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Medicine

 

Review Essays of Academic, Professional & Technical Books in the Humanities & Sciences

 

Mosby's Drug Guide For Nurses, 6th Edition by Linda Skidmore-Roth (Mosby) Mosby's Drug Guide for Nurses, 6th Edition is a portable, current drug handbook containing information on more than 60 drug classifications and 4,000 individual generic and trade name drugs. Developed to meet student needs, this handbook includes detailed coverage of IV drugs; extensive coverage of interactions between drugs, drug classes, herbs, foods, and lab tests; a full-color drug identification guide; and a drug classification section covering groups of drugs by function. A disorders index helps the student locate information about drugs commonly used to treat more than 70 disorders. Special features promote safe medication administration and prevention of drug errors, including identification of high alert drugs, Do-Not-Crush and Nursing Alert icons, special Do-Not-Confuse headings, and guidelines for overdose treatment. Combination drugs are covered in an extensive appendix listing alphabetical brand names along with the products' generic components and dosages.

2005 Physicians' Desk Reference with PDR Electronic Library on CD-Rom  (Thomson) PDR enters its fifty-ninth year offering a wider array of pharmaceutical reference options than ever before. Long available unabridged—in print, on CD-ROM, and via the Internet—PDR now provides essential prescribing infor­mation in other forms as well.

Physicians' Desk Reference is published by Thomson PDR in cooperation with participating manufacturers. The PDR contains Food and Drug Administration (FDA)-approved labeling for drugs as well as prescription infor­mation provided by manufacturers for grandfathered drugs ,and other drugs marketed without FDA approval under current FDA policies. Some dietary supplements and other products are also included.

Each full-length entry provides you with an exact copy of the product's FDA-approved or other manufacturer-sup­plied 'labeling. Under the Federal Food, Drug and Cosmetic (FD&C) Act, a drug approved for marketing may be labeled, promoted, and advertised by the manufacter for only those uses for which the drug's safety and effectiveness have been established. The Code of Federal Regulations Title 21 Section 201.100(d)(1) per­taining to labeling for prescription products requires that for PDR content "indications, effects, dosages, routes, mentors and frequency and duration of administration,. and any relevant warnings, hazards, contraindications, side effects, and precautions" must be "same in lan­guage and emphasis" as the approved labeling for the products. The FDA regards the words same in language and emphasis as requiring VERBATIM use of the

approved labeling providing such information. furthermore, information that is emphasized in the approved labeling by the use of type set in a box, or in capitals, boldface, or italics, must be given the same emphasis in PDR.

The FDA has also recognized that the FD&C Act does not, however, limit the manner in which a physician may use an approved drug. Once a product has been approved for marketing, a physician may choose to prescribe it for uses or in treatment regimens or patient populations that are not included in approved labeling. The FDA also observes that accepted medical practice includes drug use that is not reflected in approved drug labeling. In the case of over-the-counter dietary supplements, it should be remembered that this information has not been eval­uated by the Food and Drug Administration, and that such products are not intended to diagnose, treat, cure, or prevent any disease.

The function of the publisher is the compilation, organi­zation, and distribution of this information. Each product description has been prepared by the manufacturer, and edited and approved by the manufacturer's medical department, medical director, and/or medical consul­tant. In organizing and presenting the material in Physicians' Desk Reference, the publisher does not war-

rant or guarantee any of the products described, or per-form any independent analysis in connection with any of the product information contained herein. Physicians' Desk Reference does not assume, and expressly dis­claims, any obligation to obtain and include any informa­tion other than that provided to it by the manufacturer. It should be understood that by making this material avail-able, the publisher is not advocating the use of any prod­uct described herein, nor is the publisher responsible for misuse of a product due to typographical error. Additional information on any product may be obtained from the manufacturer.

