Epocrates
January 2011
What's New in 2011
 
Drug and Disease Updates
Confidence in finding A CURE
DocAlert Messages: Editor's Picks
FDA MedWatch Safety Alerts
Clinical Question of the Month
Expanded Clinical Resources
Epocrates EHR: A Solution You Can Rely On
Meet the Epocrates Team!
Fast Company: We Made the Top Ten!
What's This Disease?

Do you know where Epocrates content comes from?

Our in-house clinical team works tirelessly every day to help you deliver optimal patient care at the bedside, in the exam room, and out in the field.

The Epocrates Medical Information Team of practicing physicians and pharmacists develop proprietary content and, in collaboration with esteemed reference partners, strive to provide information that is accurate, current, unbiased, relevant and essential (A CURE). In recent years, a Clinical Oversight Board of national experts convened to review our privacy and content policies and practices to ensure data objectivity and integrity.

Be confident - you're in good hands with Epocrates.

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DocAlert Messages

Joshua L. Conrad, Pharm.D.
Managing Editor, Medical Information, Epocrates

Confidence in finding A CURE

When was the last time that you felt anxiety about something in your professional life? Was it concerning a patient with an elusive diagnosis or tricky treatment dilemma? Perhaps it was just before giving a poor prognosis to a patient's family. Now, what if you had a crystal ball that allowed you to see that the decisions you were about to make in that situation would turn out to be best possible? Would you have still felt the same level of anxiety?

Unfortunately, none of us has such foresight. But, what we do have is knowledge. Knowledge gives us confidence that the choices we make will be the best we can for our patients. And, since none of us can know everything, we must be confident in the resources and tools from which we gather our knowledge. At Epocrates, this is in the forefront of the development of all our clinical content, which is why we have the goal of providing "A CURE".

A = Accurate. The first aspect of our clinical content is that it must be scientifically accurate. Clinicians must be able to have confidence that our content is correct and backed by rigorous research. To achieve this, we only employ highly trained clinical pharmacists and physicians to develop and review our content, which undergoes focused scrutiny to ensure accuracy.

C = Current. Clinicians need to have access to the latest information to keep their practices up to date. Epocrates content is continually updated to ensure that the most current information is available.

U = Unbiased. Our medical information editors operate independently and free from commercial interests. In this way, clinicians can be confident that Epocrates references are purely evidence-based.

R = Relevant. Epocrates references have been specifically designed to offer the most clinically relevant medical information, based on extensive input from our users about what is most important to them.

E = Essential. The structure and presentation of Epocrates references streamline access to the most useful clinical content. Our editors work diligently to ensure that we do not include unnecessary and potentially distracting information. This makes Epocrates references ideal for the busy clinician at the point of care.

In short, Epocrates provides A CURE to the common medical reference.


Drug and Disease
Pityriasis versicolor
Health maintenance for adults
Evaluation of pustular rash
Actinic keratosis
Tenosynovitis of the hand and wrist
Evaluation of acute motor deficit
Myelodysplastic syndrome
Evaluation of inflamed joint
Sepsis
Monoclonal gammopathy of undetermined significance
Drugs
Abstral (fentanyl transmucosal)
Cyclafem 1/35 (norethindrone/ ethinyl estradiol)
Cyclafem 7/7/7 (norethindrone/ ethinyl estradiol)
Introvale (levonorgestrel/ ethinyl estradiol)
Jinteli (norethindrone acetate/ ethinyl estradiol)
Lastacaft (alcaftadine ophthalmic)
Latuda (lurasidone)
Percogesic (acetaminophen/ diphenhydramine)
Percogesic Extra Strength (acetaminophen/ diphenhydramine)
voriconazole (first-time generic for Vfend)
Xerese (acyclovir/ hydrocortisone topical)
     
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DocAlert Messages Editor’s Picks

Anne Meneghetti, MD
Director, Clinical Communications, Epocrates

Immunizations: Is Your Office Up to Date?


Clinicians work hard to ensure that their patients receive recommended vaccines. When it comes to prevention, we are all patients. Recent DocAlert messages featured the CDC's 2011 immunization guidelines for all age groups. Make sure that you and your office staff are well protected this year.

Vaccinations Recommended for Healthcare Professionals
View Chart (PDF)

Adult 2011 Updates
quick-guide chart (PDF)

  • Td/Tdap. Tdap can be given any time since last Td; the interval requirement has been removed. Tdap should be given once to several adult populations, including all postpartum women and close contacts of infants younger than 12 months old (new fathers, people 65 years and older, childcare providers, grandparents, healthcare professionals, and others). After 1-time Tdap, resume Td.
  • Influenza. Vaccinate all adults. Flu season typically lasts until late April. High-dose vaccine (Fluzone) is mentioned as an option for those aged 65 and older.

  • Meningococcal. A single dose suffices for most patients at risk, including unvaccinated first year college dorm residents. HIV+ patients receive a 2-dose series (2 months apart). Patients with anatomic/ functional asplenia or persistent complement deficiencies receive a 2-dose series followed by a booster every 5 years.

  • Pneumococcal. One-time revaccination after 5 years applies only to those with specific chronic conditions who are aged 19 - 64 years.

