Mims Drug Book
Is it evidence-based? Save time by looking at high-quality, pre-appraised evidence sources first, such as the Australian Medicines Handbook (AMH), Therapeutic Guidelines and BMJ Best Practice. These are sources which have done the work of searching and critically appraising the evidence for you. They integrate this evidence with expert review to produce the best advice currently available. Systematic reviews and meta-analyses are the next best evidence.
Mims drug guide Sun, 09 Dec 2018 17:59:00 GMT mims drug guide pdf - The Monthly Index of Medical Specialities or MIMS is a pharmaceutical prescribing reference guide. MIMS DRUG REFERENCE BOOK. Mims book for sale Current edition Txt. Download the Gumtree app for iOS or Android.
Reviews that are not systematic, older texts, and clinical trial reports (even randomised controlled trials) are lower quality evidence and require critical appraisal. Sources of medicines information AMH, Therapeutic Guidelines and NPS MedicineWise cover most commonly prescribed medicines and conditions and should be among the first resources consulted. This information is evidence-based, current and reflects Australian best practice. The layout of AMH and Therapeutic Guidelines also allows rapid access to the information needed to prescribe safely. NPS MedicineWise and Australian Prescriber provide free, reliable, independent information on drugs and therapeutics.
NPS MedicineWise produces a number of resources prescribers can rely on to stay informed. Australian Prescriber covers therapeutic issues and controversies, new drugs and their place in therapy, and provides practical reviews on drug use and diagnostic tests. Resources like BMJ Best Practice, Clinical Evidence, DynaMed Plus, UpToDate, and current evidence-based guidelines provide rapid access to information on treatment of specific conditions and should be consulted next. An alphabetical listing of resources and access methods to drug information is given in the.
Alphabetical list of resources and access methods to drug information AHFS Drug Information 2016. American Society of Health-System Pharmacists. AusDI AusPARs Australian Don’t Rush to Crush Handbook: Therapeutic Options for People Unable to Swallow Solid Oral Medicines. Society of Hospital Pharmacists of Australia. Australian Injectable Drugs Handbook. Society of Hospital Pharmacists of Australia.
Australian Medicines Handbook Australian Prescriber Better Health Channel BMJ Best Practice Cochrane Library Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Briggs GG, Freeman RK. Philadelphia (PA): Lippincott Williams & Wilkins; 2015. DynaMed Plus Epocrates Goodman & Gilman’s The Pharmacological Basis of Therapeutics. Brunton LL, editor.
New York: McGraw-Hill; 2011. LactMed Lexi-Interact (also available via UpToDate and Lexicomp subscriptions) Martindale: The Complete Drug Reference. Brayfield A, editor.
London: Pharmaceutical Press; 2014. Mayo Clinic (USA) MedlinePlus (USA) MedlinePlus Herbs and Supplements Medscape Micromedex Solutions Database MIMS Australia National Centre for Complementary and Integrative Health and National Guideline Clearinghouse (USA) Natural Medicines NeoFax Database NHMRC Guidelines NHS Evidence (UK) NICE (UK) NPS MedicineWise NPS Radar Paediatric Emergency Medication Book. Craig S, editor. Melbourne: Monash Children’s Hospital; 2014. Paediatric Injectable Guidelines. Royal Children’s Hospital Melbourne.
PBS Public Summary Documents Pediatric Injectable Drugs (The Teddy Bear Book). Phelps SJ, Hagemann TM, Lee KR, Thompson AJ. Bethesda (MD): American Society of Health-System Pharmacists; 2013. PEMSoft Pharmacokinetics Made Easy.
Sydney: McGraw-Hill Education; 2009. Pregnancy and Breastfeeding Medicines Guide. The Royal Women’s Hospital. RACGP Clinical Guidelines RACGP Endorsed Resources and Accepted Clinical Resources Seyffart’s Directory of Drug Dosage in Kidney Disease.
Munich: Dustri-Verlag; 2011. Stockley’s Drug Interactions Stockley’s Drug Interactions. Preston CL, editor. London: Pharmaceutical Press; 2016. Stockley’s Herbal Medicines Interactions Stockley’s Herbal Medicines Interactions. Williamson E, Driver S, Baxter K, editors. London: Pharmaceutical Press; 2013.