Other Clinical Information Products from PDR

For complicated cases and special patient problems, there is no substitute for the in-depth data contained in Physicians' Desk Reference. But on other occasions, you may find that the PDR® Monthly Prescribing GuideTM pro­vides a handy alternative. With concise summaries of the FDA-approved and other manufacturer-supplied labeling found in PDR, this 350-page digest-sized reference pre­sents certain key facts on more than 1,000 drugs, including the form, strength, and route; therapeutic class; approved indications; dosage; contraindications; warnings; precautions; pregnancy rating; drug interac­tions; and adverse reactions. Each entry alerts you to sig­nificant precautions you need to take, spells out the most common or dangerous adverse effects, summa­rizes the recommended adult and pediatric dosages, and supplies you with the PDR page number to turn to for fur­ther information. A full color insert of pill and product images allows you to correctly identify each product. Issued monthly, the guide is regularly updated, with detailed descriptions of the new drugs, to receive FDA approval, as well as providing FDA-approved-revisions to existing product information. In addition, you'll receive bulletins about major new developments on the pharma­ceutical scene, an overview of important new agents nearing approval, a heads-up on the latest pharmaceuti­cal issues to hit the consumer media, in-depth analysis of the common nutritional supplements that patients are taking, and a handy reminder of upcoming medical meet­ings. In fact, in one neat package you'll find the critical information you need to make a prescribing decision—with confidence that you're acting on the latest informa­tion available. To order your personal subscription to this important free monthly publication, simply call 1-800-232-7379. -

If you prefer to carry drug information with you on a handheld device like a Palm® or Pocket PC, you will want to know about mobilePDR®. This easy-to-use software allows you to retrieve in an instant concise summaries of the FDA-approved and other manufacturer-supplied label­ing for 1,500 of the most frequently prescribed drugs, lets you run automatic interaction checks on multidrug regimens, and even alerts you to significant changes in drug labeling, usually within 24 to 48 hours of announce­ments. You can look up drugs by brand or generic name,

by indication, and by therapeutic class. The drug inter-action checker allows you to screen for interactions between as many as 32 drugs. The What's New feature provides daily: alerts about drug recalls, labeling changes, new drug: introductions, and so on. This portable electronic reference is updated daily with the latest available. FDA-approved revisions to existing prod­uct information, plus the essential facts you need to make prescribing decisions for newly approved agents. Sync, anytime, day or night, at your convenience, to be sure you have the most recent information available. Our. auto-update feature updates the content and the soft-ware, so upgrades are easy to manage. mobilePDR® works with both the Palm and Windows CE operating sys­tems, and it's free to U.S.-based MDs, DOs, NPs; and PAs in full-time patient practice and to medical students and residents: Check it out today at www:PDR.net.

For those who prefer to view drug information on the Internet, PDR.net is the best online source for compre­hensive FDA-approved and other manufacturer-supplied labeling information, as found in PDR. Updated monthly, this Incredible resource allows you to look up drugs by brand or generic name, by key word, or by indication, side effect, contraindication, or manufacturer. The drug interaction checker allows you to screen for interactions between as many as 20 different drugs. The site pro­vides an index that can be searched to find comparable drugs. As a terrific extra benefit, images of all products are included for easy identification. Finally, as an added benefit, PDR.net hosts the download for mobilePDR®. At this one website, you get two great PDR products in one. In addition to all this, PDR.net provides links to such

useful information as Stedman's Medical .Dictionary,

MEDLINE, online CME programs, clinical trials registries, evidence-based treatment decision tools, medical newsletters, Internet directories, online formularies, and the FDA's Medwatch. A wealth Of information all in one place! Registration for PDR.net is free for U.S: based MDs, DOs, NPs, and PAs in full-time patient practice as well as for medical students and residents. Visit www.PDR.net today to register.

For those times when all you need is quick confirmation of a particular dosage, you will want to have a copy of the 2004 PDR PharmacopoeiaTM Pocket Dosing Guide. This handy little book can accompany you wherever you need to go, around the office or on hospital rounds. Only slightly larger than an index card and a half inch thick, it fits easily into any pocket, while providing you with FDA-approved dosing recommendations for more than 1,500 drugs. Unlike other condensed drug references, the infor­mation is drawn almost exclusively from the FDA-approved drug labeling published in Physicians' Desk Reference. And its tabular presentation makes lookups a breeze. The 2004 PDR Pharmacopoeias Pocket Dosing Guide is a tool youreally can't afford to be with-out.

The use of over-the-counter nutritional supplements has skyrocketed, and PDR can help you to learn more about this unfamiliar—even exotic—set of agents. PDR® for Nutritional SupplementsTM.. offers the latest scientific

consensus On hundreds of popular supplement prod­ucts, including an array of amino acids, co-factors, fatty acids, probiotics, phytoestrogens, phytosterols, over-the-counter hormones, hormonal precursors, and much more. Focused on the scientific evidence for each sup­plement's claims, this unique reference offers you today's most detailed, informed, and objective overview of a burgeoning new area in the field of self-treatment. To protect your patients and ensure that they use only truly beneficial products, this book is a must.

