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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5739_Библиотеки_им_академика_М_И_Перельмана.pdf
Drug information service is a dedicated and specialized service
provided by pharmacists to enhance knowledge of medicines
use, promote rational prescribing among prescribers, and
reduce medication errors.
Since pharmacists are expert on drug and are most suitable
and competent professional who can provide these services.
Drug information is to provided various pieces of information
needed. Nowadays hospital pharmacist is in position to alert
the physician of any untoward reaction encountered within
the hospital from the use of particular drug. All such
information can be provided to the physician by the hospital
pharmacist through the pharmacy library. This is possible
because in accordance to the latest texts and journals, the
hospital pharmacist can remain in daily touch with the medical
service representative of various drug manufacturers.
DRUG INFORMADRUG INFORMA
DRUG INFORMADRUG INFORMA
DRUG INFORMA
TION CENTRETION CENTRE
TION CENTRETION CENTRE
TION CENTRE
Drug information centre (DIC) is scientifically derived,
documented and an independent body which provides
information on drugs and health aspects. This centre provides
unique opportunity for a pharmacist to contribute his role in
health care development.
Objectives of Drug Information CentreObjectives of Drug Information Centre
Objectives of Drug Information CentreObjectives of Drug Information Centre
Objectives of Drug Information Centre
• To uplift the profession of pharmacy by bringing better
interaction between the pharmacist and the community.
Drug Information
Service
12
Drug Information Service 119
• To improve patient compliance with drug dosage regimen
and to improve therapeutic output.
• The drug information centre by using suitable techniques,
and methods such as verbal, written or audiovisual
communication, educate and council the patient about the
following aspects:
i. Advising and educating patients for proper use of drugs
(trade name and generic name) mechanism of action,
properties, root of administration, recommended dosage,
and dosage form, identification, pharmacokinetics,
direction, precautions, side effects, therapeutic indi-
cations, proper storage and cost of drug.
ii. Clarify doubts regarding sexual problems and myths,
contraceptives and family planning.
iii. Drug addiction, drug abuse, alcoholism, smoking
hazards, and other socio-medical problems.
iv. Drug toxicity poisoning, drug over dose.
v. Advise on self medication for minor complaints.
vi. Other activities like publishing newsletter or bulletins,
conducting seminars, group discussions, complaints, etc.
vii. Maintenance of record: Different files should be prepared
to differentiate the technical data and for easy search. A
reference number should be used while making
correspondence.
Qualification of Pharmacist to RQualification of Pharmacist to R
Qualification of Pharmacist to RQualification of Pharmacist to R
Qualification of Pharmacist to R
un DICun DIC
un DICun DIC
un DIC
• To critically evaluate the drug literature.
• To edit the information to facilitate decision making.
• He should be aware of the source of information to enable
him to collect secondary data.
The other useful functions of the DIC are as follows:
• Monitoring: The adverse drug reactions and reporting to
the committee on the safety of drug.
• Educational: Teaching should be an integral part of DIC for
the undergraduate level and as a part of continuing
education of pharmacist.
• The services enable the pharmacist to function in the patient
area to participate in the decision-making about medication,
patient counseling and in taking medication history.
Pharmacy Practice120
• These services are also helpful in preparing and maintaining
the hospital formulary. Pharmacist engaged in the DICs,
prepare drug education monograph for the drug to be
consider for the formulary addition or deletion.
Large hospitals have developed and staffed a new division
of the department of pharmacy which is commonly referred
as “drug information centre”. This new concept in hospital
pharmacy operation is usually located in separate section of
pharmacy, containing large number of references texts,
journals, reprints and brochure. Sometime they are also
equipped with electronic data processing equipment and have
a full time director and adequate secretarial assistants. Now
computers have made possible networking of regional drug
information centers located in different hospitals. Even a single
hospital LAN (local area networking) provides pool of
information on the main computer for several users at any time.
