WHAT IS A DRUG INFORMATION CENTRE?

Drug Information Centre are defined as operational units that provide up‑to‑date scientific and technical information on medicines in an objective and timely manner. They represent an optimal strategy to address specific needs for information sought by health‑care professionals. Ideally, DICs have adequate sources and specifically qualified professionals, who provide independent and appropriate information to the queries. The users can contact the center by telephone, personally, fax, or e‑mail and their queries are answered in verbal or structured written format.

DIC services are rendered both in proactive and reactive approaches. The reactive approach is commonly followed in hospital based DICs which serve health‑care providers (doctors) by answering time‑critical questions on the safe and effective use of therapeutic and diagnostic pharmaceuticals. The sample case record form for recording the communication is presented here as a supplementary file at the end of the article. Proactively, some DICs also publish and circulate regular updates on various topics such as dosing guidance in organ impairment, interpretation of therapeutic drug monitoring (TDM) levels, possible drug–drug or drug– disease interactions, safety profile including the Food and Drug Administration (FDA) alert, adverse event linked to a drug, efficacy comparison, recent updates in treatment guidelines, new drug approvals and local availability, drug use in any special situation, important study findings in reputed journals, guidance on procuring already approved drug in other countries, and many more types of questions from available literature sources.

ORGANIZATIONAL STRUCTURE, RESOURCES, AND FUNCTIONING OF DRUG INFORMATION CENTER

The organizational structure of DIC can vary considerably. A survey of DICs of 18 European countries had reported that they are mainly affiliated to hospitals (68%), but rather uncommonly with state departments (15%), other health‑care organizations outside the hospital (12%), and faculty of pharmacy (6%). Similar findings were also reported in an American survey carried out on 151 DICs. Within medical institutions or universities, DICs are usually affiliated with the Department of Pharmacology/Clinical Pharmacology or Clinical Pharmacy.

The location of the DIC within the hospital has the advantage of being close to the different specialized departments, patient care areas, the hospital library, and the hospital pharmacy. Such a close proximity to different departments and service areas enable easier contacting.[16] They are usually staffed by clinical pharmacologists and pharmacists who review the queries of the clinicians, search the literature, and provide the information sought, in structured, evidence‑based manner.[17] In certain centers, the DIC is manned by faculty members and postgraduate students of pharmacy practice.[18] In some places, DICs also provide poisoning‑related information and primarily act as poison information centers.[19] The availability of qualified individuals to run the DIC is of paramount importance as they act as the first interface with the health‑care professional. Proper communication skills, literature search and appraisal skills, and knowledge about the efficacy and safety of drugs are very important in order to provide quality services to those who contact the DIC.[20]

Drug and Poison information Centres

The Poisons Information Centre (PIC) is a specialized unit providing information on prevention, early diagnosis and treatment of poisoning and hazard management. Most of the developed and many developing countries have well established poison control centres with poisons information service, patient management facility and analytical laboratory. Poison information service also deals with the risk assessment, diagnosis, management and prevention of exposure to any poison, in patients of any age irrespective of type (intentional or accidental) and route of exposure. The primary aim of PIC is to reduce the morbidity and mortality due to poisoning and improve the patient’s quality of life. In India, the National Poisons Information Centre (NPIC) was established in February, 1995 in the Department of Pharmacology at the All India Institute of Medical Sciences, New Delhi.

The centre gives toxicological information and advice on the management of poisoned patients adapted to the level of the enquirer. The basis of this service is the databases on poisoning, drug reactions and also the continuous and systematic collection of data from the library.

NATURE OF INFORMATION SOUGHT FROM DRUG INFORMATION CENTER

There are many reports on the quantum and nature of inquiries received by the DIC around the world. A study from a regional DIC in Germany reported that questions concerning therapeutic use (34%), adverse drug reactions (28%), pregnancy/lactation (16%), and pharmacokinetics/dosage (15%) were asked most frequently. The major users of the DIC were internists (19%), general practitioners (19%), pediatricians (18%), and gynecologists (11%).[23] A similar pattern had been observed in a study in Slovak Republic, where questions concerning pregnancy/lactation (25%), adverse drug reactions (16%), basic information regarding drugs (14%), and interactions (13%) were frequently asked. A study in a DIC in South India reported that questions most commonly asked were regarding dosage and administration (27%), adverse reactions (24%), and drug therapy (15%).