For counseling patients who favor herbal remedies, another PDR reference may prove equally valuable. The very popular PDR for Herbal MedlcinesT provides you with the latest science-based assessment of Some 700 botanicals. Indexed by, scientific, common, and brand names (as well as Western, Asian, and homeopathic indications), this volume also includes a Side Effects Index, a Drug/Herb Interactions Guide, an Herb Identification Guide with nearly 400 color photos, and a Safety Guide that lists herbs to be avoided during preg­nancy and herbs to be used only ;under professional supervision. Although botanical products are not official­ly regulated or monitored in the United States, PDR for Herbal ,Medicines provides you with authoritative infor­mation—the findings of the German Medicines Agency's expert committee on herbal medicines, Commission To maximize the value of PDR itself, you'll also need a copy of the 2004 edition of the PDR Companion Guide, a 1,700-page, (See review below) reference that augments PDR with nine unique decision-making tools:

•           Interactions Index identifies pharmaceuticals and foods capable of interacting with a chosen medication.

•           Food Interactions Cross-Reference lists drugs that may interact with a given dietary item.

•           Side Effects Index pinpoints pharmaceuticals associat­ed with each of 3,600 distinct adverse reactions.

• Indications Index presents a broad range of therapeu­tic options for any given diagnosis.

•           Off-Label Treatment Guide lists medications routinely used—but never officially approved—for treatment of nearly 1,000 specific disorders.

•           Contraindications Index lists drugs to avoid in the pres­ence of any given medical condition.

•           International Drug Name Index names the U.S. equiva­lents of some 15,000 foreign medications.

•           Generic Availability Guide shows which forms and strengths of a brand-name drug are also available generically.

•           Imprint Identification Guide enables you to establish the nature of any unknown tablet or capsule by match­ing its imprint against an exhaustive catalog of identi­fying codes.

The 2004 PDR Companion Guide includes all drugs described in PDR, PDR for Nonprescription Drugs and Dietary SupplementsTM, and PDR for Ophthalmic Medicines. It will assist you in making safe, appropri­ate selection of drugs faster and more easily than ever before. PDR and its major companion volumes are also found in the PDR® Electronic Library on CD-ROM, now used in more than 100,000 practices. This Windows-compatible disc provides users with a complete data-base of PDR prescribing information, electronically searchable for instant retrieval. A standard subscription includes PDR's sophisticated search software and an extensive file of chemical structures, illustrations, and full-color product photographs. Optional enhancements include the complete contents of The Merck Manual Seventeenth Edition, Stedman's Medical Dictionary, and Stedman's Spellchecker. For anyone who wants to run a fast double check on a proposed prescription, there's also the PDR' Drug Interactions and Side Effects SystemTM— sophisticated software capable of automat­ically screening a 20-drug regimen for conflicts, then proposing alternatives for any problematic medication. This unique decision-making tool now comes free with the PDR Electronic Library. For more information on these or any other members of the growing family of PDR products, please call, toll-free, 1-800-232-7379 or fax 201-722-2680.

Nonprescription Drug Therapy: Guiding Patient Self-Care 3rd edition by Timothy R. Covington (Facts and Comparisons) Writing for pharmacists, physicians, and other health care providers, Covington provides information on 100 common conditions and over-the-counter therapy options. Each entry on a condition summarizes etiology, pathophysiology, symptoms, diagnostic parameters, treatment options, and product information. Entries are in chapters on areas such as CNS conditions, diabetes, musculoskeletal conditions, and women's health.

 

Drug Facts and Comparisons® 2005:  Pocket Version (Facts and Comparisons®) Drug Facts and Comparisons - Pocket Version is the indispensable portable drug reference for busy professionals. Derived from Drug Facts and Comparisons® the premier source of unbiased drug information for more than 55 years, its abridged monographs include the information you most often need "on the move"- an ideal compact reference for rounds and use in the clinic. Revised annually, this new edition features the following:

New drugs, including Aprepitant (Emend), Daptomycin (Cubicin), Emtricitabine (Emtriva), Enfuvirtide (Fuzeon), Fosamprenavir calcium (Lexiva), and Memantine (Namenda)

New combinations, including Carbidopa/Levodopa/Entacapone (Stalevo)

Additional drugs now included, such as Acyclovir (Zovirax), Amlexanox (Aphthasol), Methotrexate (Rheumatrex, Trexall), Mitoxantrone (Novantrone), Peginterferon alfa-2a (Pegasys), Sodium Ferric Gluconate Complex (Ferrlecil), Succimer (Chemet), Sulfuric Acid/Sulfonated Phenolics (Debacterot), and Trientine (Syprine) 7 updated group monographs, including Antipsychotic Agents (subgroups include Atypical Antipsychotics, Phenothiazine and Thioxanthene derivatives, and Phenylbutylpiperadine Derivatives), ACE inhibitors, Estrogens, and Tetracyclines Up-to-date information on more than 600 generic drugs, with 2,000+ representative trade names

Organization by 13 therapeutic divisions, making it easy to identify and compare similar agents

Indications and Administration and Dosage sections at the beginning of the monographs

Drugs most likely to require quick, on-the-spot confirmation of dosing recommendations, warnings, interactions, adverse reactions, etc.