  • Hib. One dose should be considered for the following, if they have not previously received Hib: sickle cell, leukemia, HIV, asplenia.
Child and Teen 2011 Updates
age 0-6 yrs chart | age 7-18 yrs chart | catch-up chart (All PDF)

  • Influenza. Vaccinate everyone 6 months and older. Guidance added regarding 1 vs. 2 doses based on history of 2009 H1N1 vaccination.

  • Tdap. Tdap can be given any time since last Td; the interval requirement has been removed. Added info for children aged 7 - 10 years who are incompletely vaccinated against pertussis.

  • Hep B. New guidance for children who did not receive a birth dose.

  • Pneumococcal. Added info on the 13-valent pneumococcal vaccine.

  • Meningococcal. A dose at age 11-12 years plus newly recommended booster at 16-18 years old. Added info for catch-up timing. For HIV+ patients, a 2-dose primary series (2 months apart) is followed by a booster. For children older than 2 years with persistent complement deficiency or functional/anatomic asplenia, a 2-dose primary series is followed by boosters every 5 years.
Search "vaccination" or "immunization" in Epocrates Rx® on mobile or Epocrates® Online Premium Tables section to find continually updated CDC guidance on adult, child, and travel immunizations.
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FDA Medwatch Safety Alerts

Prescription drugs: Antipsychotic Drugs During Pregnancy: Potential Risk to Newborns, Warfarin (Jantoven): Mislabeled Dose on Bottle, Terbutaline: Warnings Against Use for Preterm Labor, Qualitest Hydrocodone Bitartrate + Acetaminophen Mislabeled as Phenobarbital, American Regent: Sodium Thiosulfate, Potassium Phosphate - Visible Particulates, Avandia (rosiglitazone): Risk of Cardiovascular Events

OTC products: Triad Alcohol Prep Pads, Swabs, Swabsticks: Potential Microbial Contamination, Extenze Tablets: Contain Tadalafil, Sibutramine

Medical devices:  Triad Lubricating Jelly in Kits/Packs/Trays: May Not Be Sterile, Medtronic SynchroMed II, SynchroMed EL Implantable Infusion Pump/Refills: Recall, Arstasis One Access System: Components May Fracture/Separate, Merit Prelude Catheter Introducer: Tip May Detach, B. Braun Outlook 400ES Infusion System: Hardware May Become Unresponsive


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Jennifer Swenson, PharmD, BCPS
Editor, Medical Information, Epocrates

Q: Pediatrician, Dr. B., asks, "Why are the drug interactions on Epocrates different from the package insert and other drug references?"

A: Our medical information editors go far beyond drug product labeling (package inserts) when researching drug interactions, by using specialty references, consulting experts, and conducting extensive investigation with drug manufacturers, the FDA, and primary literature. We commonly extrapolate broad statements involving pharmacokinetic and pharmacodynamic actions, including effects on cytochrome P-450, P-glycoprotein, and QT interval, and extend them to carefully researched lists that are maintained to help us identify potential metabolic and clinical interactions. From there, we include only clinically relevant interactions and organize them according to recommended action, such as using an alternative therapy, monitoring an objective parameter, or modifying a specific dose. In this way, it is clear to clinicians which interactions are expected to be significant and what to do to mitigate these potential risks.

We feel that Epocrates drug references are quite comprehensive in the area of drug interactions. In fact, the most recent independent study on drug interaction content in electronic references for mobile devices found Epocrates products to be the most reliable in detecting clinically relevant interactions without the distraction of detecting those of no clinical significance. [PubMed
]


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Expanded Clinical Resources REMOVE AFTER TESTING (iPhone)

  The modalityBODY iPad® app is just one of more than 65 new medical apps available from Epocrates.

Build your iPad's reference image library with thousands of premium collections, including the brand new Fitzpatrick's Clinical Dermatology Image Collection.


Learn more about all the apps »


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Epocrates EHR: A Solution You Can Rely On

With the input of over 300,000 physicians, we've built an EHR system for small practices that is simple to learn, easy to use, and accessible from virtually anywhere. You can be assured that Epocrates EHR will help you improve productivity, while maintaining the highest levels of patient care.

Coming Spring 2011. Learn more at www.epocratesehr.com.


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Meet the Epocrates Team!

 

Going to the American Medical Student Association Annual Convention? Visit Epocrates at Booths 46 & 47! Demo new apps, grab cool swag and let our experts assist you with your mobile app needs!

AMSA 2011 Convention, March 10-13, 2011 in Washington, DC


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We Made the Top Ten!




 

Fast Company named Epocrates as No. 10 on their annual list of the world’s Most Innovative Companies! This recognition appears in Fast Company’s March 2011 issue.

To create the Most Innovative Companies list, Fast Company’s editorial team analyzed information on thousands of businesses across the globe. The result is a package unlike that of any other business media. They strive to identify creative models and progressive cultures-to define the many forms of innovation that exist across the business landscape.


     

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Answer

   
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Log in to Epocrates Online for continually updated drug information and disease content and images.

Mobile Updates

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We always love to hear from our members about Epocrates products or any other topic at youropinion@epocrates.com. We occasionally select reader comments to feature in future newsletters. All readers featured in the newsletter will receive a free one-year subscription to the premium product of their choice.

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