Drug Information

As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here's a quick look at some of the stuff I found interesting.

Our facility is running a trial of DynaMed, “an evidence based medicine point-of-care” database. It reminds me of UpToDate.

From the DynaMed site:

• According to the National Academy Press (2001) 44-98,000 American deaths per year occur due to preventable medical errors; medical errors are estimated to cost the U.S. $17 to $29 billion annually
• Using the "best available evidence" for clinical decision-making improves health outcomes and reduces health care costs
• Busy clinicians use "fast and easy" resources expected to answer most of their questions instead of resources designed to provide the best current evidence
• Clinicians sometimes turn to textbooks and online resources with substantial breadth, but these resources do not use the best available evidence
• Physicians and other health care professionals need a resource where they can reliably answer most questions quickly and accurately (i.e., with the best available evidence)

The application is web-based and easy to use. I only played around with it for about 30 minutes, but was satisfied with what I saw. DynaMed has a nice list of clinical calculators and supports the use of handhelds, including the iPhone, iPod Touch and Android based devices.

I'll spend some more time evaluating DynaMed next week, but at this time I prefer UpToDate over DynaMed for the following reasons:

1) UpToDate appears to, on the surface at least, contain more in-depth information on any given condition

1) UpToDate use Lexi-Comp for their drug information

2) UpToDate has a nicer user interface

One of the best pharmacy jobs I ever had was working for a small compounding pharmacy in the Bay Area of California. Many of the prescription items compounded in this particular pharmacy had to be flavored based on the needs of the patient; sometimes animal, sometimes human. Regardless, the art of flavoring was always a challenge but also a lot of fun. I learned quite a bit about how to mask bitterness, how to use various sweeteners to get the flavor just right and how to use various flavor combinations to create some pretty tasty medications; it's an art. And don't underestimate the amount of science that goes into creating flavors like these or the science behind using those flavors to mask unpleasant tastes. It takes time, energy and patience.

FLAVORx, a company in Columbia, MD has taken a lot of the experimentation out of the flavoring equation by creating a system for dealing with “yucky medicine”.

The National Library of Medicine has a website know as Pillbox beta that allows anyone to use various identifiers on a tablet or capsule, i.e. imprint, shape, color, size and/or scoring, to quickly identify a medication. I've used systems like this many times for the emergency department when a patient would roll in the door with ten different medications all thrown together in a plastic baggie. The nurse would bring them to the pharmacy and say “I need you to tell me what these are”. I tried holding the baggie to my head like the Great Carnac on Carson, but most of the time I had to use other references to help me out.

The Palmdoc Chronicles:” I’ve had a Palm Pre for about 2 months now and I can declare that the device has seen tremendous improvement with firmware updates (pushed OTA) and a steadily increasing amount of useful applications in the Palm App Catalog and the unofficial Homebrew scene.

How usable is it as an smartphone for doctors? Well I can say it pretty much does replace your old PalmOS device as it is. One of the cool features of the old Palm PDAs is the ability to keep snippets of information in the Memos (Notes) in various categories for instant recall. These notes may be protocols, clinical pearls or practically any bits of information which you want to look up while rounding for instance.

WebOS’ builtin “post-it” type Memos is ok if you are keeping about 10-20 notes but pretty useless if you are talking about 300-500 notes or more. There are several solutions at hand which overcome this limitation.”

2009 brought many new and exciting changes not only in my personal life, but in the world of pharmacy and technology as well. I’ve learned many new things, gained some skills previously absent from my armamentarium, met some great new people, discovered the “real” internet for the first time, traveled more than ever before, discovered I don’t know diddly squat about a great many things, and am more excited about the next year than I can remember in recent history.

Below is a list of opinions about a great many things that I have seen and done over the past year. Some are pharmacy related, some are technology related, some are personal, and some are just random thoughts.

Recently I was fortunate enough to be a beta tester for the new Android version of Lexi-Comp's suite of medical information software. I was very excited for the opportunity as I've been using what I would consider inferior drug information resources since purchasing my Droid about a month ago. The installation was a problem initially as the databases wouldn't install directly to the microSD card on the Droid. As you can imagine, the databases are large and immediately filled up the physical memory on the device. Within a couple of weeks of reporting the problem to Lexi-Comp they had corrected the issue and sent me a new build that installed seamlessly.