Abbreviated monographs that provide just the information needed at the point-of-care Charts and tables that facilitate quick comparisons of drugs, classes, and doseforms

Drug monographs in Drug Facts and Comparisons®, Pocket Version are arranged by use. Drugs with similar therapeutic or pharmacologic characteristics have been grouped together to allow the health care provider to compare these drugs easily and determine the most appropriate drug therapy. Standard sections within the monographs occur in a consistent format. Once the user is familiar with the organization of the data, the desired information can be located quickly.

Monograph Organization

Therapeutic class: Drugs that share the same therapeutic class will share a com­mon title that appears on the right-hand pages. The monograph title appears on the left-hand pages. If there is no shared class, the monograph title will repeat on the right-hand page.

Drug name: Generic names and any common synonyms appear in a horizontal bar that introduces a new monograph. Synonyms follow the generic name in parentheses and are separated by semicolons.

Product table: Doseforms and strengths of generic drugs are listed in the left col­umn with their schedules (eg, Rx, otc, c-ii). If more than one generic entity is included in the monograph (eg, beta blockers), the drugs appear in all caps with specific information underneath it. The more common trade names, with their specific manufacturers/distributors, are listed in the right-hand column. If the drug is available generically, the word "Various" appears at the beginning of the trade name listing.

Warning box: Potentially life-threatening reactions specified in the product labeling will appear in a box. Not included in sample.

Indications: All FDA-approved indications are included. In addition, off-label uses with substantial documentation about dosing may appear under the term "Unlabeled uses."

Administration and Dosage: Appropriate dosage, dosage range, etc. is included. When available, specific information for administration in situations such as renal impairment, elderly patients, etc., is included.

Actions: This section includes a brief discussion of significant pharmacologic and pharmacokinetic information is included.

Contraindications: All known contraindications are included.

Warnings: This section includes a brief description of major warnings associated with the drug. Standard sections (eg, Pregnancy, Lactation, Children) appear at the end of this section. The Pregnancy section generally only lists the Standard Pregnancy Category (A, B, C, D, or X). A description of these categories can be found in the Appendix.

Precautions: Potential conditions for which the patient should be cautioned (eg, photosensitivity) are included, as well as other significant situations where cau­tion is warranted.

Drug Interactions: Drugs that may interact (affect or be affected by the interact­ing agent) are listed. Lab test and drug/food interactions also are included. Adverse Reactions: Where possible, reactions that occur in 3% or more of patients have been listed. When percentages are not available, significant reac­tions not discussed in Warnings or Precautions are included.

The Real Drug Abusers by Fred Leavitt (Rowman & Littlefield), with a Ph.D. in psychopharmacology and 20 years of service at Cal State University in Hayward , sorts out facts about drug abuse from fantasy, intentional misrepresentation, and public policy.

  • Drug abuse causes havoc over the entire globe and is considered one of the most pressing social problems in the United States .
  • It is the number one health prob­1em in the United States . According to the Substance Abuse and Mental Health Services Administration, it causes more deaths, illnesses, and disabilities than any other preventable health condition.

The news media thrive on lurid reports of drug-related dissolution and degra­dation. Readers and viewers avidly follow sensational stories about pushers solic­iting junior high school children, strung-out addicts mugging people and terrorizing businesses, girls and young women turning to prostitution to support their habits, police officers being corrupted by the lure of easy money, inform­ants turning on friends and relatives, gangs killing each other in wars over drug territory, and entire neighborhoods being destroyed while kingpins live in island villas with fleets of luxury cars and pleasure craft. But media reports often go well beyond what the facts about drugs warrant. The media are concerned more with ratings than accuracy, and sensationalized stories sell. The stories draw large au­diences, whereas original research findings, described in technical language and published in specialized journals with limited readership, have little direct influ­ence on public opinion.

