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• Introduction:

A clinical drug literature is basically a document

containing all the information including (but not limited)

 Side /adverse effects

 Drug interactions

 Uses

 Teratogenicity

 Stability

 Compatibility

 Product identification and availability

 Dosages and administration

 Toxicity

 Pharmacokinetics

 Pharmacodynamics

 Pharmacogenomics

 Health related quality of life

 Pharmacoeconomics

and efficacy including the comparative efficacy among drugs in the same
pharmacological or chemical class as well as drugs from other classes

Accessing, reviewing, analyzing, evaluating and interpreting the clinical

drug literature are important responsibilities of the health care
professionals and particularly for the pharmacists who are expert on the

The advances in computer technology, continual growth of internet and

widespread availability of the database search capabilities have placed
unprecedented amounts of information into individuals grasp.

In particular healthcare professionals are also now moving to internet as

an information resource but the key responsibilities of the entire
healthcare professionals is to differentiate good from poor quality
information and indentifying the strength and limitations of information
and applying it to information they obtain to patient care.

A key activity of modern
healthcare providers particularly pharmacist is conducting literature
searches to locate complete, up-to-date and valid information upon which
patient care decisions can be made.

A term medical informatics has been defined as the rapidly developing

science which deals with the storage, retrieval and optimal use of
biomedical information data, and knowledge for problem solving and
decision making.

Health professionals must be familiar with not only the variety of literature
sources but also to analyze, interpret and evaluate them.

Different types of literatures with their little introduction are

Types of clinical drug literature:

There are three types of clinical drug literature

i. Tertiary sources

ii. Secondary sources

iii. Primary sources

i. Tertiary sources:

Consist of general reference books and texts when

basic information on topics such as pharmacotherapeutics, toxicology
or drug interaction is needed then tertiary literature source is the best
means of starting the learning process and also provide references.

ii. Secondary sources:

Literature used to identify and locate primary and other
resources consist of bibliographies, abstracting services, and indexing
services. Pharmacist should use it when extensive information is

iii. Primary sources:

Consist of original studies and reports in journals,

monographs and proceedings and symposia. They should be consulted
when making recommendations regarding therapy for the disease
states or looking for new or investigational drugs information or uses.

Once acceptable sources of
information are identified and retrieved, the pharmacist must analyze and
evaluate the published literature and develop recommendations based on
best available data.

An understanding of searching techniques, research design and

biostatistics is important in evaluating a literature.

Pharmacist should critically evaluate study methods and results to ensure

they are sufficiently valid to produce useful information.

Special care must be taken when reviewing promotional literature and

using pharmaceutical sales representatives as sources of drug and drug
related information.

The successful pharmacy practitioner should have the skills to critically

evaluate a literature and to draw their own conclusions based on a
study`s merits, rather than simply relying on author`s conclusions.

In general medical studies can be divided into 2 broader general types

 Descriptive

 Explanatory

 Descriptive:
It is used to simply record data from observations. This
study is employed to document and communicate experiences that the
author feels are important to bring to the attention of medical community.
This study describes new or unusual events. This study is further divided

• Case reports (based on observations of individual patient)

• Case series (based on observations from group or series of patients)

 Explanatory:

These studies use a more strict design to identify

answers to questions that arise in clinical medicine. This design is
employed to determine efficacy of medicine or its effects. This is further
divided into

• Observational (examine natural course of health events gather data

about subjects and then classify & sort the data)

• Experimental (prospective trials in which intervention occurs on part

of the investigators and may be controlled or uncontrolled)

Pharmacist in an
expert for the communication of the literature to other healthcare
practitioners and patients as well. He should be well equipped with the
terms used in the literature.

Clinicians are often interested in obtaining a comprehensive summary of

the available information on a specific topic instead of individual studies.

Review articles constitute one type of publication, a systematic overview,

used for summarizing literature on a certain subject. These reviews
compile published information on broad aspects of a topic and offer
recommendations. One advantage of the review articles is that it provides
a healthcare practitioner who might know little about a specific subject
with a summary of much of published information on that topic allowing
the practitioner to be up-to-date with the topic quickly.
Unlike qualitative review article a meta-analysis is a summary article that
provides quantitative data and uses statistical data to reach to a

But review articles and meta-analysis are not based on a focused clinical
question, might not include criteria used by author in locating the relevant
material, might not include validity of studies included etc. So a secondary
source of information is very useful in communication of a literature.

Always furnish other health care professionals and patients with

comprehensive, to the point, in a well behavior and up-to-date information
up to their satisfaction.



Utilization of Clinical Drug