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Peer review: assessment of clinical trial by experts for scientific merit, participant safety, ethics


Primary Original information about clinical Scientific journals (Pharmacy

trials/research Connection, Canadian Family
Most current information keeps up Physician, Canadian Pharmacy Journal)
with latest developments & research
in pharmacy
Source of continuing education
Does not guarantee article accuracy,
but good info credibility
Secondary Info from primary sources compiled Indexes (Clin-Alert, Index Medicus),
as abstracts and published in bibliography, abstracts, internet
secondary sources search, Medline/PubMed
Quick, selective screening of primary
literature for specific info
Each indexing service may provide
specific list of journals, which can limit
thoroughness of literature search
Tertiary Obtained from primary/secondary Textbooks, compendia (CPS, US
sources pharmacopoeia, Martindale, Mother
Easy, comprehensive topics in 1 book risk, Remington, RxTx, Cochrane
No recent information database, Health Canada Drug Product

Compendium of Drug monographs, s/e, clinical uses, interactions, contraindications,

Pharmaceutical Specialty pharmacology, dosing, storage info, drugs containing allergens
(CPS or RxTx) (peanut, soy, ethanol), immunization schedule
Compendium of Treatment options (1st line, alternatives)
Therapeutic Choices (CTC)
Compendium of Self care, OTC
Therapeutic Minor
Ailments (CTMA)
US approved FDA drugs
USP-DI Vol 1 Vol 3: Orange book: Approved drug products with therapeutic
equivalence evaluations
Cochrane database Evidence-based medicine systematic review
Health Canada DPD Newly approved drugs
Medline/Pubmed Off-label drugs
Martindale Drugs manufactured in foreign countries, off-label drugs
Handbook of Injectable IV mixture compatibility
Remington: Science and Pharmaceutics, therapeutics, pharmacy practice, industrial
Practice of Pharmacy Compounding, buffers, excipients
Compounding: Remingtons, Merck index Pregnancy, Lactation: Mother Risk

Health Canada MedEffect Drug advisories, withdrawals, recalls

Health Canada Pharmacovigilance ADR in post-marketing surveillance
Canadian Institute of Health Information (CIHI) Medication incidences in hospital
Institute of Safe Medication Practices (ISMP) Medication incidences in community
Canadian Patient Safety Institute (CPSI) Promotes innovative solutions & facilitates
collaboration among government &
stakeholders to enhance patient safety

Drug recalls

Class/Type I Class/Type II Class/Type III

Strong likelihood that product May cause temporary but Product not likely to cause
will cause serious ADR/death reversible adverse; small ADR
chance of ADR

Types of medication errors

Prescribing Wrong dosage form Deterioration

Omission Wrong Monitoring
Wrong time administration Compliance
Unauthorized drug Wrong drug Other
Improper dose preparation

Take w/ plenty of water:

Sulphonamides ( chance of crystalluria)

Bulk laxatives
Irritating drugs (theophylline, K supplements, some antibiotics)

Take w/food or milk

Valproic acid

Take on empty stomach (1h before or 2-3h after food)