Public opinion is also shaped by politicians, bureaucrats working within gov­ernment agencies, and representatives from drug company marketing departments. They often refer to research findings and comment on isolated incidents involving drugs, but their pronouncements too often reflect vested interests rather than ded­ication to the truth. Nevertheless, they are influential and help keep the public woe­fully misinformed about the nature of drug abuse. For example, the view that drug addicts arc qualitatively different from other people is entrenched in the public consciousness despite there being little support from research in biochemistry, neu­roscience, psychology, sociology, or anthropology.

Societies differ in their strategies for making beneficial drugs available and restricting the use of harmful drugs. All societies have unique sets of behavioral norms, methods for discouraging de­viation from the norms, and attitudes toward violators. Although drug abuse cuts across socioeconomic boundaries, certain groups—the mentally ill, the homeless, and people who do not receive proper medical care, who lack skills or motivation to find meaningful work, and who have been or merely feel oppressed—are espe­cially vulnerable to relying on drugs in attempts to cope. Disparities in education, wealth, and power occur in all societies, but attitudes toward people at the lower end of the continuum differ greatly. Responses to both licit and illicit drugs, the likelihood that casual use will turn into addiction, and the harms caused by ad­diction depend to a great extent on these cultural factors.

The Molecule Is Not the Message. Advertisements directed at both doctors and laypersons suggest that drug actions depend almost exclusively on molecular structure. Authors describe effects in minute detail: “LSD, 1966, a presumptuous little pill, causes dilated pupils, increased heart rate, and vivid hallucinations of used car salesmen.” The authors make subtle distinctions between structurally similar molecules, disregarding the fact that even experienced users cannot discriminate between heroin and mor­phine or between injected amphetamine and cocaine. They consider humans passive respondents, little different from litmus paper or other forms of labora­tory apparatus. Just as litmus paper reliably changes color if dipped into an acidic substance, human neurons change in reliable ways following exposure to certain drugs. But this perspective ignores the fact that changes in brain chemistry de­pend on many factors and are not the sole determinants of how recipients re­spond to drugs. People’s expectations affect their responses to all experiences. Consider two studies by Martin Orne that do not involve drugs:

  • Most subjects in early sensory deprivation experiments reported extreme stress. Orne manipulated expectations by asking some subjects to sign a frightening release form and showing them a panic button they could press if the stress became too great. Then he ushered them into a quiet room and told them to sit there. He treated control subjects identically except for the release form nd button. The experimentals experienced considerable stress, and many pressed the panic button. The controls did not. (As further evi­dence of the power of expectations, Suedfeld gave positive instructions to sensory-deprivation subjects and induced relaxation and calm.)
  • Orne told only one of two groups of students that the dominant hand of hypnotized subjects becomes rigid. The information is false. Later, he asked for volunteers from both groups to be hypnotized. Several of the stu­dents in the first group and none in the second developed dominant hand rigidity.

Expectations can be manipulated so that sugar pills (placebos) affect recipients as though they are powerful drugs. Expectations induced by living in a particular so­ciety shape responses to real drugs. Among these The Real Drug Abusers discusses 1) Alcohol, 2) Caffeine, 3) LSD, and 4) Marijuana.

Societal norms and laws related to drugs have widespread ramifications. Societal norms and laws have impacts that extend far beyond shaping the re­sponses of drug users. They influence long-range prospects of users of illegal drugs, treatments of those in need of medical drugs, and people’s general atti­tudes toward seeking alternatives to medical drugs and experimenting with recre­ational ones. The norms and laws affect safety, taxes, and quality of life for most citizens. Therefore, they should be frequently reevaluated. U.S. norms have changed dramatically during the past century. Several trends are clear for three different categories of drugs. The Real Drug Abusers discusses 1) Illegal Drugs, 2) Prescription Drugs, and 3) Over the Counter Drugs That Do Not Require a Prescription.

Drug abuse—an expanded perspective. Drug abuse, narrowly conceived, is any use of illicit substances or excessive use of legal ones. That is how government agencies define the term. But, though pro­scribed personal use makes headlines and gets people sent to prison, several less-publicized activities involving drugs cause great harm to the general public. Chapters of The Real Drug Abusers discuss examples from each of the following categories:

