color, etc. If imprint readable, type it in
and click Identify Pills Scroll through results until you find your
pill. Click name to go to monograph.
Slide 46
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates Online
Tables
Slide 47
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Epocrates
Vaccinations
Slide 48
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
Using any of the Immunizations tools: Patient has planned a mission
trip to Central America. What immunizations does she need? The news
of a meningitis outbreak brings in a 53 yr old man with a history
of TB but otherwise healthy who is worried that he might be
exposed. Should we give him Menactra?
Slide 49
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine PEPID Rx Monographs OTC
Monographs Alt Meds Monographs Drug Interaction Tool Drug Costs
Dosage Calculator Formulary Tool Pill Identifier Antibiotics Guide
Immunizations
Slide 50
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine PEPID Drug Information 1.
Click on Dose
Slide 51
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine PEPID Drugs iPhone 1. Pick
CRC
Slide 52
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
Using PEPID online or PDA You have a child with otitis media for
whom you need to give PO amoxicillin. The child weighs 62 Lbs. How
many ml of 250 mg/5 ml should you prescribe per dose?
Slide 53
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine PEPID Interaction
Tool
Slide 54
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
digoxin, furosemide, lisinopril lisinopril, metformin, and
hydrochlorothiazide Peds example: isoniazid, rifampin, ethambutol,
acetaminophen
Slide 55
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Immunizationss
Slide 56
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine FACTS AND COMPARISONS Rx
Monographs OTC Monographs Alt Meds Monographs Drug Interaction Tool
Drug Costs Dosage Calculator Formulary Tool Pill Identifier
Antibiotics Guide Immunizations
Slide 57
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine eFacts and Comparisons
Detailed For pharmacists New interface Browse Resources
Slide 58
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Search eFacts &
Comparisons 1. Type 2. Pick drug 3. Click Go
Slide 59
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine eFacts & Comparisons
Online Monograph in Drug Facts and Comparisons will come up Expand
sections Or Show All See link to Class Breadcrumbs
Slide 60
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Classifications
Slide 61
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Tables in Facts and
Comparisons
Slide 62
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
Using Facts and Comparisons Online Is it possible that Wellbutrin
causes tinnitus? (hint: CTRL-F) Which of the proton pump inhibitors
are used off label for GERD in children?
Slide 63
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine eFacts Drug Interactions
Type in patients drugs, add Check list, add more if needed then
click GO>>
Slide 64
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine eFacts Drug Interactions
Click on Interaction to see monograph
Slide 65
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Exercises for Practice
digoxin, furosemide, lisinopril lisinopril, metformin, and
hydrochlorothiazide Peds example: isoniazid, rifampin, ethambutol,
acetaminophen
Slide 66
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine eFacts Pill Identifier 1.
Fill in and click Go 2. Click on underlined drug name
Slide 67
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine DYNAMED- EVIDENCE BASED Rx
Monographs OTC Monographs Alt Meds Monographs Drug Interaction Tool
Drug Costs Dosage Calculator Formulary Tool Pill Identifier
Antibiotics Guide Immunizations
Slide 68
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine 1. Type & choose 2.
Choose
Slide 69
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Choose category
Slide 70
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Dynamed New 1000 drug
monographs Evidence-based Linked to disease content
Slide 71
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine MDCONSULT Rx Monographs
OTC Monographs Alt Meds Monographs Drug Interaction Tool Drug Costs
Dosage Calculator Formulary Tool Pill Identifier Antibiotics Guide
Immunizations
Slide 72
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine MDConsult Drug Monographs
Gold Standards Clinical Pharmacology Thorough By Indication,
Contraindication and Adverse Reactions
Slide 73
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine ACCESS MEDICINE HARRISONS
PRACTICE Rx Monographs OTC Monographs Alt Meds Monographs Drug
Interaction Tool Drug Costs Dosage Calculator Formulary Tool Pill
Identifier Antibiotics Guide Immunizations
Slide 74
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine LexiDrugs in Access
Medicine Access Medicine Lexi Drug Content (Rx and OTC) Also in
Harrisons Practice online and PDA
Slide 75
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine NATURAL MEDICINES DATABASE
Rx Monographs OTC Monographs Alt Meds Monographs Drug Interaction
Tool Drug Costs Dosage Calculator Formulary Tool Pill Identifier
Antibiotics Guide Immunizations
Slide 76
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Natural Medicines
Database
Slide 77
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Natural Medicines
Effectiveness
Slide 78
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Interaction Checker
Slide 79
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine PEDIATRIC CARE ONLINE Rx
Monographs OTC Monographs Alt Meds Monographs Drug Interaction Tool
Drug Costs Dosage Calculator Formulary Tool Pill Identifier
Antibiotics Guide Immunizations
Slide 80
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Pediatric Care Online
Antimicrobial Therapy Guide Information by Diagnosis Agent
Class
Slide 81
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Pediatric Care Online
Interactive Periodicity Schedule includes Childhood
Immunizations
Slide 82
F LORIDA S TATE U NIVERSITY The College of Medicine F LORIDA S
TATE U NIVERSITY The College of Medicine Summary Epocrates on PDA
different than online. PEPID competes well with Epocrates as a one-
stop shop Facts and Comparisons more detailed monographs and
interactions but only online Many other resources have good drug
information but without tools (formularies, interaction tools,
dosage calculators)