ACRL News Issue (B) of College & Research Libraries C&RL News ■ July/August 2001 / 701 I N T E R N E T R E S O U R C E S Drug information Where to lo o k for drug information on the Internet by Mignon Adams I nformation distributed about prescription drugs is tightly controlled by federal regu­ lation both in this country and in others. Thus, the inform ation found abou t prescription drugs on the Web, unlike many other topics searched, is likely to b e accurate. The chal­ lenge is to find com plete information and descriptions written at an appropriate level, b e it health professional or consumer. A description o f a drug, including its indi­ c a t io n s fo r t h e r a p e u t ic u s e , d o s a g e , contraindications, etc., is called a d ru g m o n o ­ g r a p h . P ro d u ct P a ck a g e In se rts The pamphlet often included with a prescrip­ tion drug, the Product Package Insert (PPI), consists o f the w ording required and ap­ proved by the Federal Drug Administration. The content o f this pamphlet is essentially identical to the m onograph included in the P h y s ic ia n s D esk R e fe r e n c e and is written by em ployees o f the pharmaceutical m anufac­ turer. Most often, the information from the PPI is also listed on the manufacturer’s site; here it is generally called “prescribing infor­ m ation.” • Scholz H ealthcare. Scholz Healthca is a German company that sells software prod­ r ucts and services to the U.S. pharmaceutical industry. The company maintains a site where visitors can search for either the generic or brand name o f a drug and be linked directly to the prescribing information on the Web site o f the drug manufacturer. This is the same information listed in the P h y s ic ia n s D esk R ef­ e r e n c e (and it may b e more up-to-date). A c­ cess: http://www. ditonline. com/ monograph/ index.html. • D ru g łn fon et. T h o se w ho m aintain Druginfonet have scanned in both the official package insert and the patient package insert. Again, it is the same information that is in the P h y sicia n s D esk R eferen ce, although the num­ ber o f drugs listed may not be as large. Access: http://www.druginfonet.com/drug.htm. • Federal Drug Adm inistration (FDA). The FDA site not only contains a great deal o f useful information, but it is also well de­ signed and easy to navigate. It lists drug la­ beling information (from which the PPI is obtained) for drugs approved since 1998, as well as consumer-friendly versions; new drug approvals; and discussions o f items currently in the news. Also available online is the Or­ a n g e B o o k , w hich lists “therapeutic equiva­ e lents” (generic drugs that can replace a brand­ name drug). The hom epage directs users to A b o u t t h e a u t h o r Mignon Adams is director o f Library and Information Services at the University o f the Sciences in Philadelphia, e-mail: m.adams@usip.edu http://www http://www.dmginfonet.com/dmg.htm mailto:m.adams@usip.edu 7 0 2 / C&RL N ew s ■ Ju ly/A u gu st 2001 information for consumers, patients, health professionals, industry, press, women, se­ niors, and kids. Anyone who wants to know about the pharmaceutical regulatory system in the United States should begin here. Ac­ cess: http://www.fda.gov. Other inform ation about prescription drugs Most pharmacists consider the package in­ sert useful but limited because it contains no more information than is required by law and it is written in standard regulatory style. Other sites provide information that is not written by the manufacturer, and therefore their monographs are considered to be less biased and are often much more clearly written. • Rxlist. Rxlist was created by Neil Sandow, a hospital pharmacist. This well-re­ spected site contains the same drug mono­ graphs that appear in Mosby’s GenRx. In ad­ dition to therapeutic information, other use­ ful information is given, such as the annual cost of taking the drug and brand names under which the drug may be sold in other countries. Excellent monographs for patients, in both English and Spanish, are found here. You can also identify a pill here by entering its imprint code. There are a small, but very good, number of monographs on herbals. Finally, there is a collection of Rx cartoons— but only your pharmacist may find them funny. Access: http://rxlist.com. • Drug Facts and Comparison. This highly respected publication, known gener­ ally only to pharmacists, examines drugs within a particular class—say, antidepressants or calcium channel blockers— and compares their therapeutic action, dosage, precautions, and drug interactions. By registering on their Web site, you may access an abridged ver­ sion of the publication at no cost; access to the complete version is by paid subscription only. There is a consumer section with good monographs. There is also a drug interaction index, as well as drug quizzes for the health professional. Access: http://www.drugfacts. com. • The