What resources do you use while on the job

[dingo499]

Hello everyone,

I was wondering what resources do you use when you get various queries from a doctor. For example lets say patient is prescribed X drug but it's not available and you have to suggest a suitable alternative? Also do you have a resource for checking the latest guidelines for various conditions e.g. recommended treatment for hypertension?

Thanks

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[CountBy5s]

I don't look up guidelines at work. Who has more than say 30 seconds to 2 min to make a choice but I do have a copy of the recent Stanford guide for antibiotics. And a recent copy of a pharmacotherapy handbook. I've used them maybe once a year.

So I'm curious to see some answers here.

 

[Chrissystone]

I have the wholesaler order page up to see if anything's on backorder and a few major insurance formulary. If I don't have it open, I tell the doctor I'll look on the insurance formulary for an alternative that they pay for, give me a few minutes. Facts and comparisons up for any dosing conversions.

There isn't time to look up guidelines at work. You'll have to do that on your off time. I also subscribe to pharmacists letter that gives me nice little charts for most disease states. I like their charts because it includes the retail price too.

 

[RxRetailRx]

For abx I have a list of bug/drug coverage in my pocket, bud ref for all insulin, all other info I use Lexicomp

 

[DrVader]

I love the Medscape app

 

[Rouelle]

I consult Clinical Pharmacology and Trissels fairly regularly. I keep a copy of Lexi’s Drug Information Handbook at home for when I am taking call. I actually look on package inserts once in a while.

 

[Lexington2012]

An updated antibiogram based on the local area.

 

[dingo499]

Thanks for sharing! Same thing here in the UK you rarely get time to look at guidelines but we have a book called the BNF which has a good summary of Tx options for various indications. Was wondering if there was a US equivalent?

 

[RxPreceptor]

Brain, Clinical pharmacology (work), & Lexicomp (personal) in that order...

 

[Charcoales]

Medscape -> type in condition -> medications

 

[Sine Cura]

Your pharmacy education and your work experience?

For example Qvar Redihaler does not work with spacers so what is your other readily available option for a mono-steroid that can be used with a spacer?

Atrovent is unavailable at the moment but why can't the patient use long-acting anticholingerics?

Pazeo is unavailable at the moment so the patient can settle for Pataday

 

[positivesign]

I love UpToDate for looking up first line therapies for condition X. Many of their recommendations follow guidelines from national organizations.
If this doesn't work, I go to PMC and they sometimes have good review articles I can quickly glance through.

 

[Chrissystone]

Your pharmacy education and your work experience?

For example Qvar Redihaler does not work with spacers so what is your other readily available option for a mono-steroid that can be used with a spacer?

Atrovent is unavailable at the moment but why can't the patient use long-acting anticholingerics?

Pazeo is unavailable at the moment so the patient can settle for Pataday

Actually had a qvar script the other day that rejected for redihaler for a 6 year old. Told the doctor he can do pa for qvar but it might be discontinued by manufacturer soon not sure. And then he asked me for alternative. I told him the plan covers asmanex hfa, arnuity ellipta and qvar redihaler. He asked me which one can be used with spacer and I said asmanex hfa and he said he doesn't know what that is and told me to disregard script. Huh???

 

[lane one]

I use that PharmD brain that I paid 150k for . Joking aside, in retail I used lexicomp mobile (well worth the money). On the inpatient side a combination of lexicomp, uptodate and globalrph will tackle 95% of the stuff you don't know. Primary literature is my last resort and I usually only dig through it if the inquiry is about something very new or very obscure.

 

[dingo499]

Nice one guys, so it looks like there are different resources people prefer. Would be interesting to hear from hospital pharmacists too, I'm sure they have their own preference. Hope the dispensaries aren't too hard on you all!

PS: As I type this reply I hear a medical negligence advert on the radio :/ (those *!%$)

 

[beautifulrobot]

I actually look on package inserts once in a while.

Bless you. You don't even want to know how much work goes into updating / revising those package inserts...

 

[RxPreceptor]

Rare occasions: Package insert (usually dose form specific question or about excipients), Plumbs, Epocrates (really good for pics on skin marks/derm diseases)

 

[BidingMyTime]

Nice one guys, so it looks like there are different resources people prefer. Would be interesting to hear from hospital pharmacists too, I'm sure they have their own preference. Hope the dispensaries aren't too hard on you all!)

AHFS Drug Information and for IV compatibility Handbook on Injectable Drugs.

 

[ThreeSouthAM]

• Micromedex (especially for Drug ID, IV compatibilities, storage & stabilities)
  
• UpToDate (especially for disease state guidelines)
  
• Lexicomp (especially for estimated drug prices)
  
• GlobalRPH (sterile IV compounding facts)
  
• Package Inserts (sterile IV compounding facts)