Tuesday, April 22, 2014

Using a Lifeline: Drug Information

Posted by Adam Loyson at Tuesday, April 22, 2014

With the end of the semester approaching, final exams on the horizon, and commencements just around the corner, I write to you about my exciting tour on rotation with drug information (DI).  On this second to last rotation, I made sure to put in extra effort and learn as much knowledge as possible before my chapter as a student pharmacist later comes to a close.  I also continued to grow my skills in conducting systematic searches for information and providing clear and concise evidence-based answers to a variety of healthcare professionals.  Routine day on rotation you say?  Definitely not!  There were so many more opportunities to get involved while working in DI, some of the most rewarding I elucidate on below. 

The Basics
Today, there is an abundant amount of health information on the internet with much of it sketchy at best.  DI services, therefore, are a valuable resource to provide accurate and quality information in a timely manner.  The Drug Information Service I worked with while on rotation was responsible for servicing a tertiary healthcare center comprised of an adult hospital, a children’s hospital, 120 outpatient clinics, and 40 health centers, comprising a total of over 900 patient beds.  In addition, the service also provided pharmacotherapy consultation services for practitioners in southeastern Michigan.  The DI call center’s volume was rated at approximately 1,800 questions annually.  While on rotation, I had the opportunity to explore and find answers to the most common questions (medication’s therapeutic use, pharmacokinetics, dosing, drug interactions, toxicity, pregnancy/lactation use, compatibility, shortage availability) to the more extraordinary inquiries (homeopathic use, tapering regimens, stability in refrigerator/freezer outages, compounding regulations).  To answer effectively, I participated in weekly topic discussions and evidence-based medicine assessments to review most helpful DI resources, including those found online.
Of the more interesting requests during rotation, I was tasked to find out more on the use of oseltamivir in national strategic stockpiles, specifically the proper emergency preparedness handling of expired medications.  As someone hoping to enter public health after graduation, this was right up my alley!  After contacting the Food and Drug Administration, Centers for Disease Control, and my state’s community health department, I discovered that select lots of oseltamivir may receive extensions to their expiration dating via FDA announcement in emergent times of natural disaster.  Another interesting request came from a transplant pharmacist wanting to know more about the bioavailability and safety profile of magnesium treatments complexed with protein.  Early studies demonstrate more patients tolerating this organic chemical identity as compared to magnesium oxide.  I also found that larger trials were currently being conducted by the manufacturer, who agreed to send my institution notice as soon as they were published.

More than just an Operator
While answering drug information requests was a primary responsibility, I also participated in numerous projects associated with the Pharmacy and Therapeutics (P&T) committee, ambulatory infusion formulary committee, the cancer pharmacy committee, and the product and vendor selection subcommittee within the health system.  As the opportunity presented, I completed a P&T drug monograph on a monoclonal antibody aimed at inducing remission for those with ulcerative colitis and Crohn’s disease.  I also completed several MedWatch reports detailing drug adverse events and wrote a newsletter article to be sent out to the entire health system outlining the new guidelines released by the US Public Health Service detailing HIV post-exposure prophylaxis in occupational healthcare providers.  Of high value to the health system, I concluded my rotation by finishing a medication use evaluation on intravenous immunoglobulin to ensure proper ordering and dispensing of this extremely expensive blood product to patients.

Fuel for the Future

DI was just the rotation I needed to boost my skill set and confidence.  I now task other healthcare providers and students to give me their best shot.  If I don’t know the answer, I’ll know where to find it.  With another rotation completed, I continue on my path to being a professional with newly learned integration and collaboration skills necessary to help in determining the most appropriate course of action in a given healthcare situation.

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