Networking on regional, national, subcontinental levels will
place DIS at a global level. Fax services, and email is a great
help to the DICs. The drug information centre may also assume
the responsibility of gathering information on all investigations
of drugs which are in current use in hospital. These centres
record all the data on drug reaction in the institutions. DICs
can provide information regarding poisons, their toxicities and
treatment round the clock. In absence of any available
treatment, the centre give only first-aid advice and recommend
symptomatic treatment.
The need for the reliable local source of drug information
within a hospital is of utmost importance in rendering effective
clinical care to the patients. The main aim of this centre should
be provide drug information when it is needed.
The concept of drug information services or drug
information centre is to attempt to document drug by
abstracting information about them. Drug information is the
knowledge gathered either in the written from (books, journals,
periodicals, etc.) or transmitted by oral communication or by
electronic device of the physical, chemical, biological and health
care sciences.
Drug Information Service 121
POISON INFORMAPOISON INFORMA
POISON INFORMAPOISON INFORMA
POISON INFORMA
TION CENTERTION CENTER
TION CENTERTION CENTER
TION CENTER
Pharmacists are specialists trained in poison information and
in the management of poisoning emergencies.
They help in poisoning prevention and to provide rapid
access to information valuable in assessing and treating
poisonings.
PICS (poison information centers) are mainly for two reasons:
1. For the provision of service regarding poison and related
danger, and to manage with the poisoning cases
2. To provide public and professional educational programs
They also plays an important role in developing contingency
plans for, and responding to, chemical disasters, in monitoring
the adverse effects of drugs, and in handling problems of
substance abuse. Its main functions are provision of
toxicological information and advice, management of poisoning
cases, provision of laboratory analytical services, toxi-
covigilance activities, research, and education and training in
the prevention and treatment of poisoning.
A poison information centre (PIC) may be defined as a
specialized unit in hospital that advises on the toxicity
assessment and effective treatment of poisoning cases. PICs
help by providing information and guidelines about first aid
treatment for emergencies during toxic exposures. A PIC
generally needs a multidisciplinary team of poison information
services. The other team members may include physicians,
nurses, pharmacist, etc. having a sound knowledge of
toxicology and related scientific disciplines.
LL
LL
L
ocationocation
ocationocation
ocation
A PIC in a hospital is required to be located near Intensive care
unit (ICU) and drug information.
DIC: This would help to have a quick communication between
the DIC, PIC and the ICU staff treating the poison cases.
PP
PP
P
rotocol for a PlC includes following stepsrotocol for a PlC includes following steps
rotocol for a PlC includes following stepsrotocol for a PlC includes following steps
rotocol for a PlC includes following steps
Step 1: Secure demographics of requestor
Step 2: Obtain background information
Pharmacy Practice122
Step 3: Determine the ultimate questions
Step 4: Develop strategy and conduct research
Step 5: Perform evaluation and analysis
Step 6: Formulate and provide response
Step 7: Conduct follow-up and documentation
FF
FF
F
unctions of PICunctions of PIC
unctions of PICunctions of PIC
unctions of PIC
• To provide toxicological information manage the poisoning
• To manage the poisoning cases.
• To provide laboratory analytical services and research
pertaining to poisons.
• To provide education and training in the prevention and
treatment of poisoning
• To advice on development, implementation and evaluation
of measures for the prevention of poisoning.
SOURCES OF DRUG INFORMASOURCES OF DRUG INFORMA
SOURCES OF DRUG INFORMASOURCES OF DRUG INFORMA
SOURCES OF DRUG INFORMA
TIONTION
TIONTION
TION
Primary sources: There are those sources which contain the
original reports of scientific, technical or professional
investigations. They contain recent and uptodate information.
The research reports, thesis, dissertations, patients periodicals,
etc. The most important drawback of primary sources are that
they are widely scattered and not easy to locate. Periodicals
also refereed as journals, serials, magazines, bulletins, etc. are
published as issues (e.g. weekly, monthly or quarterly) and as
volumes. They contain scientific information, research articles,
book reviews, announcements and even advertisements,
whereas books contain a compilation of information so that
there is a big time lag between a discovery of an idea and
publication.
Periodicals are further classified as:
• Primary periodicals: They contain report of original research.