TGA TGA Prescribing Medicines in Pregnancy Database The Doctor’s Bag app ( Australian Prescriber) Therapeutic Guidelines TRIP Database UpToDate UpToDate Patient Information Pharmaceutical companies can provide information on their own products, including detailed information on stability, excipients and adverse effects. Product information and consumer medicines information The product information contains basic information on a medicine including its ingredients, pharmacokinetics, mechanism of action, approved indications, doses, contraindications, precautions, adverse effects and appearance. It does not contain comparative information. The product information is written by the pharmaceutical company sponsor, then reviewed and amended by the Therapeutic Goods Administration (TGA). For older or off-patent drugs, the product information may not reflect current accepted practice, and adverse effects and interactions information may not be up to date. For example, metformin is widely and safely used for type 2 diabetes in patients with creatinine clearances less than 60 mL/minute, despite this practice being contraindicated in the product information. Polycystic ovary syndrome is a recognised indication for metformin but is not listed in the product information.
The consumer medicines information is also written by the pharmaceutical company. It is based on the product information and provides clear, unbiased information to help patients take medicines safely. The current product information and consumer medicines information are available from the TGA website, NPS MedicineWise and from compendia like MIMS and AusDI (previously AusDI Advanced or Catalyst). Many prescribing software packages use MIMS as their information source, while AusDI is the information source behind Medical Director. Both MIMS and AusDI write their own abbreviated information for drugs and have features such as interaction checkers, gluten content, use in sport, and searchable product images that can help identify tablets and capsules.
Each also has unique features. For an additional cost MIMS includes information on crushing or dissolving products for patients with swallowing difficulties or nasogastric tubes from the Society of Hospital Pharmacists of Australia’s (SHPA) publication the Australian Don’t Rush to Crush Handbook.
AusDI’s unique features include information on lactose and latex content, and detailed independent drug monographs which cover approved and unapproved uses, mechanism of action, pharmacokinetics, interactions, dosage in age groups and organ failure, and use in pregnancy and lactation. Pharmacology texts and databases Pharmacology texts provide information on how drugs work, how they compare to other drugs, their pharmacokinetics, interactions and uses. Goodman and Gilman’s The Pharmacological Basis of Therapeutics is considered the gold standard text on pharmacology but there are many others. Pharmacokinetics Made Easy is a simple and helpful guide to practical pharmacokinetics.
Micromedex is a database containing drug monographs, an interaction checker, information on intravenous compatibility, drug use in pregnancy, Martindale (the UK standard reference on drugs), and a toxicology database (Poisindex). Some features require additional subscriptions. The monographs have detailed information on clinical use, adverse effects and comparative efficacy. Other evidence-based medicine sources The TRIP database (Turning Research into Practice) is a search engine designed to find high-quality evidence quickly. Results can be filtered by type, for example systematic reviews, and scored for relevance, quality (by publisher) and currency, with higher ranked results appearing first. The National Institute for Health and Care Excellence (NICE) provides Evidence Search, a search engine of several authoritative UK sources. The Cochrane Library is free within Australia and provides access to Cochrane reviews, critiques of other systematic reviews, economic evaluations and a large database of controlled trials.
Evidence-based guidelines such as Therapeutic Guidelines and the RACGP clinical guidelines provide information on diagnosis and treatment in specific conditions, but usually have little information on drugs other than dosage and indications. UpToDate provides information on diagnosis and pathophysiology, but therapeutic recommendations may not be consistent with Australian practice. It may be useful for information on rarer conditions, for example those not covered by Therapeutic Guidelines. Bibliographic databases PubMed/Medline and Embase provide access to the medical literature and should ideally be used together. Both cover the major medical journals but they also have unique content, so using only one may mean that essential references are missed. Learning how to use them well can save time and improve the quality of information retrieved. The ‘Clinical Queries’ filters can save time by restricting results to clinical studies.
If you do not have the time or skills to search properly, consult a medical librarian or medicines information specialist. Information found from literature searches requires critical appraisal. Drug use in pregnancy and lactation The product information rarely contains useful information on drug use in pregnancy or lactation. The Women’s Pregnancy and Breastfeeding Medicines Guide provides brief information on the safety of drug use in pregnancy by trimester, and in lactation. The print version was replaced by an online database in July 2015. More detailed information can be found in Briggs and Freeman’s Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk.
Micromedex has information on drug risk in pregnancy via the three databases in Reprorisk. There are two telephone advisory services: MotherSafe (NSW) and the Royal Women’s Hospital (Victoria). Lactation resources include Medications and Mothers Milk (print and online), and free fact sheets from LactMed. Complementary and alternative medicines Reliable information on complementary and alternative medicines (including herbs and products used with or instead of conventional medicines) is harder to find than for conventional medicines.