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Queries were also asked on many occasions for other purposes such as availability/cost, drug interactions, pharmacokinetics, pharmacodynamics, pregnancy and lactation, indication, content, contraindication, generics, drug profile, and poisoning. Similar trends have also been reported in various analyses conducted in Nepal, Iran, Italy, Israel, Mexico, and Finland. The nature of queries to community‑based DICs differs slightly from the hospital‑based ones. A study in Finland analyzed and described the utilization of a community pharmacy‑operated national drug information call center. Data were recorded for 2196 calls, 56% of which were drug related. The majority (83%) of these calls were therapeutic or pharmaceutical inquiries, with 26% concerning costs and reimbursements, 14% interactions, 14% dosages, and 11% related to adverse effects.

A recently published study on a Brazilian community‑based DIC managed by the Federal Council of Pharmacy reported that mostly information on drug administration, indications, drug interactions, and legislations was sought from the DIC by pharmacists and pharmacy students. The DIC in Dresden, Germany, that caters exclusively for patients has been frequently contacted for information pertaining to adverse drug reactions (22.1%), general information about prescribed drugs (19.9%), information about therapy (12.4%), and drug interactions (10.2%).

CHALLENGES IN ESTABLISHING A DRUG INFORMATION CENTER IN INDIA

Although establishment of DICs offers benefits in terms of addressing the awareness gaps of health‑care professionals and improved patient care, there are many challenges that have to be encountered while setting up these centers.

Funds and resources

In resource‑limited developing countries, the major hurdle in establishing a DIC comes in the form of constraint of funds. Establishing and running DIC services successfully requires a good supply of recurring and non-recurring budgets, as mentioned in Table 1.

Since DICs in hospital settings are affiliated to clinical pharmacology/pharmacy departments, the expenses are usually borne out of the departmental budget. Since departmental budgets in such disciplines are already low in India, the expenses may act as a deterrent to the establishment of a stand‑alone DIC.

Therefore, in addition to drug information, the DIC could also provide other value‑added services such as poison information, adverse drug reaction monitoring, and training of postgraduate students of concerned and allied disciplines to justify its budgetary requirements. For example, the National Poisons Information Centre at AIIMS, New Delhi, established in 1995 in the Department of Pharmacology under the INTOX project of the International Programme on Chemical Safety/WHO provides round‑the‑clock information on poisoning, drug reactions, and analytical services on an emergency basis to help in diagnosis and management. It also provides training to residents posted in the center.

Human resource

Providing quality drug‑related information requires employment of trained and experienced individuals in the DIC. However, there is a dearth of such individuals within academic hospitals. Annually, only 15–16 students get trained in the D.M. Clinical Pharmacology course and approximately 550 students get trained in M.D. Pharmacology. This is compounded by the fact that the same faculty has to teach dental, nursing, and other paramedical courses, leaving little time to serve in the DIC. To counter this lack of human resource, it has been suggested that there could be dual appointments of teachers from clinical specialities, public health departments, or industry in clinical pharmacology in academic institutions and increase in the number of students enrolled per teacher and in the number of departments of clinical pharmacology.

EVALUATION OF PERFORMANCE OF DRUG INFORMATION CENTER

Evaluation of drug information services has been widely performed through the assessment of the processes against predetermined standard criteria, the assessment of user satisfaction, or the evaluation of clinical and economic outcomes. However, the survey of DICs carried out in the USA reported that only half of the DICs surveyed had a formal quality assurance program. The national German drug information service conducted a user’s satisfaction study and concluded that there was high satisfaction among users, based on quality, understandability, timeliness, and helpfulness regarding counseling. Response time to queries is a major determinant of user satisfaction.

In Israel, Lustig reported that the mean response time varied according to the type of query; 1 min was the lowest response time for queries regarding the availability of products and 13.5 min was the highest response time for answers to questions on drug indications and interactions. In South India, George and Rao categorized the time needed to reply into three categories: immediately, within 2–4 h, and within a day or 2 days.

