AMC Resource

Once the appropriate data have been gathered, reference sources should be consulted to confirm previous documentation of the ADR and to establish whether any alternative causes (such as other medications, disease states, etc.) could have caused the ADR. Information concerning the signs and symptoms, pathology (if appropriate), relevant laboratory findings, treatment, prognosis, and outcome of the ADR is gathered from the literature sources to not only help in assessing the ADR, but also to provide important information the pharmacist needs for appropriate intervention.

The three types of literature sources that may be useful in evaluating suspected ADRs include the following:

1. Tertiary literature

• Facts and Comparisons

• AHFS Drug Information

• Goodman & Gilman’s The Pharmacological Basis of Therapeutics

• Martindale: The Extra Pharmacopoeia

• Handbook of Clinical Drug Data

• Handbook of Nonprescription Drugs

• Physician’s Desk Reference

• Applied Therapeutics: The Clinical Use of Drugs

• Meyler’s Side Effects of Drugs

• Pharmacotherapy: A Pathophysiologic Approach

• Micromedex Drugdex database

2. Secondary literature

• Index Medicus

• Clin-Alert

3. Primary literature

• American Journal of Health-System Pharmacy

• Annals of Pharmacotherapy

• Pharmacotherapy

• American Journal of Medicine

• Annals of Internal Medicine

• Journal of American Medical Association

• Lancet

• New England Journal of Medicine

As one becomes familiar with these literature sources, it becomes easier to investigate and assess suspected ADRs. Also, frequent perusal of the primary literature provides knowledge that can be instrumental in early detection and treatment of ADRs.