One of the best resources is the Natural Medicines database. It has an interaction checker which includes conventional medicines and complementary and alternative medicines. The database also has information on indications, safety, efficacy, adverse effects, nutrient depletions, and use of complementary and alternative medicines in pregnancy, lactation and sport. Medicines Complete offers three online resources – Herbal Medicines, Dietary Supplements and Stockley’s Herbal Medicines Interactions. Reliable free information is available from MedlinePlus Herbs and Supplements and the National Centre for Complementary and Integrative Health, a US National Institutes of Health resource.
Where not to look Wikipedia, Google and internet searches can uncover worthwhile information but they should not be relied on as the primary source of drug information. They provide background information and show what information patients may be reading. While Google Scholar may retrieve more scholarly publications, searching is less precise than with medical databases and the quality of results is not consistent. It can be worth checking Google Scholar for full text articles.
Finding the few useful references in Google or Google Scholar often takes far longer than a medical database search. PubMed/Medline, Embase, Cochrane and the TRIP database will provide more reliable references, and more precise results.
Results: We observed a variation in average number of indications per drugs given in CDSCO (2.2 ± 0.25), NFI (3.51 ± 0.42), MIMS (2.98 ± 0.29), and PI (3.18 ± 3.52). The CDSCO and NFI did not contain information about indication for 10 and 17 drugs, respectively, while MIMS and PI contained information about all the selected drugs. A subset analysis was done for 24 such drugs which were mentioned in all the four sources and it was found that NFI had listed the maximum number of indications per drug (3.79 ± 0.53), followed by PI (3.08 ± 0.44), MIMS (3.04 ± 0.51), and CDSCO website (2.66 ± 0.37) and this difference was found to be statistically significant ( P = 0.02). We also observed some gross qualitative variation regarding drug information given in different sources.
INTRODUCTION Irrational and inappropriate use of drugs can lead to suboptimal clinical benefit and possible adverse drug reactions (ADRs). Availability of clinically relevant, contemporary, and unbiased drug information goes a long way in promoting rational use of drugs. There are various sources of information which are utilized by treating physicians for accessing relevant drug information such as their indications, ADRs, contraindications, and special precautions.
Drug information is usually sourced from National Formularies (e.g. National Formulary of India (NFI), British National Formulary), package inserts (PIs) of drugs, drug compendia such as Monthly Index of Medical Specialities (MIMS), Current Index of Medical Specialities (CIMS), and medical textbooks., The drug information available in various sources should be uniform, reliable, and conforming to the regulatory label of the drug. Every drug is approved for a specific indication(s) by drug regulator of the country, and these indication(s) is/are known as approved indication(s) of the drug., If the drug is used for any indication other than the approved indication, it is known as off-label use of the drug. Approved indications of all the approved drugs are available with Central Drugs and Standards Control Organization (CDSCO), which is the national drug regulator in India. It has been observed that there is variation in the quantity and quality of information mentioned in different drug information sources and a single credible benchmark is lacking.
Mims Drug Book Pdf
Such variation not only deprives the medical fraternity from accessing reliable drug information but can also promote off-label and irrational drug use leading to increased incidence of adverse reactions and possible treatment failure., We planned the present study to assess this variation in a sample of randomly selected drugs with respect to their indications given in various sources of drug information. MATERIALS AND METHODS We identified 50 commonly used drugs belonging to different groups (e.g. Antimicrobials, antihypertensives, analgesics, antiulcer and antiemetics, anticancers, antidiabetics, and antiobesity drugs and also lifestyle drugs such as sildenafil) used in various specialty and superspecialty centers of our hospital.
These drugs were chosen on the basis of prescription pattern in the hospital. Two senior residents (D.M. Clinical Pharmacology students) and one PhD student collected and analyzed the PIs of the selected drugs. These drugs were then analyzed for any variations in the information on a number of indications as mentioned in commonly used drug information sources (CDSCO web site, NFI, MIMS, and PIs). The following parameters were assessed. A subset analysis was done in respect of only those 40 drugs which were available in CDSCO.