A modeling study predicted that the most important workload factor predicting the time spent in handling the queries was the type of literature search that had to be performed. The categorization of queries, as judgmental or not, also affected the time spent answering the queries. However, the number of drugs involved did not seem to significantly influence the time spent in answering drug information queries.

Advantages of Poison Information resources

1. Reduction in overall cost of operation
2. Combined programs share personal, information resources, space and utility charges
3. Improved access to information services
4. Poisoning can be controlled at speed
5. It helps in providing round the clock services
6. Speedy access to literature search and evaluation skills

Disadvantage Poison Information resources

The prime disadvantage is a single staff is involved that can place pressure on the poison information provider.

FULL PDF >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> CLICK HERE

REFERENCES

1. Diaz JA, Griffith RA, Ng JJ, Reinert SE, Friedmann PD, Moulton AW, et al. Patients’ use of the internet for medical information. J Gen Intern Med 2002;17:180‑5.
2. Ioannidis JP. Why most clinical research is not useful. PLoS Med 2016;13:e1002049.
3. Nikalje AP. Nanotechnology and its applications in medicine. Med Chem 2015;5:81‑9.
4. Alper BS, Hand JA, Elliott SG, Kinkade S, Hauan MJ, Onion DK, et al. How much effort is needed to keep up with the literature relevant for primary care? J Med Libr Assoc 2004;92:429‑37.
5. Pradhan SC. The performance of drug information center at the university of Kansas medical center Kansas city, USA‑experiences and evaluation. Indian J Pharmacol 2002;34:123‑9.
6. Drug Information Association; 2017. Available from: http://www.diaglobal.org/en/about‑us. [Last accessed on 2017 Mar 03].
7. Walton CA. Education and training of the drug information specialist Ann Pharmacother 2006;40:311‑5.
8. The Rational Use of Drugs: Report of the Conference of Experts, Nairobi, 1985. World Health Organisation; 2017. Available from: http://www.apps.who.int/medicinedocs/documents/s17054e/s17054e.pdf. [Last accessed on 2017 Mar 03].
9. Chauhan N, Moin S, Pandey A, Mittal A, Bajaj U. Indian aspects of drug information resources and impact of drug information centre on community. J Adv Pharm Technol Res 2013;4:84‑93.
10. Escalante‑Saavedra PA, Marques‑Batista G, Maniero HK, Bedatt‑Silva R, Calvo‑Barbado DM. Brazilian drug information centre: Descriptive study on the quality of information 2010‑2015. Farm Hosp 2017;41:334‑45.
11. Fathelrahman AI, Awang R, Bashir AA, Taha IA, Ibrahim HM. User satisfaction with services provided by a drug information center in Sudan. Pharm World Sci 2008;30:759‑63.
12. Guidance Document on Common Submission Format for Import and Registration of Bulk Drugs and Finished Formulations in India. CDSCO; 2017. Available from: http://www.cdsco.nic.in/writereaddata/Guidance%20documents.pdf. [Last accessed on 2017 Mar 03].

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Notes:

1. Attempt all parts.
2. Students are advised to specially check the Numerical Data of Question paper in both versions. If there is any difference in Hindi Translation of any question, the students should answer according to the English version.
3. Use of Paper and Mobile Phone by the students is not allowed.

PART-A

Answer any six questions. Each questions carries equal marks. [6×5=30]

1. Explain the role of Community Pharmacist?
2. Describe different part of Prescriptions?
3. What do you mean by verbal communication? Give Advantage and Disadvantage of Verbal Communication.
4. Describe various stages involved in patient counselling?
5. Discuss various strategies to overcome medication non adherence?
6. What is procurement? Explain process of procument.

PART-B

Answer any ten questions. Each questions carries equal marks. [10×3=30]

1. Write a note on handling of the prescription.
2. Write a note on body language is a type of communication.
3. Define patient information leaflet. Give importance of patient information leaflet.
4. Write in brief counselling point for Tuberculosis.
5. Define health screening services. Give scope of health screening services.
6. Write a brief note on OTC medication in India.
7. Give the symptoms and advice for self care in skin disorders.
8. What are various types of community pharmacy?
9. Write in short about the pharmacy design and interiors.
10. Define financial planning. Give importance of financial planning.
11. Give the standard operating procedure for dispensing of medicines.

