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The Quest: Get the Lowdown on the Pills You’re Popping

The views expressed are those of the author and are not necessarily those of Scientific American.


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Credit: CDC/Debora Cartagena

Looking up information about prescription medications used to mean thumbing through the pages of the big blue Physicians’ Desk Reference (PDR), or more recently, searching the PDR website. But for a really comprehensive search that includes extensive clinical trial data, you can’t beat DailyMed, another one of the authoritative-and-free-to-use offerings from the National Library of Medicine (NLM).

You can always treat DailyMed as a simple search engine. Just type in the name of a drug, like Gleevec—the anti-cancer pill that works against some kinds of leukemia and gastrointestinal tumors—and you’ll get the standard descriptions: generic name manufacturer, how it works, dosage and side effects.

But there is so much more to DailyMed. For example, if you look to the left hand column, you have several key options for even more information about a drug, including:

Or once you’ve learned to which class or biochemical grouping a drug belongs, you can check to see what else is available in the same category—particularly important with chemotherapy drugs such as Gleevec (a kinase inhibitor) and anti-depressants.

You can even report a bad reaction you may have experienced while taking the drug (“Report Adverse Event).

Part of the reason DailyMed searches are so powerful has to do with its integration into the other NLM databases. But the way the information is submitted in the first place—known as the way it is structured—also plays a major role.

Ever since 2005, the labeling information for all drugs and biologics that are submitted to the Food and Drug Administration must be entered in a particular electronic format that allows it to be reused in other applications without the need for additional inputting or conversion of information. (Details on the specific XML markup requirements can be found at the FDA’s Structured Product Label resource page.)

These sorts of behind-the-scenes initiatives for managing large data sets are going to become increasingly important, in my opinion, as medicine becomes more oriented towards genetics (and the exponential growth in data generation that implies). The more computers and databases are designed to talk to each other in ways that humans can understand as well, the easier the search for authoritative medical information will be for all of us.

Previous posts in The Quest series:

$84,000 Miracle Cure Costs Less Than $150 to Make

How To Get A Medical Librarian to Do Your Search for Free

Practical Advice for Online Searches

 

About the Author: Christine Gorman is the editor in charge of health and medicine features for SCIENTIFIC AMERICAN. Follow on Twitter @cgorman.

The views expressed are those of the author and are not necessarily those of Scientific American.





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  1. 1. u14087627 5:23 pm 05/3/2014

    This seems like a brilliant website. The problem that many patients find with doctors is that they often do not fully understand the condition they are being treated for and often do not fully understand the medication itself. Because of this, doctors can often persuade a patient to take a drug that they might not have taken if they had fully understood the side effects or the way in which it works. I have personally experienced this with a family member of mine who had leukemia and was pushed to take a specific drug. Only after being read the side effects (by a family member, not a doctor) did she realise that this was not a drug that she wanted to be taking. Websites such as DailyMed allow the power to be put back into the patients hands and allows them to understand fully what they are putting into their bodies.

    On the other hand however, this also leads to the problem of patients believing they can do the doctors job because of the internet. Patients can now try to insist on a specific drug not completely understanding the reasoning behind why the doctor may want them to be taking a different drug. Furthermore,some patients may try to self medicate, getting their hands on drugs using not-so-legal methods because now they feel that they have a comprehensive understanding of what they should be taking due to a website instead of trusting a doctor that has studied many years and is experienced in that field.