• Secondary periodicals: They contain that portion of original
research which is according to their need in condensed
form.
Drug Information Service 123
On the basis of scope they are classified as under:
a. Scientific periodicals: They contain the original research
articles which are reviewed by expert who are eminent
scientist. Indian journal of pharmacology, international
journal of pharmaceutical science.
b. Professional periodicals: They contain articles which have
practical aspects. They are less technically and scientifically
oriented as compared to the articles present in the scientific
periodicals, e.g. pharmacy times, American Journal of
Pharmaceutical Education.
c. Commercial periodicals: They contain the information that
is useful to the trade people, i.e. information regarding the
entry of new product into the market, price change infor-
mation, promotional literature, etc., for example, CIMS drug
index, MIMS, drug topics.
Secondary sources: Pharmacopoeias and formularies: Pharma-
copoeias and formularies are the books of standards for drug and
related articles with descriptions, tests, and formula for
preparing the same, selected by some recognized authorities.
Collectivelly pharmacopoeias and formularies are referred to drug
compendia.
Official drug compendia are those compilations of drugs and
devices which have been recognized as legal standard of purity,
quality and strength by the government agencies of the country
of origin. The various existing pharmacopoeias and formularies
with which a pharmacist should be familiar are: Biological
abstract, chemical abstract, international pharmaceutical
abstract and dissertation abstract. They do not contain original
reports, i.e. the information present in second-hand in nature
but the most important advantage is that they are easily
available to searchers like indexing and abstracting services,
computerized search services, textbooks, encyclopedias,
handbooks, dictionaries, monographs, pharmacopoeias,
periodicals, etc.
• Formulary
1. National Formulary of India
2. British National Formulary
Pharmacy Practice124
3. National Formulary of America
4. Australian Pharmaceutical Formulary
• Pharmacopoeia
1. Indian Pharmacopoeia
2. British Pharmacopoeia
3. British Pharmacopoeial codex
4. German Pharmacopoeia
5. French Pharmacopoeia
6. US Pharmacopoeia
Tertiary sources: The information contained in the publication
under the heading usually does not answer the problem in hand
but act as a pointer to where it may be found. The following
fall under the sources of drug information:
• The chemist and druggist directory
• Indian pharmaceutical guide
COMPUTERIZED SERVICESCOMPUTERIZED SERVICES
COMPUTERIZED SERVICESCOMPUTERIZED SERVICES
COMPUTERIZED SERVICES
Nowaday’s computer are used in pharmaceutical industries,
hospitals and in various departments for drug information,
education, evaluation, analysis, medication history and for
maintenance of financial record, etc. they have become
indispensible in the development of clinical pharmacy, hospital
pharmacy and in pharmaceutical research.
• Maintenance of records: Various records like patients
medication history, current treatment, and financial
records, etc. are maintained in computer by feeding
accurate data. Data is a collection of facts. Computer works
as a data base manager.
“Medline” is a data base package used for such purpose. It
gives the current information of the patients regarding
paient’s name, age, sex, room no., weight, allergy, diagnosis,
and special precaution to be taken for the patient. These
records are stored in a “File” like Physician name” file,
“Direction” file, “Drug interaction” files, etc. Specific infor-
mation records in coded form are entered in various file like
“Physician name, registration number, phone number and
address. Computers store, all pieces of information in files
and make them available whenever required.
Drug Information Service 125
• Inventory control: Inventory control is very essential
because it maintains the balance between stock in hand and
excessive capital investment. Computers are used to detect
the items which had attained the minimum order level. It
than prepare list and purchase order for suppliers.
Generally there are two systems for inventory control.
1. Periodic inventory control
2. Perpetual system
1. Periodic inventory control: In this system stock levels are
checked manually and the amount of inventory in hand is
compared with minimum and maximum stock maintained
in the computers. Computers help in placement of order to
different suppliers after checking their turms and conditions
because all the entries of stock are present in it.