  • Too many pharmacological researchers face strong conflicts between finan­cial gain and accurate reporting of their findings.
  • Individuals and institutions distort and suppress information to promote their objectives.
  • The prescribing habits of some doctors depend less on the medical literature than on how drugs are promoted to them. Their diagnoses and prescriptions often demonstrate sexist and racist biases.
  • Some Health Maintenance Organizations (HMOs) are multidrug abusers. Many require their doctors to choose from a preselected formulary of drugs, with price overriding effectiveness as a criterion for inclusion in the fortulary. Most HMOs arc biased toward prescribing drugs for psychiatric patients rather than giving them lengthier, costlier (and proba­bly more effective) access to someone to listen to their problems.
  • Hundreds of thousands of patients in U.S. hospitals experience bad drug re­actions each year, and thousands die. The reported figures are probably an undercount, because many errors go undocumented and unreported. The problem keeps growing, as doctors rely increasingly on drugs and pharmacists’ workloads get heavier and heavier. Between 1983 and 1993, deaths due to medication errors more than doubled among hospital patients and increased eightfold among outpatients. A high proportion of residents of nursing facilities receives inappropriate prescriptions.
  • Patients in chronic pain, and especially the elderly, are often medicated in­adequately. Health care professionals share an unwarranted fear that they will create narcotics addicts if they administer too much. So doctors under­prescribe, and nurses underadminister pain medications to many patients, especially the elderly.
  • Politicians and other government officials are guilty of drug-related abuse when they spread misinformation and disinformation about drugs. Entire societies abuse by encouraging the use of drugs for falling asleep, waking up, losing weight, overcoming shyness, and having bowel movements with clocklike regularity. The same societies, and the United States in particular, sentence staggering numbers of nonviolent drug offenders to longer prison terms than are given to rapists and murderers. Alexander Shulgin writes: “Our generation is the first ever to have made the search for self-awareness a crime, if it is done with the use of plants or chemical com­pounds as the means of opening the psychic doors.” Shulgin’s belief that the search for self-awareness should be encouraged can be con­trasted with the view of Gerald Smith, who wrote a pamphlet distributed to schoolchildren in Utah . Entitled “How Parents Can Help Children Live Marijuana Free,” the pamphlet includes a preface by Utah Senator Orrin Hatch and offers parents the following tip on how to recognize drug use by their children: “Excessive preoccupation with social causes, race relations, environmental issues, etc.”
  • Various state and federal asset-forfeiture laws allow government agencies to confiscate assets of convicted traffickers. A New Hampshire family with three small children had their home seized for growing four marijuana plants in the back garden. The practice has outraged civil libertarians.
  • Many unethical medical experiments were conducted in the not-too-distant past. Powerful, dangerous, experimental drugs were administered to unwit­ting prisoners, soldiers, and civilian victims, including the mentally retarded and psychotic. Such abuses probably continue, although the extent may never he known.

The various categories of abuse can be traced to three types of causes: 1) Human error, 2) Lack of information, misinformation, and disinformation, and 3) Money. Leavitt discusses each of these in detail.

Each of the chapters is headed with an assertion about one aspect of drug abuse. The text provides evidence and argument for the assertion. The Real Drug Abusers is a must read for anyone who cares to sort out, in detail, what is, in fact, known about drug use and misuse and what is not. Be warned, however, side effects of reading this book include paranoia.

PDR Companion Guide (Thomson) is a necessary companion as it contains all the indexex to the print edition of the PDR. Welcome to one of the most useful drug references in current clinical practice, the 2004 edition of the PDR®'''' Companion Guide TM. Keyed to the 58th edition of Physicians' Desk Reference®, this unique handbook provides you with a complete drug selection system. From its Indications Index, which permits you to instantly identify the full range of phar­maceutical alternatives for any given illness, to its Contraindications Index, which just as swiftly singles out alternatives to avoid, the PDR Companion Guide is designed

v to make safe, effective prescribing as fast, easy, and accu­rate as possible. Whether the challenge is identification of an unknown tablet or capsule, detecting the source of an adverse reaction, or avoiding a negative interaction, the PDR Companion Guide provides the tools you need to quickly find the answer. Here's a brief overview of the many features offered in the 2004 edition:

Interactions Index. In this section you'll find an entry for each product described in PDR and its companion volumes. Listed are generic compounds and dietary items that may interact with the product, as well as the specific brands con­taining each generic ingredient. A brief description of the interaction also appears. (Because product labeling varies in the scope of its interaction reporting, be sure to check the listing for each product in the patient's regimen.)

 

Food Interactions Cross-Reference. If you suspect an inter-action with a specific dietary item, turn to this section. There you will find potential drug/food and drug/alcohol interac­tions cross-referenced alphabetically by the name or type of food. Each entry includes a list of implicated drugs and a brief description of each interaction.