    Link to this
  2. 2. u14163609 8:33 am 05/4/2014

    The only trouble with patients or their family members taking matters into their own hands is that they may not possess the necessary background knowledge or may lack context of the issue at hand. Also when it comes to side effects two vital questions need to be addressed: the frequency of their occurrence and their severity. Once this is known the alternatives to the discussed medication need to be investigated so that the issue of effect versus side effect can be addressed. If one experiences an unpleasant side effect due to a drug but essentially this drug could cure or greatly reduce their disease then surely that smaller sacrifice is worth it?
    However, I do find such websites are a fantastic tool for people to empower themselves as they can gain fully comprehensive insight and knowledge into their sickness or disease which will allow them a better understanding. This can enable patients to provide their doctors with more insightful questioning rather than self-diagnosing. Also choosing to be more knowledgeable over ignorance is always a wise decision.
    In addition to tools such as DailyMed I can also recommend Medscape which provides lots of information on diseases, drugs and clinical data and also provides numerous links to other sources of medical information. There is also MIMS (Monthly Index of Medical Specialties) which is released monthly and the annual MIMS desk reference also known as the MDR. MIMS has also now started producing disease based books for example they recently released a book focusing on female health. These are available both in hard copy and electronic versions which makes it a very convenient source to utilize. Lastly additional features are now also included such as support groups, locums and even ambulance services so it is highly unlikely that you will be unable to find the information you require.

    Link to this
  3. 3. nyscof 12:47 pm 05/6/2014

    You once said you feared reporting fluoridation critics’ information because you thought that would ultimately hurt people. However, the link you direct people to says that fluoride supplements are unapproved drugs which have “not been found by FDA to be safe and effective.”

    Do you still fear bringing that important information to the public? From the link:

    FLUORIDE DROPS (SODIUM FLUORIDE) LIQUID [FLUORITAB CORPORATION]
    NOTE:THIS DRUG HAS NOT BEEN FOUND BY FDA TO BE SAFE AND EFFECTIVE, AND THIS LABELING HAS NOT BEEN APPROVED BY FDA.
    http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=2e05a9bf-f8e7-41b1-b382-2dc9d8dafee4

    Link to this
  4. 4. Christine Gorman 2:00 pm 05/6/2014

    Interesting. But one of the hallmarks of a good search is that you don’t stop simply because you’ve found something you agree with.

    You seem to imply that the FDA knows that flouride generally is somehow unsafe, not this particular product.

    But in fact, If you search for “flouride” generally, you find other products that fall into the class of “human OTC” for “over the counter” with the following message “NOTE: MOST OTC DRUGS ARE NOT REVIEWED AND APPROVED BY FDA, HOWEVER THEY MAY BE MARKETED IF THEY COMPLY WITH APPLICABLE REGULATIONS AND POLICIES. FDA HAS NOT EVALUATED WHETHER THIS PRODUCT COMPLIES.”

    Same holds true for aspirin, by the way:
    http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=7dd0ae95-32e3-4e44-b9cf-a91e422ec4db

    http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=5f6f4125-6264-4724-bb7e-a6e100939b41

    Link to this
  5. 5. nyscof 8:56 am 05/12/2014

    Thanks for your reply. No, it actually took me two years to be firm that the science supporting fluoridation doesn’t hold water with a binder full of copies of typed correspondence to fluoridation supporters from about 30 years ago. I’m hoping mainstream science writers will be allowed to review and publish their honest finding about the scientifically validity of the studies which purport to show fluoridation is the reason that tooth decay declined.

    Hydrofluosilicic acid is the fluoridation chemical most used for fluoridation in the US. It has never been safety tested in animals or humans. Fluoridationists will say it completely dissociates and only fluoride is in the water and, since there is no evidence or harm, this proves hydrofluosilicic acid is safe. After all, people aren’t dropping dead in the streets, they often say However, they have no studies to prove drinking fluoridated water is safe for everyone. Although they will admit nothing is safe for everyone, they are loathe to admit or disclose who should avoid fluoridated water – lest fluoride’s reputation be tainted.

    Fluoridation began with the mistaken belief that ingesting fluoride reduced tooth decay. The CDC now reports that fluoride gets into tooth enamel by topical means alone.

    Sodium fluoride supplements were prescribed to children who didn’t live in fluoridated areas upon the assumption that ingested fluoride reduced tooth decay and was safe.

    Sodium fluoride is actually an off-label use of rat poison as correspondence with the FDA reveals that, before fluoridation, sodium fluoride was not sold as a decay preventive. Sodium fluoride was grandfathered in after the 1938 law was enacted requiring safety testing of drugs.

    Link to this

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