DEFINTION

Tertiary DIR
MSc. Mustafa Al-Shoqran Al Shoqran

Tertiary literature is a core Knowledge established via primary literature or accepted as standard of practice within the medical community.

INTRODUCTION
Consist of textbooks, handbooks, compendia, review articles in journals. Serve as an i iti l place t id tif i f S initial l to identify information ti due to the fact that they provide a fairly complete and concise overview of information available on a specific topic

Textbooks

On various disease or drugs topics

Compendia

A vast array of information about many drugs such as Physician Desk Reference

Full texts databases

Including the internet, MICROMEDEX, Lexi

Review articles

Summarize a particular topic contain more current information

ADVANTAGES
The most commonly used sources of information because are easy to use, concise information. They provide a review of the literature by an expert in the field. Available as (handbooks, CD-ROMs)

DISADVANTAGES
Lag time (outdated even in new editions) Space limitation within a text prevent extensive discussion of a drug or topic. Errors in transcription, human bias, incorrect interpretation of information.

Evaluation of 3o DIR
Does the author have appropriate experience/expertise to publish in this area?

Evaluation of 3o DIR
Does the resources used free from bias or errors? Is the reference clear, concise, and easy to use?

Assess the text for timelines (when was the last edition published?) Are A statements of f f fact appropriately supported b i l t d by references? How many references does each section have and how up-to-date are they?

AVAILABILITY
Hard copy Coputarized: g p CD ROMs for single user computer or network. Internet access.

CLASSIFICATION
Tertiary drug information

General references

Specialized references

GENERAL Ref.
They are referral books. Their formats are either monographs or monographs plus chapters chapters. Used through their indexes NOT through their contents lists.

GENERAL Ref.
The most helpful of them to answer a drug related question are:

Martindale: the complete drug reference

Martindale
Provides reliable, unbiased and evaluated information on drugs and medicines used throughout the world. Published by Royal Pharmaceutical society of Great Britain every 4 years. Has a manufacturer directory and index by clinical use. Supplementary drugs and other substances (Herbals, toxic substances, acids, essential oils)

Drug facts and comparison

Drugs facts and comparison

Yearly publication Arranged by Therapeutic category, and Appendix of treatment guidelines. OTC listing Helpful summery/ comparison tables Contains information about investigational, D/C drugs, off-labeled uses, patient information.

Mosbys drug consult

Arrangement

Mosbys drug consult

Alphabetically by generic drug term Keyword index includes generic and brand names, indications, pharmacologic class and therapeutic use Pregnancy categories, FDA approval. Provide Extensive cost comparisons with up-to-date pricing information.

Mosbys drug consult

Provides childhood and adult immunization schedules. Brand names from more than 100 countries. y pp Commonly used herbals and supplements. Comparative Drug tables. Includes normal values of standard laboratory and function tests. Includes IV and syringe compatibility tables.

American Hospital Formulary Service (AHFS) Drug information

(AHFS) Drug information

FDA approved and off-labeled uses Yearly publication Information in monographs: g p

Drug Information Handbook (Lexi comp)

Chemistry, pharmacology, mechanism Dose, administration, pharmacokinetics Drug interaction, preparation, toxicity

Drug Information Handbook

Available as Pocket sized, PDA & online versions. Published annually. Drugs listed alphabetically by generic name. Useful charts and tables

MICROMEDEX

MICROMEDEX
Available as CD-ROM and PDA versions. Access information by brand or generic name of drug. Databases available: DRUGDEX main drug information database

Physician Disk Reference (PDR)

DISEASEDEX disease states IDENTDEX drug identification by imprint code POISINDEX Poisoning and toxicology

Physician Disk Reference (PDR)

Yearly publication Color pictures and markings for drug identification FDA approved product information only Available as hard copy, electronic format (CD-ROM), PDA.

Specialized References
1 Pharmacotherapy 1.

1. Pharmacotherapy
Pharmacotherapy: A Pathophysiologic A i l i Approach (Di i ) h (Dipiro)

1. Pharmacotherapy
Pharmacotherapy: A Pathophysiologic Approach (Dipiro)
Well written and referenced with helpful tables Pocket version available Focuses on drug therapy good background information therapy, Also covers non-drug treatment options Updated edition about every 4 years

1. Pharmacotherapy
Applied Therapeutics: The clinical (Koda-Kimble) i l use of d f drugs (K d Ki bl )

1. Pharmacotherapy
Applied Therapeutics: The clinical use of drugs (Koda-Kimble) (Koda Kimble)
Well written with focus on drug therapy Updated every 4 years Useful summary tables Case presentation format, may be more difficult to use as quick reference.