 

Side Effects Index. When a multidrug regimen masks the source of a side effect, this section provides the solution. It contains an alphabetical list of the more than 3,600 distinct reactions cited throughout PDR and its companion volumes. Each entry includes an alphabetical list of the brands that have been associated with the problem. To help target the most likely offenders, incidence data are included whenever found in the official labeling.

 

Indications Index. If you need to locate an alternative to a problem medication—or simply want to review the full range of options for a particular diagnosis—turn to this part of the book. Here each indication cited in PDR and its companions is listed alphabetically, with a cross-reference to all brands approved for that purpose. For easy comparison, the listings include the generic name and manufacturer of each product. (Only FDA-approved indications are referenced.)

 

Contraindications Index. When therapy is complicated by other medical conditions, this convenient index will enable you to eliminate quickly any contraindicated drugs from con­sideration. Here each contraindication cited in PDR is listed alphabetically, together with the drugs to avoid when the problem occurs.

International Drug Name Index. This section enables you to determine quickly a U.S. equivalent when you're confronted with a medication from another country. The index describes the pro-duct's country of origin, the closest domestic generic equivalent, all associated PDR brand-name entries and their PDR page number. Included are more than 33,000 entries covering prod­ucts from more than 25 nations. Prescribing a U.S. substitute has never been easier!

 

Generic Availability Guide. If you've ever had trouble remem­bering whether there's a generic alternative for a particular brand, you're sure to appreciate this handy guide. It alerts you to the existence of alternatives, form by form, and strength by strength. Included are all prescription drugs described in PDR and PDR®'' for Ophthalmic Medicines.

 

Imprint Identification Guide. This comprehensive table per­mits you to establish quickly the identity of virtually any unknown tablet or capsule. Organized alphabetically by imprint, it supplies the brand or generic name of the drug, its strength and manufacturer, and, to confirm its identity, the color, form, and shape.

 

Based on the FDA-approved labeling in the 2004 editions of Physicians' Desk Reference and PDR for Ophthalmic Medicines and the current edition of PDR for Nonprescription Drugs and Dietary Supplements-and augmented with a wealth of authoritative data from such PDR affiliates as Red Book®' and Micromedex, Inc.—the entries in the PDR Companion Guide cover some 3,000 domestic drug products. Please note, however, that because the entries in the Indications, Contraindications, Interactions, and Side Effects indices are derived directly from the FDA-sanctioned prescribing informa­tion published by PDR, only products described in Physicians' Desk Reference and its main companion volumes are cited in these sections.

 

Please note, also, that the publisher cannot guarantee that all entries are totally accurate or complete, nor is the pub­lisher responsible for misuse of a product due to typographi­calerror. Remember that important qualifications of the information listed in these indices may reside in the underly­ing text. Use this Guide as a convenient cross-reference, but consult the PDR text, as well as the medical literature, when more detailed information is needed.

 

Other Prescribing Aids from PDR

For complicated cases and special patient problems, there is no substitute for the in-depth data contained in the Physicians' Desk Reference. But on other occasions, you may find that the PDR® Monthly Prescribing Guide provides a handy alternative. With concise summaries of FDA-approved and other manufacturer-supplied labeling found in PDR, this 350-page digest-sized reference presents the key facts on more than .1,000 drugs, including the form, strength, and route; therapeutic class; approved indications; dosage; con­traindications; warnings; precautions; pregnancy rating; drug interactions; and adverse reactions. Each entry alerts you to

the significant precautions you need to take, spells out the most common or dangerous adverse effects, summarizes the recommended adult and pediatric dosages, and supplies you with the PDR page number to turn to for further information. A full-color insert of pill and product images allows you to correct­ly identify each product.

The Monthly Prescribing Guide is continuously updated with detailed descriptions of the latest drugs to receive FDA approval, plus FDA-approved revisions to existing product information. In addition, you'll receive bulletins about major new developments on the pharmaceutical scene, an overview of important new agents nearing approval, a heads-up on the latest pharmaceutical issues to hit the consumer media, in-depth analysis of the common nutritional supple­ments that patients are taking, and a handy .reminder of upcoming medical meetings. In fact, in one neat package you'll find just about everything you need to make a routine prescribing decision—secure in the knowledge that you're acting on the latest FDA-approved data. To order your per­sonal subscription to this important new monthly publica­tion, simply call 1-800-232-7379.