PART-C

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Answer all questions. Each questions carries equal marks. [20×1=20]

1. The history of community pharmacy in India start with opening of chemist shop in _____
   • a) 1811
   • b) 1812
   • c) 1813
   • d) 1814
2. The preparation of SOPs in pharmacy is responsibility of ______
   • a) Staff nurse
   • b) Physician
   • c) Pharmacist
   • d) None
3. The part of prescription called subsription contains direction to the _____
   • a) Physcian
   • b) Pharmacist
   • c) Staff nurse
   • d) None
4. Communication is a part of _______
   • a) hard
   • b)soft
   • c) rough
   • d) short
5. Email and websites are the type of ______ Communication.
   • Oral/Written
6. Patient Counselling is a _______ process.
   • Unidirectional/bidirectional
7. A faithful adherence by the patient to the prescriber instruction is called ______.
   • Patient compliance/ Patient non compliance
8. Sphygmomanometer is used to measure ______.
   • Blood Pressure/ Blood glucose level
9. Mammogram is look for early sign of ______.
   • Breast cancer/ Blood pressure.
10. ________ is the disorder in which stools become hard, dry and difficult to pass from the bowel.
    • Constipation/ Diarrheas
11. _______ mean study of causes and development of disease.
    • Etiology/ Etiopathogenesis
12. ______ means process of vomitting.
    • Emesis/ Nausea
13. OTC are ____ drugs.
    • Prescription/ Non-Prescription
14. The amount contributes by proprietor or partner in the business is known as ______.
    • Capital/ Asset
15. In VED analysis method. E stands for _______
    • Essential/ Economic
16. Minimum space required for retail drug store is ________.
    • a) 100m²
    • b) 50m²
    • c) 10m²
    • d) 20m²
17. Minimum practical training required for registration of pharmacist is not less than _____
    • a) 100 hours
    • b) 200 hours
    • c) 500 hours
    • d) None
18. Arogya Setu app is launched by government of India during the fight against ___
    • a) T.B
    • b) Pollio
    • c) Covid-19
    • d) Leprosy
19. Online pharmacy is also known as _______
    • Drug store/ Web drug store
20. Petty cash book of account which records ______ amount.
    • Major/ Minor

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What is HIV?

HIV, or human immunodeficiency virus, is a virus that attacks the body’s immune system by destroying white blood cells called CD4 cells. This weakens the immune system, making it easier to get sick with other infections and diseases.

HIV is spread through contact with an infected person’s bodily fluids, such as blood, breast milk, semen, and vaginal fluids. It can be transmitted through:

• Unprotected sex: That is, sex without condoms, or other forms of barrier protection with someone who has HIV. (Unprotected oral sex is extremely low risk for the transmission of HIV.).
• Sharing needles, syringes, or other equipment used to prepare drugs
• Being born to an infected mother: This can happen when a mother doesn’t know she has HIV, or is not on effective HIV treatment.

HIV can be prevented and treated with antiretroviral therapy (ART). People who take ART as prescribed can live long, healthy lives and protect their partners. Here are some other facts about HIV:

1. HIV is not spread by kisses, hugs, or sharing food.
2. HIV is a fragile virus that doesn’t survive outside the body for long.
3. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is more virulent and infective than HIV-2.
4. HIV can remain dormant in the body for up to ten years after primary infection.
5. If left untreated, HIV can lead to AIDS (acquired immunodeficiency syndrome).

Protect Yourshelf from HIV in Hospital

To prevent the spread of HIV, hospitals follow strict infection prevention and control guidelines. All blood and body fluids from patients are treated as potentially infectious:

Syringes and needles are ‘single use’ and disposed of in approved sharps containers. Re-usable medical devices are decontaminated and sterilised after each patient use. Many medical devices are disposed of after single use. Healthcare workers wear protective equipment (including gowns, gloves and eyewear) when carrying out any invasive procedures involving a patient’s blood or body fluids. All spilt blood and body fluids are cleaned up according to strict cleaning guidelines.