1. Pharmacotherapy
The Washington manual medical therapeutics of

Quick references with many charts and tables. p y y Updated about every 2-3 years.

Specialized References
2 Internal Medicine 2.

2. Internal Medicine
Harrisons principles of internal medicine

2. Internal Medicine
Harrisons principles of internal medicine
Gold standard for internal medicine, referenced. Published every 5 years. Pathophysiology clinical presentation, diagnosis and Pathophysiology, presentation treatment guidline. Little drug information & dosing recommendation

2. Internal Medicine

2. Internal Medicine

The Merk Manual

The Merk Manual

Used by many healthcare professional Includes pediatrics, gynecology, psychiatry, p gy, y g gy, ophthalmology, otolaryngology, dental disorders. Available for health care profisional copy and for public copy

2. Internal Medicine

2. Internal Medicine

Clinical Medicine (Kumar and Clark)

Clinical Medicine (Kumar and Clark)

Explains the management of disease including the latest developments in treatment. p Color coded chapter are attractive and make the book easy to navigate. Comprehensive index, clearly displayed, pinpoints information rapidly

2. Internal Medicine

Clinical Medicine (Kumar and Clark)

Boxes and tables display important information. Includes GI, Rheumatology, Renal, cardiovascular, p y, , g py respiratory, Intensive care unit, drug therapy and poisoning.

Specialized References
3 Cardiology 3.

3. Cardiology

3. Cardiology

Text book of cardiovascular medicine

Text book of cardiovascular medicine

Published every 5 years Addresses modern-day issues such as medical gq y economics and assessing quality of care. Well referenced

3. Cardiology

3. Cardiology

Hursts the Heart

Hursts the Heart

Organized by condition Comprehensive information on drug therapies and g regimens Rapid interpretation of ECG. Best guide to learning ECG

4. Pediatrics

Harriet Lane Handbook

Specialized References
4 Pediatrics 4.

4. Pediatrics

4. Pediatrics

Harriet Lane Handbook

Useful pocket guide published every 3 years Has dosing information Electronic version updated annually Four sections: emergency management, diagnostic, formulary, and therapeutic data Some information on pregnancy and lactation

Pediatrics injectable drugs ( Teddybear Book ) (Teddybear Book)

4. Pediatrics

4. Pediatrics

Pediatrics injectable drugs ( Teddybear Book ) (Teddybear Book)

Alphabetical order by generic name Formerly known as guidelines for administration of p patient intravenous medications to pediatric p Dose, concentration, rate, cautions

Pediatric dosing handbook (lexi-comp) (lexi comp)

4. Pediatrics

5. Pregnancy

Pediatric dosing handbook (lexi-comp) (lexi comp)

Dose, administration, how supplied, contraindications, adverse effects, drug interactions, antidotes. Also contain adult doses Indexed by generic name alphabetically

Drugs in pregnancy and lactation (Briggs)

5. Pregnancy

6. Infectious Disease

Drugs in pregnancy and lactation (Briggs)

Excellent reference, gold standard Updated every 4 years Alphabetical by generic name Generic name,class, & pregnancy risk factor Summaries of risk to fetus and during breastfeeding referenced

Mandells Principle and practice of Infectious Dzz

6. Infectious Disease

6. Infectious Disease

Mandells Principle and practice of Infectious Dzz

Gold standard reference Infections, diagnosis, treatment and useful background information.

