UpToDate Lexidrug User Academy: Getting Started

The Blue Clinical Tool Bar provides access to those clinical tools that are included in your subscription. This bar is available from any screen in the application. The most commonly used tools can be accessed directly from the blue tool bar. These include:

• Trissel’s IV Compatibility* – full access to the Trissel’s™ 2 Clinical Pharmaceutics Content set (Trissel’s IV Check).
• Interactions – a drug-drug, drug-allergy, drug-herbal interaction, and duplicate therapy analysis tool that uses a predictive, evidenced-based model.
• Drug I.D. – identify various unknown drug products based on imprint, dosage form, shape and/or color.
• Patient Education – access to multi-language patient education materials for medications, disease/conditions, procedures, discharge instructions, natural products, and healthy living.
• Calculators – access more than 130 medical calculations, developed by Lexidrug and EBMcalc, that have been designed to assist in drug dosing, drip rates and organ function assessment in both adults and children.
• History – access previously searched monographs by using the history drop-down above the blue tool bar.

Tools that have more selective usage are found under the More Clinical Tools drop-down menu. You can access additional tools here, including:

• Drug Comparisons – provides the ability to perform side-by-side monograph comparisons using the Monograph View, or create data comparisons between 2-4 drugs, using the Data View.
• Drug Plans* – access to more than 5,500 insurance formularies, including managed care organizations, pharmacy benefit managers, health maintenance organizations, state Medicaid formularies, self-insured companies and other healthcare plans.
• Formulary Monograph Service* – access detailed information about recently released and investigational drugs, including pharmacy and therapeutic reviews, editorial comments, and drug utilization evaluations.
• MSDS* – access to material safety data sheets for drugs.
• Toxicology – access information on agents of toxicity, antidotes and decontaminants, household products, Safety Data Sheets (SDS), toxicology-specific calculators, and drug identification in one single tool.
• UpToDate* – use this link to search the UpToDate evidence-based medicine application.
• VisualDx* – access to diagnostic clinical decision support for skin conditions.
• Indexes – access a list of all available content sets using alphabetical and other relative indexes.
• Other Clinical Links – a list of links to other significant websites for information on new drugs, drug shortages, recalls and more.
• Advanced Search – search the Use, Adverse Reactions, Contraindications, and other fields within the databases included in your Lexidrug subscription.

*Availability depending on subscription

Searches can be initiated from the home page search or from the search box found at the top left of every page throughout the application.

Searching from the home page

From the opening screen, enter any keyword (i.e., drug, lab, disease) in the search box and use either the Enter key or click on the Search icon. To assist with searching, a possible keyword list will appear after you enter at least two (2) characters. To select a suggested term, simply click on the desired search term and the system will automatically perform a search and display the results.

Handling misspelled terms

If you misspell a search term, the search logic will try to determine the likely term that was intended. If possible, search results for the intended term will be displayed, and the gray contextual navigation bar will indicate that the search was performed using this term. A "did you mean" choice will also be displayed (when applicable) with additional options that the search service has determined are possible matches.

Search results display

After performing a search, you will be presented with the results from all available content sets that have a match to the search performed. If there are more than 5 results returned per content set, the top matches based on user activity will be displayed first. Additional search results can be displayed by clicking on the "show all" link. To view the monograph within any content set, click on the hyperlinked drug name displayed.

Use the Advanced Search link to narrow your search to specific areas within Lexidrug. Once you click on the link, a new box opens with options of areas to which the search can be targeted.

Options include:

• All Text – searches all text within Lexidrug
• Monograph Name – searches for the title of the monograph
• Adverse Reactions – searches the Adverse Reactions sections of the drug monographs
• Contraindications – searches the Contraindications sections of the monograph
• Charts/Special Topics – searches the content within the Charts/Special Topics section of the content set Drug Interactions – searches the Drug Interactions section of the monographs
• Use – searches the Use section of the monographs
• Warnings/Precautions – searches the Warnings/Precautions section of the monographs
• NDC – searches for monographs using the NDC. This allows users to search for drugs using NDC numbers
• Methodology – searches the Methodology section of the lab monographs
• Pharmacologic Category – searches the Pharmacologic Category section of the monograph
• Field Name – searches only the section headings
• Drug Database – searches a specific database included in your license

Once you select a search result, the monograph will be displayed. In the top left corner of the screen, the monograph title and content set name will be displayed as a point of reference.

The entire monograph can be viewed using the standard browser scrolling functionality. As you scroll through the monograph, the Outline contents will scroll along with you to indicate your place within the monograph.

The Outline provides a table-of-contents view of the available sections of the drug monograph. The contents of the Outline can be viewed alphabetically by selecting “Alphabetical”.

To jump to a particular section, click on the desired topic heading. Sections that have an arrow sign next to them have sub-sections that allow you to jump to more specific areas of content.

To expose all of the sub-sections at once, click the “Expand All” link found to the right of the Outline title on the left side of the screen.

Lexidrug monographs include important drug information related to:

• Dosing: Find dosing information, including dosing related to special populations, such as hepatic, renal, obesity, and neonatal
• Administration: Find considerations for a drug’s relevant route of administration, storage issues, dietary considerations, and more
• Adverse Reactions: Identify incidents that could be life threatening, debilitating, or otherwise significant to the patient’s safety
• Pharmacogenomics: Link to specific pharmacogenomics monographs that review the influence of inherited genetic variants on agents used to treat cancer and supportive care medications
• Pharmacology and pharmacokinetics: Optimize dosing for antimicrobials and minimize adverse effects
• Warnings and precautions: Find a drug’s contraindications and warnings for adult and pediatric populations
• International Brand Names: Find more than 500,000 international brand names from over 150 countries in an easy-to-search functionality
• And more

Throughout the monograph, hyperlinks are presented that allow you to link to additional content. In some instances, these links provide access to related content within Lexidrug, such as: calculators, disease/organism content (infectious disease drugs only), pharmacogenomics information, charts/special topics, allergy/idiosyncratic reaction information, off-label and pregnancy/lactation detail, comparative efficacy information, and AHFS content, to name a few.

Along with the additional Lexidrug content, other hyperlinks provide access to content found on the Internet, such as: FDA medication guides, Clinical Practice Guidelines, FDA warnings/alerts, and PubMed links for references.

The gray contextual navigation bar is located at the top of every monograph and contains several ways to navigate the content.

The “Find in Document” tool allows you to find any word or phrase that may be located within the monograph. Click on the “Find in Document” link to open the search box. Enter the desired text to be located and click on the Search icon. The monograph will jump to the first location of the desired text and highlight the found text. Use the arrows to find subsequent places within the monograph that contain the desired text. Click on the Done key to close the search box.

In the upper left side of the gray bar, the Back to Search arrow will navigate back to the Search Results page, where you can choose a different monograph.

This bar also contains the Print button, as well as access to the Help menu for the monograph.

In addition to the monograph information, content is available via the tabs across the top of the monograph window. Clicking on these tabs will give you access to (1) images of various dosage forms; (2) adult patient education material and (3) pediatric patient education material.