Hospital workers can become infected with HIV if they accidentally prick themselves with a needle or other sharp instrument contaminated with the virus. However, only a very small number of hospital workers around the world have become infected with HIV in this way. Preventive treatment (called post-exposure prophylaxis, or PEP) is available for healthcare workers who have accidentally pricked themselves with a needle or other sharp instrument contaminated with HIV. Their health will be monitored closely.

If you are exposed to HIV in the workplace, you might need repeated HIV testing. There is a brief “window period” after exposure during which your body is developing HIV antibodies to attack the virus. You may experience flu-like symptoms, such as fever, aches, rash, and swollen lymph nodes.

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What is Hepatitis?

Hepatitis is a general term for liver inflammation caused by a variety of viruses, chemicals, drugs, alcohol, genetics, or an overactive immune system. It can be a short-term (acute) or long-term (chronic) infection.

There are five main types of hepatitis, A, B, C, D, and E, each with different modes of transmission, severity, and prevention methods. Some types of hepatitis can be treated without serious problems, while others can cause chronic liver disease, liver cancer, and death.

Here are some types of hepatitis and how they are spread: Hepatitis A Spread through contaminated food or water, or through oral-anal sex.

Hepatitis A is not usually chronic, but it can cause debilitating symptoms and rarely fulminant hepatitis, which is often fatal. Practice good personal hygiene, such as washing hands before meals and after using the bathroom. Also, make sure you have safe drinking water and proper sewage disposal in your community. Avoid eating raw or undercooked meat and fish, and in developing countries, avoid eating raw fruits and vegetables that you can’t peel yourself. The CDC recommends that children ages 12–23 months and children and adolescents 2–18 years old who haven’t been vaccinated before get the hepatitis A vaccine.

Hepatitis B Can be passed to a baby during birth. Symptoms include abdominal pain, dark urine, fever, joint pain, loss of appetite, upset stomach, vomiting, weakness, and jaundice. Get vaccinated as soon as possible after birth, and then get two or three more doses at least four weeks apart. The vaccine is safe and effective for almost everyone, and it protects against hepatitis B for at least 20 years

Hepatitis C Spread through infected blood, often by sharing needles or other items used to inject drugs. It can also be passed from a mother to her child at birth, or in rare cases, through unprotected sex. Avoid behaviors that can spread the disease.

Protect Yourself from Hepatitis in Hospital

Prevention is always better than cure, especially where an organ as vital as your liver is concerned. Here are some tips to help avoid unnecessary transmission of the disease in its various forms:

1. Practise good hygiene and avoid consuming the local water, ice, undercooked shellfish and raw fruit and vegetables when travelling in developing countries.
2. Avoid sharing needles, razors or toothbrushes. Do not touch spilled blood. Practise safe sex by using condoms.
3. Get vaccinated against hepatitis A and B.

If you suspect you may have hepatitis, consult a gastroenterologist for an accurate diagnosis of your condition and the available treatment options.

<p>The post How to Protect Yourself from Hepatitis and HIV in Hospitals first appeared on PHARMA PUSH.</p>

Web and e-commerce have significantly changed society, the economy, and the world of wellbeing care. The web offers openings to move forward wellbeing, but it may too speak to a enormous wellbeing risk since it is a fundamentally unregulated advertise with exceptionally moo buyer security. In this paper we analyze promoting and estimating techniques of online pharmacies.

Our examination appears that OPs utilize procedures that would be more reasonable for a product showcase than for drugs. These techniques separate concurring to assortment (brand or nonexclusive), quality, amount, and target gather. OPs are well mindful that the vacuum in the enactment permits them to reach a target of buyers that drug stores cannot ordinarily reach, such as those who would like to utilize the sedate without counseling a physician. Internet and e-commerce have significantly changed society, the economy, and the world of wellbeing care.

The web offers openings to move forward wellbeing, but it may too speak to a enormous wellbeing danger since it is a fundamentally unregulated advertise with exceptionally moo buyer security. In this paper we analyze promoting and estimating techniques of online pharmacies. Our examination appears that OPs utilize techniques that would be more reasonable for a product showcase than for Drugs.

These procedures separate concurring to assortment (brand or nonexclusive), quality, amount, and target bunch. OPs are well mindful that the vacuum in the enactment permits them to reach a target of shoppers that drug stores cannot regularly reach, such as those who would like to utilize the medicate without counseling a physician.