NFI was excluded from this analysis as this source had information of only about 24 of these 40 drugs. Hence, this analysis included only three sources (CDSCO, MIMS, and PI). In respect of these 40 drugs, the PI had listed maximum number of indications (2.95 indications/drug), followed by MIMS (2.70 indications/drug) and CDSCO website (2.20 indications/drug). We found that the difference in a number of indications given in these three sources was not statistically significant ( P = 0.07). DISCUSSION In India, Drugs Controller General of India is the drug regulatory authority who is responsible for granting approval and marketing permission of drugs in our country.
The drugs are approved by drug regulator of any country for specific indications in specified dosage, which is known as the labeling information of that particular drug. However, the actual use of the drug in clinical practice may vary and may not be according to its labeling information at times. Treating physicians can and do use drugs for any indication based on his/her clinical judgment.
For example, metformin is used for the treatment of polycystic ovarian disease which is not its approved indication. Such a use of an approved drug is known as off-label use.
Off-label use of a drug is not illegal, however, it may be irrational or unscientific. In order to promote the rational and scientific use of drugs, it is important that relevant information about any drug, namely its indications, contraindications, and dosage are readily available to the prescribing physicians. Some common sources which are relied upon by the prescribing physicians to access drug information are NFI, PI, commercially published drug compendia such as MIMS and CIMS., The information available in such sources should confirm with the labeling information approved by the drug regulator of that country so that there is uniformity in decision making irrespective of the source(s) of information. We undertook this study to assess the quantity and quality of drug information available in various sources and compared it with the labeling information of the drug as provided in the CDSCO website, which is the regulatory benchmark. The information about indications was taken as the sole benchmark of overall drug information, and various sources were compared on the basis of this parameter. It was observed that no information about indications of 10 out of the selected 50 drugs was available on the CDSCO website. Of these 10 drugs, 8 (tablet metformin, tablet acetazolamide, tablet verapamil, tablet carbamazepine, tablet spironolactone, tablet nitrofurantoin, tablet methotrexate, and injection isoprenaline) drugs were not even mentioned and the rest 2 (tablet propranolol and tablet prazosin) were enumerated without any mention of indications.
This can be explained on the basis of the fact that CDSCO website only contains information from 1971 onward, and all these missing drugs are fairly old. NFI, on the other hand, did not contain information about 17 drugs. NFI is mandated to include all the drugs in National List of Essential Medicines and some other commonly used drugs.
The most of the missing drugs (such as risedronate, erythropoietin, and faropenem) are used only in specialized centers and hence shall not be a part of NFI. However, the indication information about some commonly used drugs such as prazosin, levofloxacin, and chlorthalidone was also missing in NFI. MIMS is a commercially available drug information compendium and was found to contain more number of indications as compared to the regulatory benchmark. Since this source is commonly utilized for seeking drug information, such a discrepancy may encourage off-label, and sometimes irrational, use of drugs. PIs were also found to contain maximum indications over and above the ones mentioned in regulator's website.
In our country, PIs are to be provided to the regulator at the time of registration. However, providing and publishing PIs along with drug packages in neither regulated nor mandatory. In fact, all the pharmaceutical companies do not provide PIs. However, when available, listing any indication in PI which is not in consonance with the regulator's website may again lead to off-label and possible irrational drug use., On the basis of aforementioned, it can be safely inferred that the CDSCO website does not contain information about some commonly used drugs even while these drugs are marketed in India.
These 10 drugs are part of 50 commonly prescribed drugs as identified for this study. If all the drugs marketed in India are checked, this number may increase. Such a deficiency has the portent to compromise the robustness of regulatory benchmark and may lead to confusion regarding the appropriate use of drugs.
This study highlights the discrepancies in drug information available in various sources by taking a representative sample of commonly used drugs. To the best of our knowledge, this study, though parsimonious in design, is the first such attempt to address this issue.
Mims Drug Handbook Pharmacist
These 50 drugs were identified on the basis of the prescription pattern in our hospital which is a tertiary care center. One limitation of this study, is that, this prescription pattern may vary from one hospital to other, and a more broad based selection criteria for identifying drugs may be desirable.
CONCLUSION Variation exists in the quantity and quality of information on indications about drugs available in various sources. PI and MIMS provide information on indications about maximum number of drugs. However, this information does not conform to regulatory benchmark all the time. Information about a number of drugs was not available in CDSCO website and NFI.
CDSCO website is the regulatory benchmark and requires updating so as to provide a sound and reliable reference regarding drug information for all the stakeholders. Further studies involving large sample of drugs and more variables (such as side effect profile, dosage information, information on drug interactions, and special precautions and contraindications) are required to further elucidate the issue of variation in drug information.