PPC Exam #2 (DI)

Everyone defines and agrees on the approaches to practice of evidence-based medicine.

False

Based on the case reviewed in the Drug Information Case Workshop, the final answerable question was determined to be, "For an adult female with migraines, what is the efficacy of metoprolol compared with other prophylactic medications (including valproate and amitriptyline) for reduction in frequency of migraines?"

Drug Therapy/Therapeutics

Order the types of resources used in the approach to search for drug information (first to last)

As outlined in the Sketchy EBM video 'EBM Explained", what are the important aspects that make up evidence-based medicine? Select ALL that apply.

Quality, Relevant Evidence

EBM Pyramid only

Patient Values & Preferences

Relying on Latest & Greatest Research

[Healthcare Practitioner] Judgement & Experience

EBM Paralysis

Quality, Relevant Evidence

Patient Values & Preferences

[Healthcare Practitioner] Judgement & Experience

A physician asks for a tertiary reference that discusses the results of a new drug’s efficacy and safety in treating migraine headache. Which of the following is a tertiary resource in biomedical literature?

A review paper describing several clinical trials

Identify which of the following IS correct based on the writing tips provided in the Drug Information Case Workshop

Zolpidem (Ambien®) is FDA-approved for the treatment of insomnia.

A ____________ approach is the most efficient way to respond to drug information questions and search for drug information.

systematic

Match the elements of the answerable question with case-related information

P (Patient, Population, Problem) - Adult with migraines

I (Intervention) - Metoprolol

C (Comparison) - Other prophylactic medications 

O (Outcome) - reduce migraine frequency 

Name the elements of the answerable question with case-related information

P?

I?

C?

O?

C (Comparison)

P (Patient, Population, Problem)

O (Outcome)

I (Intervention)

What type of source is PubMed?

Secondary 

What type of source is randomized controlled trial?

Primary

What type of source is prescribing information?

Tertiary

The primary source of information used in drug information databases is…

primary literature 

Which of the following is a secondary resource that can assist in finding original research papers?

PubMed(R)

Match the Pharmacists' Patient Care Process with the steps in evidence-based medicine

Collect

Assess

Plan

Implement

Follow-Up

Answerable question

Locate best evidence efficiently 

Categorize question

Answer the question

Google to find information 

Evaluate performance 

Obtain background information 

Critically appraise evidence 

Integrate expertise and patient values 

Collect > Answerable question

Assess > locate best evidence efficiently

Plan > Critically appraise evidence

Implement > Integrate expertise and patient values 

Follow-Up > Evaluate performance

A medical assistant in the travel clinic calls and asks about the recommended vaccines for a patient traveling to Indonesia. Which reference would contain information on recommended travel vaccines?

CDC's Yellow Book

A physician calls and asks “my patient takes cannabidiol (CBD) oil every day. Does that interact with his abiraterone and prednisone?” What would be the most appropriate DI reference to use for this question, given the product of interest?

NatMed Pro

Which of the following electronic databases would provide the largest international biomedical journal coverage?

Embase(R)

Health information for international travel

Yellow Book

Therapeutic equivalents

Orange Book

Care of pediatric patients with infectious diseases

Red Book

Veterinary medicine

Green Book

Biologic approvals and interchangeability

Purple Book

What type of source is prescribing a meta-analysis (examination of data from several different studies)?

Tertiary 

Information found in a reference or verbalized by an individual that pertains to medications.

Drug Information (DI)

label and identify

Conscientious, explicit, and judicious use of current best evidence in making decisions about the care of the individual patient.

Evidence-based medicine

label the evidence-based medicine diagram 

In an aged adult patient with type II diabetes, does metformin reduce the risk of heart attacks, strokes, and peripheral arterial disease in comparison to insulin? (Identify PICO)

P: aged adult with type II diabetes

I: metformin

C: insulin

O: risk of heart attacks, strokes, and peripheral arterial disease

Tools that are used to find the primary and tertiary sources

Secondary resources

summary of evidence; provides overview information extracted from the primary literature 

tertiary 

Clinical practice guidelines

tertiary

Full-text computer databases

tertiary 

Merative Micromedex®

tertiary 

UpToDate®

tertiary

ClinicalKey®

tertiary

AccessPharmacy®​

tertiary

Prescribing information

tertiary

Systematic reviews

Tertiary

Medline®

secondary 

Google Scholar

secondary

ULS databases (like PittCat)

secondary

§Scopus†​

secondary

§Cochrane Library†​

secondary

Embase®

secondary

Case reports/series

primary

Randomized controlled trials

primary

Cohort​

primary

Case-control​

primary

Cross-sectional

primary

Name consumer resources that are NOT to be used as pharmacist research materials

Mayo Clinic, Medline Plus, FDA/CDC consumer pages, StatPearls

Awareness or analysis of one’s own learning or thinking processes

Metacognition

A thought, idea, or opinion formed or a remark made as a result of meditation; consideration of some subject matter, idea or purpose

Reflection

Kerwin EM, Tashkin DP, Korenblat PE, et al. Long-term safety and efficacy studies of epinephrine HFA metered-dose inhaler (Primatene® Mist): a two-stage randomized controlled trial. J Asthma. 2021;58(5):633-644.

primary

Nakamura Y, Tamaoki J, Nagase H, et al. Japanese guidelines for adult asthma 2020. Allergol Int. 2020;69(4):519-548.

Tertiary 

Rodrigo GJ, Nannini LJ. Comparison between nebulized adrenaline and beta2 agonists for the treatment of acute asthma. A meta-analysis of randomized trials. Am J Emerg Med. 2006;24(2):217-222.

Tertiary

Mishra RK, Radhi S, Nugent KM. A 20-year-old woman with severe asthma refractory to Primatene Mist. Chest. 2010;138(5):1253-1255.

Primary

Epinephrine inhalation solution (Primatene MIST®) prescribing information. Canton, MA: Armstrong Pharmaceuticals, Inc; 2021 Jun.

Tertiary 

Newborn age range:

birth-1 month

Infant age range: (2)

birth-23 months / 1-23 months

Preschool child age range: 

2-5 years

Child age range (2):

birth-18 years / 6-12 years

Adolescent age range:

13-18 years

Young adult age range:

19-24 years

Adult age range: (2)

19+ years / 19-44 years

Middle Aged age range: (2)

45+ years / 45-64 years

Aged age range:

65+ years