Internet and e-commerce have significantly changed society, the economy and the world of wellbeing care, not without moral and lawful results. Data approximately wellbeing care is far reaching, and a significant number of patients frequently utilize this device some time recently counseling a doctor and amid treatment.

The web increments the opportunity for patients to obtain data that may be utilized either to frame an conclusion on their wellbeing status or to decrease uneasiness.

A US overview found that 64% of the online populace had looked for wellbeing data at slightest once in the past 12 months, and a European study found 71% of Web clients had gotten to it for wellbeing purposes. “Drugs” (requiring medicine or over the counter) was the fifth wellbeing point looked for in the Web, in 37% of cases,.

Web has too expanded the opportunity for patients to buy drugs on line. In the nineties, a few drug stores started to work over the Web offering drugs without for all intents and purposes any control, indeed for dynamic standards requiring a medicine. Agreeing to the US Nourishment and Medicate Organization (FDA) there are at slightest 400 websites that both apportion and offer endorsing administrations and half of these destinations are found exterior the US. As detailed on the FDA site, it has been evaluated that the number of websites offering medicine drugs may presently be closer to 1000. The number of websites, be that as it may, varies from day to day and appears to be developing. A later overview of online drug stores (OPs) found that their space of enlistment was in 51% of the test in the USA, and in 22% in Europe

. It is exceptionally troublesome to gauge the number of individuals buying online, the volume of drugs exchanged and the financial degree of this commerce. A study conducted in the US by implies of phone interviews found that 4% of Americans had obtained medicine drugs on the Web. Back in 2000 the National Affiliation of Sheets of Drug store assessed that add up to deals of prescription-only drugs on the Web in the USA was $100 million, with an evaluated increment in all pharmaceutical deals to $1 billion by 2003.

Moreover, the web has no topographical obstructions and its worldwide measurement makes it troublesome to control virtual drug stores since there is no universal enactment directing this complex issue. The development of an unregulated worldwide drugs advertise may increment the chance of the spread of fake solutions, coming from nations where sedate generation is not subject to the same quality control as in the US, Canada and Europe. The World Wellbeing Organization has announced that “medicines obtained over the Web from locales that conceal their physical address are fake in over 50% of cases”.

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In expansion, numerous online drug stores offer the customer drugs without restorative medicine and this can uncover individuals to the dangers related with the admissions of improper drugs and can hurt the patient–doctor relationship, changing patients into buyers.

In reality, the medicine necessity points to protect patients from dangers related with superfluous drugs, and it allots obligation for cost/benefit evaluation to the specialist, the proficient who has the information to make this decision. This quick advancement of online drug stores is related to a few components. Web permits to reach providers around the world at any hour without having to visit shops and it may permit to get commodities at a lower cost.

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For online drug stores there is another imperative figure related to the questionable topic of direct-to-consumer promoting (DTCA) of medicine drugs, where defenders highlight the potential in terms of quiet strengthening, whereas adversaries claim that DTCA misshapes the patient–doctor relationship, producing request without prove of wellbeing benefits. In later a long time patients have expanded their inclusion in the decision-making handle concerning their wellbeing, a prepare that in the past was completely in the hands of the doctor, driving to common concern approximately the impact of such procedure on persistent wellbeing.

In a world where indeed the concept of wellbeing has changed, moving from the nonattendance of malady to well-being and wellness, pharmaceutical item special techniques may be pointed at making a request for drugs, creating consumers/patients. This is a exceptionally genuine risk which may be exacerbated by the deal of drugs through the Web. The deal online of drugs is open to everyone who has an Web get to and online drug stores offer all sorts of drugs, counting medicine drugs. To our information, the as it were taken a toll examination of online drugs was performed in the US, in a comparison between conventional drug stores and OPs which found no financial advantage in buying online, both in year 1999 and in 2006.

In our ponder we explore the financial highlights of online medicate deals, analyzing promoting and estimating techniques by online drug stores for a few “marker drugs” that were chosen either since of their tall inherent hazard if utilized improperly or since of their broad utilize. To our information, this is the to begin with consider which centers on the relationship between OP highlights and the estimating designs. Showcasing and cost procedures are examined utilizing expressive and econometric instruments.

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