This Month's Features

Hurricane Katrina

From the Epocrates Medical Editors — Vaccination Updates

"Cabbage Palm" Case Study

Quick Poll — Are Your Patients Aware of Recommended Vaccinations?

New Association Partnerships

Question Of The Month — How do I redownload my software?

Advocate Of The Month — Dipesh Navrasia, PA-C, MSIV

This Month in Medical History

Advocate Of The Month

Dipesh Navsaria, PA-C, MSIV (and loyal Mac user)

Dipesh at work on his Mac with his baby daughter, Delenn (now two)

Being a fourth-year medical student after a career of several years as a physician assistant has been an interesting contrast.

When I was in PA school in the mid to late ‘90s, PDAs were only just beginning to become useful in clinical settings. Now, I find that I can't do without mine. I refer to my PDA as my "Ectopic Brain”, and the one item on it that I couldn't do without is Epocrates.

Having the ability to ascertain clinical information at a patient's bedside not only enhances patient care, but also gives you that "edge." While other students are fumbling with paper books or finding information that may be outdated, I have the answer at my fingertips. With a recent degree in Library and Information Science (yes, I'm also a librarian!) I know how important it is to be able to find quality information "on the spot." And instead of spending my study time on rote memorization, I can spend it exploring and understanding the underlying concepts.

My former experience in pediatrics as a PA and my future career as a pediatrician makes the Epocrates pediatric dosing calculator a godsend for those times when I’m calculating an unusual dose. I actually requested this feature in the early days of Epocrates, and I was pleased to see it implemented – not just implemented, but executed very well.

Epocrates software has also been very useful to me in my role as the founder and executive director of HeRMES, a student-run free clinic. Given the uninsured population we serve, having a rough idea of the cost of medications is a great advantage.

Finally, as a die-hard Mac user since 1989, I'm pleased to see Epocrates supporting the Macintosh platform so well. I've tried other PDA-based references, and none have matched Epocrates for stability and ease of use.

In medicine, we place a sometimes all-too-heavy premium on memorizing information when the real issue is having it available – reliably and rapidly. Albert Einstein is reputed to have said, "Never memorize what you can look up." And I believe that Epocrates products make it easier than ever to do just that.

This Month in
Medical History

Alexander Fleming discovered that a penicillium mold was inhibiting a Staphylococcus aureus culture that was growing in a discarded petri dish. A few weeks later he named the mold's antibacterial properties "penicillin."

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Where Do You CME? Photo Contest!

Hurricane Katrina

In the wake of Hurricane Katrina, we know that many healthcare professionals in our network may be working in difficult circumstances, and many more are providing much-needed medical help. To all of our customers involved in this crisis, we would like to express our sincere thanks and support for your incredible work. We hope that you, your loved ones, patients, and personal property are safe and unharmed.

For information on charities and organizations that are seeking volunteers and cash donations please visit our Hurricane Aid page.

From the Epocrates Medical Editors

Immunization Awareness — Vaccination Tables Updated with New ACIP Recommendations

Immunization was a groundbreaking achievement in the 20th Century, resulting in the eradication of polio, measles, and most recently, rubella, in the United States.

The National Foundation for Infectious Diseases has designated September 25 - October 1 as National Adult Immunization Week*. Moreover, with school starting and the flu season approaching, Fall is a great time to remind everyone of the importance of immunization.

*Download the National Adult Immunization Awareness Week 2005 Campaign Kit (PDF)

This month we are highlighting updates to our Vaccination Tables as part of our continual support of national immunization activities.

For 2005, the Advisory Committee on Immunization Practices (ACIP) is recommending additions to the current routine immunizations:

• In addition to current target populations, the influenza vaccine is recommended for persons with conditions that can compromise the respiratory system or the handling of respiratory secretions or that can increase the risk for aspiration. Examples are persons with cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders.
  read more on the cdc website >

• Use of both the influenza vaccine (inactivated) and influenza nasal vaccine (live) is encouraged for eligible persons, particularly those in the recommended target groups. If the influenza vaccine (inactivated) is in short supply, the influenza nasal vaccine (live) should be given when feasible to eligible patients (healthy persons aged 5-49 years) to increase the availability of the inactivated vaccine to high-risk groups.
  
  
• The tetanus/diptheria, reduced toxoids, and acellular pertussis (Tdap) vaccine is recommended in place of the tetanus/diptheria toxoids (Td) vaccine for adolescents (11-18 years), as immunity from childhood vaccination wanes over time, leaving adolescents susceptible to pertussis.
  read more on the cdc website >
  
  
• Routine immunization with the conjugated meningococcal vaccine (Menactra™) is recommended for young adolescents (11-12 years) at their pre-adolescent healthcare visit or before high school entry as an effective strategy to reduce the incidence of meningitis in adolescents and young adults.
  read more on the cdc website >  

These new recommendations have been incorporated into the following tables:

• Vaccinations, Adult
• Vaccinations, Pediatric
• Vaccinations, Peds Intervals
• Vaccinations, Peds Accelerated <7 yo
• Vaccinations, Peds Accelerated >7 yo
• Vaccinations, Travel

Additionally, in the coming months, the Medical Editors will be adding a comprehensive list of vaccines to the Epocrates Rx drug database.  Please AutoUpdate regularly to ensure timely access to new and updated content.

Clinical Updates

We added 12 new drug monographs and made 168 revisions to the Epocrates databases in August.

Drug Edit Highlights:

• dofetilide (Tikosyn) – Updated contraindications/cautions and drug interactions to reflect MedWatch Safety labeling changes on contraindicated concomitant drug therapy
• nesiritide (Natrecor) – Updated dosing information and serious adverse reactions based on a recent MedWatch Safety Alert on the appropriate use of nesiritide and concerns about worsened renal function and mortality in patients receiving nesiritide
• efalizumab (Raptiva) – Updated contraindications/cautions and serious adverse reactions to reflect recent MedWatch Safety Alert on the potential of hemolytic anemia
• Brand Discontinued: Humulin L, Humulin U

VIEW DETAILED UPDATES >

Clinical Case Study Demo — "Cabbage Palm"

To see the Epocrates Essentials all-in-one clinical reference in action, view our new Clinical Case Study Demo — "Cabbage Palm".

We're grateful to Epocrates Advocate Marc Rucquoi, a family physician based in South Carolina, for his invaluable guidance in developing this online demo, which is based on an actual case he encountered.

View "Cabbage Palm" Demo
(requires free Flash Player)

Quick Poll — Give Us Your Opinion

The CDC recommends that all adults receive the Tetanus-Diphtheria vaccine every 10 years. Are your patients aware of that recommendation?

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 October newsletter from Epocrates!

Last month we asked: Does mobile technology make medical school easier now than it was 10 years ago? 90% said yes. 10% said no.

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

New Association Partnerships

This month Epocrates announces new partnerships with the American College of Surgeons (ACS) and the American College of Emergency Physicians (ACEP) to offer their members (including students and residents) discounts on all Epocrates products.

Learn more about the epocrates-ACS partnership >

Learn more about the epocrates-ACEP partnership >