Prescribing information: Scroll with the changes

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Online, handheld-based reference guides can help clinicians keep current on drug alerts, safety recalls, and other crucial developments.


Today’s physician needs to stay abreast of ever-changing prescribing information. Print and CD-ROM drug guides, long regarded as the gold standard in clinical reference, are constrained by press deadlines and start becoming outdated upon publication.

Electronic drug guides, available online or via handheld computers, are updated regularly and provide real-time developments about drug alerts, safety recalls, and changes in prescribing information.

Online drug guides

Benefits. Drug-drug interactions can be checked with a couple of clicks. By contrast, scanning printed lists of interactions for each medication could cost you valuable time.

Some electronic guides list the medication’s cost and formulary availability in addition to dosing, indication(s), drug mechanism, precautions, and adverse reactions.

Drawbacks. Depending on the type of subscription, access to an online drug reference may be restricted. Many institutions purchase access to online references, which are readily available at any terminal or computer in the hospital network. When attempting to access the resource from an outside computer, however, access is denied.

Some facilities circumvent this problem by providing a proxy server to relay access or use a virtual private network to connect to the hospital network. Individual subscriptions, which provide access via password, do not have this limitation.

The table lists benefits and drawbacks of individual programs.

Drug guides for handhelds

Drug guides for personal digital assistants are more accessible, but many handhelds lack sufficient memory for the guides’ databases and programs.

Some programs, such as the American Hospital Formulary Service guide and Physicians’ Desk Reference, can operate from external memory-such as secure digital or compact flash-thus preserving the limited main memory of most handhelds. In working this way, however, these programs’ databases often cannot be updated automatically and require user intervention.

The handheld’s small screen size is another potential drawback. The better handheld drug guides are designed to maximize limited screen space and promote easy navigation by utilizing hyperlinks to jump to related information or pop up windows to provide additional information. Ideally, content should be succinct yet offer sufficient detail.

How to choose a drug reference guide

Electronic drug reference guides vary greatly in their detail, organization of content, and ease of navigation and downloading. To decide which drug reference guide is right for you, try several demonstration versions:

  • Compare different features. Look for sufficient content and intuitive navigation.
  • Find out if pre-made patient education brochures are available for printing.
  • For handheld guides, determine how much memory is required by the program and databases, how often they must be updated, and whether they can be stored on external memory.
  • Ask if discounts are offered for purchases during trade shows or for a combination purchase of the guide’s online and handheld versions.

The following table, which lists quick reviews of reference guide demonstration products, can help you explore the options.

If you have any questions about these products or comments about Psyber Psychiatry, click here to contact Dr. Luo or send an e-mail to:


Dr. Luo reports no financial relationship with any company whose products are mentioned in this article. The opinions expressed by Dr. Luo in this column are his own and do not necessarily reflect those of Current Psychiatry.

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