U.S.P. Drug Information f o r th Patient. This has long been a source of choice for reliable and understandable information for patients. It is available many places on the Web, some of which ask the reader to [ register. The simplest site to find it (and with no registration) is the drug information sec­ tion of the National Library of Medicine’s MedlinePlus. Not only are prescription drugs listed, but also commonly used over-the- counter drugs. Access: http://www.nlm.nih. gov/ medlineplus/. • The People’s Pharmacy. This book, written by Joe (pharmacologist) and Terry (nurse) Graedon, has gone through many editions. The Graedons now have their own Web site, which includes their clear write­ ups of the top 150 prescription drugs (which account for the majority of prescriptions). Also included are informed looks at home rem­ edies, such as bag balm for dry skin. Access: http://www.healthcentral.com/ peoplespharmacy/peoplespharmacy.cfm. Also for consum ers • FDA Consumer. This magazine, pub­ lished by the FDA for consumers, is online. Articles may be on a recent new drug, issues in regulation or the pharmaceutical industry, food, or any of the areas the FDA covers. Back issues date to 1995, and they’re all searchable by keyword. Access: http://www. fda.gov/fdac/. • Physician’s Desk Reference (PDR). PDR has its own Web site. PDR isn’t free, even though the monographs contained within it are generally free by going to vari­ ous m anufacturers’ sites. But PDR fo r F a m ilie s and PDR Fam ily H ealth Ency­ clopedia are. Access: http://www.pdr.net/. e http://www.fda.gov http://rxlist.com http://www.drugfacts http://www.nlm.nih http://www.healthcentral.com/ http://www http://www.pdr.net/ C&RL N e w s ■ J u ly / A u g u s t 20 01 / 703 • University o f Maryland School of Pharmacy. The University of Maryland School of Pharmacy has had an “ask the phar­ macist” site for many years. It is now done in partnership with Giant Foods of Maryland. A sample question was answered fully in about five hours by a Maryland pharmacy school faculty member. Access: h ttp ://w w w . giantfood.com/pharm_ask_pharmacist.cfm. • Rite-Aid. This chain pharmacy’s site has an “Ask a Pharmacist” feature. A sample question here was answered briefly in just over an hour. Access: h ttp :// www.riteaid.com. • PubMed. To locate studies done with various drugs and drug therapies, the best place is Medline, available free to anyone at PubMed. Searches can be done either by brand name or by generic name. Access: http://www.ncbi.nlm.nih.gov/PubMed/. O nline p h a rm a c ie s1 • National Association o f Boards of Pharmacy. In response to concerns about unethical or substandard online pharmacies, the National Association of Boards of Phar­ macy has developed criteria to verify that online stores meet standards. At the present time 17 online pharmacies have been veri­ fied. Access: http://www.nabp.net/vipps/ intro.asp. C lin ical tria ls Both consumers and health professionals may want to know what drugs are currently being tested for which conditions. • ClinicalTrials. The National Institute of Health has developed ClinicalTrials to pro­ vide patients, family members, and members of the public with current information about clinical research studies. The site also pro­ vides general information about clinical tri­ als. Access: http://clinicaltrials.gov. • Centerwatch. This site considers itself the information source for the clinical trials industry. Access: http://www.centerwatch. com. N atural products Herbals, minerals, and vitamins are classed as dietary supplements. With the passage of the Dietary Supplements Act of 1994, the FDA is no longer responsible for assuring the safety of the ingredients in dietary supplements be­ fore they are marketed. Drugs must be proved to be effective and safe; dietary supplements have no such requirement. Web sites that pro­ mote natural products are generally inaccu­ rate, filled with anecdotal claims and personal testimony. Fortunately, there are some Web sites that can provide information about herb­ als that is based on evidence rather than con­ jecture. • Longwood Herbal Task Force. This joint effort of Boston’s Children’s Hospital, Massachusetts College of Pharmacy and Health Science, and the Dana Farber Cancer Institute, maintains one of the best herbal Web sites. Included here are lengthy monographs that link claims with the scientific evidence as well as leaflets for both clinicians and pa­ tients. Its only drawback is that the number of herbals covered is limited. Access: http:// www.mcp.edu/herbal/. • HerbMed. The Alternative Medicine Foundation, a nonprofit organization located in Bethesda, has created this useful database, which contains summaries of published stud­ ies done with commonly used botanicals, with links to the articles’ abstracts in PubMed. Adverse effects are linked to the FDA’s ad­ verse events reports. Access: http://www. herbmed.org/. • National Center for Complementary and Alternative Medicine. This is the part of the National Institute of Health that spon­ sors research on complementary and alter­ native medicine. At their site, you’ll find fact sheets on natural products and also “consen­ sus reports,” summaries of conferences that came to conclusions about the use of certain alternative m edicines. Access: h ttp :// nccam.nih.gov/. • International Bibliographic Informa­ tion on Dietary Supple­ ments (IBIDS). This bib­ liographic database of “published, international scientific literature on dietary supplements, including vitamins, minerals, and botanicals.” You may choose to search the full database or for consumer references or peer-reviewed http://www http://www.riteaid.com http://www.ncbi.nlm.nih.gov/PubMed/ http://www.nabp.net/vipps/ http://clinicaltrials.gov http://www.centerwatch http://www.mcp.edu/herbal/ http://www 704 / C&RL N ew s ■ Ju ly /A u g u st 2001 journals only. Access: http://ods.od.nih.gov/ databases/ibids. html. • Consumerlabs. One of the difficulties with herbals is that often the product that you buy may contain very little of the active ingredient. Consumerlabs tests natural prod­ ucts to see what they actually contain; some of their results are available for nonsubscrib­ ers. Access: http://consumerlabs.com. • A Mini-Course in MEDICAL BOTANY. For those who want to learn about natural products themselves, there is “A Mini-Course in MEDICAL BOTANY” by James A. Duke, one of the gurus on the use of herbals. The site contains his actual lecture notes. Access: http://www.ars-grin.gov/duke/syllabus/. Illegal drugs Illegal use of drugs may involve either the use of illegal substances, such as cocaine or heroin, or the illegal use of prescription drugs, such as barbiturates and tranquilizers. Un­ derstanding how these drugs act upon the body may help in understanding the addic­ tion. • National Institute on Drug Abuse. This is a nicely designed site with clearly marked sections for health professionals, par­ ents and teachers, and students. Research reports, statistics, directories of street names for drugs, and a host of other information can be found here. Access: http://www.nida. nih.gov/. • Drug Enforcement Administration. This Web site contains a listing of “drugs of concern,” as well as access to schedules of controlled substances and statistics, such as the number of meth lab seizures over the last decade. Access: http://www.usdoj.gov/ dea/. • Center for Substance Abuse Research (CESAR). Located at the University of Maryland, the CESAR site provides good basic information and nu­ merous charts and statis­ tics. Access: http:// www.cesar.umd.edu/. Drug sales statistics • Hoover’s Online. The pharmaceutical industry is one of the largest in the United States. Information about the industry itself can be found on business sites, such as Hoover’s O nline. Access: http:// www.hoovers.com. • Drug Topics. Very often students seek statistics on the use or sales of prescription drugs. Once a year, a marketing firm, IMS America, does a National Prescription Audit, sampling the number of prescriptions per drug. Some of its results can be found on the Drug Topics site, a pharmacy trade maga­ zine. Its “Pharmacy Facts and Figures” lists the top 200 brand-name and generic drugs, both by number of prescriptions and by re­ tail sales. Access: http://dt.pdr.net/dt/. Note 1. PharmInfonet (pharminfo.com) has been a primary gateway for pharmacy infor­ mation for a number of years. Unfortunately, it has evidently gone out of existence. ■ ( “Inform ation literacy . . . ” cont. from page 690) major theme that ran through my interviews and other work observations is that it is criti­ cal that employees be good learners in any fast-paced work environment. 3. The newly developed TekXam, “the nationwide standard for technical lit­ eracy,” incorporates many information literacy skills. Note the test objectives and online quiz at their Web site (http://www.tekxam. com). 4. “Information Literacy in the Informa­ tion Age: Sabbatical Project Report,” includ­ ing the instructional modules, is available on the Web at http://www.cabrillo.cc.ca.us/ -tsmalley or http://www.topsy.org. ■ http://ods.od.nih.gov/ http://consumerlabs.com http://www.ars-grin.gov/duke/syllabus/ http://www.nida http://www.usdoj.gov/ http://www.cesar.umd.edu/ http://www.hoovers.com http://dt.pdr.net/dt/ http://www.tekxam http://www.cabrillo.cc.ca.us/ http://www.topsy.org C&RL N e w s ■ Ju ly / A u g u s t 2001 / 705 Find it. Faster. You just got a request for a list of grocery stores in a three-state area with more than 20 employees. You could search through dozens of reference sources to create that list. Or, you could call the Library Division of infoUSA. We offer the country’s most extensive databases of business and residential information. 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