This Month's Features

Baby Boom! — New Pregnancy Categories

It's Back To School Time!

Quick Poll — Do PDAs make medical school easier?

From The Medical Editors

Manage Your Device Memory

Vote For Epocrates!

Question Of The Month — Can I add my own notes?

Advocate Of The Month — Linda D'Eramo, Medical Student

This Month In Medical History

Advocate Of The Month

Linda D'Eramo, medical student

As a medical student, my Palm is never far from me. The first program I check is Epocrates — whether I am checking for the mechanism of action of a particular drug, a differential diagnosis or the significance of certain lab value, all of the information is within the reach of my stylus. Rotations are an important time to meld the textbook picture of disease with the clinical application. Epocrates helps medical students by providing information in succinct "bytes", along with the references for further study.

Epocrates products are extremely helpful and make you look like a star pupil! I couldn’t live without the "Dx" section! You get a quick review of all the basic information of the selected disease process from etiology and risk factors to signs, symptoms and diagnostics procedures to treatment strategies.

The other category I couldn’t live without is the “Lab” section. It helps medical students gain an understanding of the whys and wherefores of ordering and using lab studies. I also regularly use the “Medical Bag” for formulary and conversion factors and the “MultiCheck®” feature, which checks drug interactions. The layout of "adverse reactions" and "contraindications" for the drugs is straightforward and easy to grasp with a quick glance. It’s the most efficient set-up keeping those important facts at your fingertips. Epocrates is essential to my daily rotations and studies — it truly is a medical student’s best friend!

This Month In Medical History

Thanks to users like you, Epocrates has played a role in the evolution of medicine. To honor accomplishments in medicine over time we bring you this milestone in medical history:

August 12, 1792 — France passed a law to abolish the Royal Society of Medicine, the Academy of Surgery, and all of its medical schools!

During the French revolution academic institutions and societies were closed down, and trained doctors were treated with no more respect than "charlatans who distribute poisons and death."(1)

(1) The Officiers de Santé of the French Revolution: A Case Study in the Changing Language of Medicine

Baby Boom!

According to U.S. census statistics, the peak birth months are July and August.

We are celebrating this "Baby Boom" season with an update to Epocrates pregnancy categories.

Our Medical Editors understand that prescribing medications for pregnant patients can be extremely challenging. The FDA assigns pregnancy categories (A, B, C, D, X) to most medications, but relying solely on this letter category may lead clinicians to oversimplify risks associated with some medications in pregnancy.

For example, ibuprofen has been assigned pregnancy category B, but specific precautions are included in its labeling on the potential for premature closure of the fetal ductus arteriosus if given in the third trimester. To alert prescribers to this, a contraindication of “pregnancy, 3rd trimester” is listed in the “Contraind/Caut.” section of the Epocrates Rx, Epocrates Rx Pro, and Epocrates Rx Online ibuprofen monograph.

However, customer feedback indicated that clinicians assessing drug use in pregnant women may only look at the pregnancy category in the "Other Info" section. In response, the Medical Information editors recently made revisions to the "Other Info" pregnancy category for medications assigned to pregnancy category B and C that have existing trimester-specific risks, directing prescribers to additional, relevant information in other areas of the drug monograph. For example, the new pregnancy category in the "Other Info" section of the Epocrates Rx ibuprofen monograph is “B, see Contraind/Caut.” You can also tap on the underlined pregnancy code for a detailed explanation and relevant information.

If you do not see this enhancement in your Epocrates drug reference, please AutoUpdate (sync while connected to the Internet) to install the latest version.

Currently, the FDA Pregnancy Labeling Task Force is working to improve the quantity and quality of data available on the use of medications during pregnancy, focusing on eliminating the pregnancy categories scheme and providing more useful clinical information in a narrative format (1,2). When this new model is available, we will promptly incorporate it into the Epocrates Rx drug database.

1) Kweder SL, Kennedy DL, Rodriguez E. Turning the wheels of change: FDA and pregnancy labeling. The International Society for Pharmacoepidemiology. Scribe Newsletter 2000;3:2-4,10.

2) Meadows, M. Pregnancy and the Drug Dilemma. FDA Consumer Magazine, May-June 2001.

It's Back To School Time!

Welcome students ...

The Epocrates team would like to wish all new and returning students the very best in your studies and clinical training in 2005-2006.

We invite you to learn about our new student discounts.

Hear from Linda D'Eramo, a medical student and our Advocate of the Month.

Calling all medical educators ...

As part of Epocrates' ongoing commitment to education, we would like to learn from medical educators in our network. How do you promote the clinical and practical benefits of PDAs and Epocrates in your healthcare setting? Tell us what works in the classroom and beyond by emailing tips@epocrates.com.

Quick Poll — Give Us Your Opinion

Does mobile technology make medical school easier now than it was 10 years ago?

Please note that poll questions can only be answered via the HTML version of our newsletter email.

To find out how your colleagues answered, be sure to read the September newsletter from Epocrates!

Last month we asked: Are you seeing an increase in the number of patients using herbal medicines? 87% said yes. 13% said no.

Do you have an idea for a poll question? Send us your question (type "quick poll" in the subject line).

From The Epocrates Medical Editors

We added 22 new drug monographs and made 269 revisions to the Epocrates databases in July.

New drug monographs include:

• alendronate/cholecalciferol (Fosamax Plus D)
• azithromycin (Zmax)
• dapsone topical (Aczone)
• dexmethylphenidate (Focalin XR)
• ethinyl estradiol/ethynodiol diacetate (Kelnor)
• exenatide (Byetta)
• hydralazine/isosorbide dinitrate (BiDil)
• lidocaine/tetracaine topical (Synera)
• megestrol (Megace ES)
• metformin (Glumetza)
• tigecycline (Tygacil)

VIEW DETAILED UPDATES >

Ways To Manage Your Device Memory

With the addition of new MedTools applications and ongoing enhancements, the amount of main memory required for Epocrates software has increased. To address this issue, we have recently introduced the option for Palm/Windows customers to save 2 MB of memory on their devices, by moving the Epocrates Dx application from main memory to a memory expansion card.

Our customer support team also recommends that you download only the formularies you need, and learn how to manage MedTools applications either on your device or in the "My Account" section of our website.

Please do not hesitate to contact our support team if you encounter any memory constraint issues when attempting to install Epocrates products.

Vote For Epocrates!

Epocrates is excited to be nominated for the 2005 Mobile Star Awards™ on mobilevillage.com. The Mobile Star Awards recognize the top mobile products, deployments, and leaders. If you would like to support Epocrates, please visit http://www.mobilevillage.com/awards.htm and cast your vote for Epocrates Essentials (Software: Healthcare Professional Reference) and/or Kirk Loevner, our president and CEO (Mobile Industry Leader). Voting closes August 31^st. Thank you for your support!

Please note that in order to vote you need to be registered for "Go Mobile," a free e-newsletter from Mobile Village, which is not affiliated with Epocrates.