2. Perpetual system: In this system computer tells us about the
present position of the drugs because when they are
received, they are entered in the initial stocks to get the
current stocks. As the drugs are deliverers to various
departments the quantities are subtracted accordingly. Such
type of additions and deletions from inventory balance are
done with the help of “data base” package.
3. Medication monitoring: To meet the goal of optimum drug
therapy, medication monitoring is essential. The pres-
cription of a particular patient received over a period of time
is entered and serves as a chronological patient drugs file. It
helps in suggesting drugs along with their dosage schedule
for medication monitoring. Computer provides two types of
information.
a. Pharmacokinetic
b. Non-pharmacokinetic.
a. Pharmacokinetic information: “NONLIN” is a
computer program which can predict pharmaco-kinetic
parameter very easily. These parameter include volume
of distribution, bioavailability, rate of clearance, etc. It
helps in maintaining dosing pattern of various drugs like
antibiotic, aminoglycosides, etc.
Pharmacy Practice126
b. Non-pharmacokinetic information: It includes various
allergic reaction, drug interaction, adverse drug reaction,
etc. for such information two computer programs are
available.
i. MEDIPHOR (monitoring and evaluation of drug
interaction by a pharmacy oriented reporting)
ii. PAD (pharmacy automated drug) interaction
screening
4. Drug information services: Computer has become an
important tool for clinic pharmacist in drug information
service. Computer aided drug design help the chemist to
formulate a new drug molecules can be generated through
graphics and by changing molecular configuration. CD-
ROM technology helped a lot in the evaluation of electronic
library. “Micromedax” provides the information on drugs,
their identification, poison, their emergency, etc. in single
compact disc.
5. Storage data retrieval : In 1960, national library of medicine
created a computerized medical information retrieval
system “MEDLARS” (medical literature analysis and
retrieval system). Now they developed a fast working
system “MEDLINE” (MEDLARS online). It is a data base
containing around 300 medical journals since 1966.
Similarly BIOSIS is produced by bioscience information
service containing various biological abstracts.
6. Marketing and distribution: Computers are used for
marketing and distribution of drugs. It involves processing
of orders, invoicing, maintenance of record, billing, etc.
7. Pharmaceutical industry: Complete computerized pro-
grammes are available for drug manufacturer and for
quality control management. Information for the beginning
of the process and for the finished product is available.
Comparative evaluation is done for various products with
the help of computers. Various instruments and appara-
tuses are can be adjusted and calibrated using computers.
8. Hospital pharmacy and retail pharmacy: Computers help
hospital pharmacist in keeping overall patient care like
maintenance of patient record, entry of prescription, list of
Drug Information Service 127
preparations to be manufactured, consumption of drugs,
cost analysis, updation of drug information, etc. for proper
functioning of a hospital. Computer in hospital pharmacy
department should be linked to nursing station, testing of
laboratories, registration counter, account and purchase
section, etc.
Following are the application in hospital and retail pharmacy
a. Calculation of monthly gross income
b. Generating salary slip
c. Updating the employee information
d. Placement of supply order
ISOLISOL
ISOLISOL
ISOL
AA
AA
A
TED KEY POINTSTED KEY POINTS
TED KEY POINTSTED KEY POINTS
TED KEY POINTS
• Drug information service is a dedicated and specialized
service provided by pharmacists to enhance knowledge of
medicines use, promote rational prescribing among
prescribers, and reduce medication errors.
• Drug information centre is scientifically derived, docu-
mented and an independent body which provides
information on drugs and health aspects
• Some useful functions of the DICs are
i. Monitoring: The adverse drug reactions
ii. Educational
iii. Patient are advised in decision-making about medication,
patient counseling and in taking medication history.
iv. Helpful in preparing and maintaining the hospital
formulary
• Poison information center: Pharmacists are specialists
trained in poison information and in the management of
poisoning emergencies.
• Poison information centers are mainly for two reasons:
i. For the provision of service regarding poison and related
danger, and to manage with the poisoning cases
ii. To provide public and professional educational
programs
• Sources of drug information are:
a. Primary sources: There are those sources which contain
the original reports of scientific, technical or professional
investigations.