If you prefer to carry drug information with you on a handheld device like a Palm® or Pocket PC, you will want to know about mobilePDR®. This easy-to-use software allows you to instantly retrieve concise versions of the FDA-approved and other manu­facturer-supplied labeling, lets you run automatic interaction checks on multidrug regimens, and even alerts you to signifi­cant changes in updated drug entries. Covering more than 1,500 drugs, this portable electronic reference is updated daily with the latest FDA-approved revisions to existing product infor­mation, plus the essential facts you need to safely prescribe newly approved agents. Sync anytime, day or night, at your con­venience to be sure you have the most recent information avail-able. Our auto-update feature updates the content and the soft-ware, so upgrades are easy to manage. Free for U.S.-based MDs, DOs, NPs, and PAs in active practice, as well as to med­ical students and residents, mobilePDR® is available for down-loading from www.PDR.net Check it out today.

For those who prefer to view drug information on the Internet, PDR.net is the best online source for comprehen­sive FDA-approved and other manufacturer-supplied labeling information, as found in PDR. Updated monthly, this incred­ible resource allows you to look up drugs by brand or gener­ic name, by key word, or by indication, side effect, con­traindication, or manufacturer. The drug interaction checker allows you to screen for interactions between as many as 20 different drugs. As a terrific extra benefit, images of all products are included for easy identification. In addition to all this, PDR.net provides links to such useful information as Stedman's Medical Dictionary, MEDLINE, clinical trials registries, evidence-based treatment decision tools, med­ical newsletters, Internet directories, online formularies, and the FDA's Medwatch. A wealth of information all in one place! Registration for PDR.net is free for U.S based MDs, DOs, NPs, and PAs in full-time patient practice as well as for medical students and residents. Visit www.PDR.net today to register.

 

For those times when all you need is quick confirmation of a particular dosage, you may also want to order a copy of the PDR® Pharmacopoeia Pocket Dosing Guide. This handy little book can accompany you wherever you need to go, around

the office or on rounds. Only slightly larger than an index card and a half inch thick, it fits easily into any pocket,, while pro­viding you with FDA-approved dosing recommendations for more than 1,500 drugs. Unlike other condensed drug refer­ences, it's drawn almost exclusively from the FDA-approved drug labeling published in Physicians' Desk Reference. And its tabular presentation makes lookups a breeze. The 2004 PDR Pharmacopoeia Pocket Dosing Guide is a tool you really can't afford to be without.

 

The use of over-the-counter nutritional supplements has sky-rocketed, and PDR has responded with a brand new medical reference covering this unfamiliar—even exotic—set of agents. PDR® for Nutritional Supplements offers the latest scientific consensus on hundreds of popular supplement products, including an array of amino acids, co-factors, fatty acids, probiotics, phytoestrogens, phytosterols, over-the-counter hormones, hormonal precursors, and much more. Focused on the scientific evidence for each supplement's claims, this unique new reference offers you today's most detailed, informed, and objective overview of a burgeoning new area in the field of self-treatment. To protect your patients from bogus remedies and steer them toward truly beneficial products, this book is a must.

 

For counseling patients who favor herbal remedies, another PDR reference may prove equally valuable. Now in its second edition, PDR® for Herbal Medicines provides you with the latest science-based assessment of some 700 botanicals. Indexed by scientific, common, and brand names (as well as Western, Asian, and homeopathic indications), this volume also includes a Side Effects Index, a Drug/Herb Interactions Guide, an Herb Identification Guide with nearly 400 color photos, and a Safety Guide that lists herbs to be avoided during pregnancy and herbs to be used only under profes­sional supervision. Although botanical products are not offi­cially regulated or monitored in the United States, PDR for Herbal Medicines provides you with the closest analog to FDA-approved labeling—the findings of the German Medicines Agency's expert committee on herbal medicines, Commission E.

 

PDR and its major companion volumes are also found in the PDR® Electronic Library on CD-ROM, now used in more than 100,000 practices. This Windows-compatible disc pro­vides users with a complete database of PDR prescribing information, electronically searchable for instant retrieval. A standard subscription includes PDR's sophisticated search software and an extensive file of chemical struc­tures, illustrations, and full-color product photographs. Optional enhancements include the complete contents of The Merck Manual Seventeenth Edition, Stedman's Medical Dictionary, and Stedman's Spellchecker: For anyone who wants to run a fast double check on a proposed prescrip­tion, there's also the PDR® Drug Interactions and Side Effects System — sophisticated software capable of auto­matically screening a 20-drug regimen for conflicts, then proposing alternatives for any problematic medication. This unique decision-making tool now comes free with the PDR Electronic Library.

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