Sanford Guide antimicrobial therapy

to

6. Infectious Disease

7. Oncology

Sanford Guide antimicrobial therapy

Published annually Pocket size and easy to use

to

Cancer: principle and practice of oncology (devita)

g p g Includes: dosing in renal impairment, brand & generic names, empiric therapy guidelines, antimicrobial spectra of the agent Not well referenced

7. Oncology

7. Oncology

Cancer: principle and practice of oncology (devita)

Gold standard Published every 3-4 years Pathology treatment options, and advers effects Pathology, options Referenced

Cancer handbook

chemotherapy

7. Oncology

8. Pharmacology
Goodman & Gilmans pharmacological basis of therapeutics

Cancer handbook

chemotherapy

Useful index, introduction on malignancies Pharmacology and use of chemotherapeutic agents Lists investigational drugs and combinations Well referenced

8. Pharmacology
Goodman & Gilmans pharmacological basis of therapeutics Useful index, introduction on malignancies Pharmacology and use of chemotherapeutic agents Lists investigational drugs and combinations Well referenced

9. Drug Interaction
Hansten & Horns drug interactions analysis and management

9. Drug Interaction
Hansten & Horns drug interactions analysis and management Introductory chapters discusses mechanisms of interactions g Rates significance of interaction and recommends management Referenced Not complete, subjective rating system

9. Drug Interaction

Stockleys drug Interaction

9. Drug Interaction

9. Drug Interaction

Stockleys drug Interaction

Monographs contains a summery, clinical evidence for interactions under discussion, the probable mechanism, clinical importance and management. Covers interactions between therapeutic drugs,

Stockleys drug Interaction

Based on published sources and fully referenced. Covers over 14000 drug interactions Contains over 2800 monographs Available as Books & CD-ROM

proprietary medicines, herbal medicines, foods, drinks, pesticides and some drugs of abuse.

10. Adverse Drug Reaction Meylers side effects of Drugs

10. Adverse Drug Reaction Meylers side effects of Drugs

Indexed by drug and by adverse event Most comprehensive, Contains tables and lists Published every 4 years Information provided: effects on organs and systems, lab/diagnostic interference.

11. Compatibility & Stability Handbook on Drugs (Trissels) (Trissel s) Injectable

11. Compatibility & Stability Handbook on Drugs (Trissels) (Trissel s)

Gold standard reference Updated every 2 years with annual supplements Drug organized alphabetically and stability with diluents and drugs Solution, Y-site, syringe, and additive compatibility. Table format, very useful

Injectable

11. Compatibility & Stability King Guide to Parenteral Admixtures

11. Compatibility & Stability King Guide to Parenteral Admixtures

Chart format Alphabetical listing by generic name May have informations not available in Trissels Trissel s Pages are not numbered

12. Compounding & Pharmaceutics Remingtons the science and practice of pharmacy

12. Compounding & Pharmaceutics Remingtons the science and practice of pharmacy
Helpful for extemporaneous compounding Pharmaceutical calculations, chemistry, radioisotopes New edition every 5 years

12. Compounding & Pharmaceutics

12. Compounding & Pharmaceutics

Merk index

Merk index
Chemical name, formula, & structure Physical data, therapeutic category Published every 6-10 yeaars

12. Compounding & Pharmaceutics United state PharmacopoeiaNational formulary

12. Compounding & Pharmaceutics United state PharmacopoeiaNational formulary

Official monographs for preparation and assay of pharmaceutical products y y periodic supplements. pp Published every 5 years with p Information on storage, packaging, labeling, reference standards, & assays

12. Compounding & Pharmaceutics United state PharmacopoeiaNational formulary

USP: drug substances & dosage forms NF: pharmaceutical ingredient

13. Pharmacokinetic Basic clinical kinetics (winters) Pharmaco-

13. Pharmacokinetic Basic clinical kinetics (winters)

Case study format Includes principles of monitoring therapy, basic p pharmacokinetics, & clinical application , pp Appendix of commonly used equations

13. Pharmacokinetic
Applied Pharmacokinetics: principles of therapeutic drug monitoring

Pharmaco-

13. Pharmacokinetic
Applied Pharmacokinetics: principles of therapeutic drug monitoring Published by applied therapeutics Most advanced reference More specific drug information than Winter s Winters Includes analytical methods and clinical applications.

14. Toxicology
Toxicologic Emergencies (Goldfranks)
Poison management guidelines Useful tables and case studies Practice multiple-choice questions

14. Toxicology
Casarett & Doulls Toxicology: the basic science of poisons
Gold standard in toxicology field Basic concepts & fundamental principles needed to grasp current issues in modern toxicology The text is organized and presented in a logical progression of general principles to specific topics such as organ system, specific agent, & environmental toxicology