NANCY CLARK, M.ED.DIRECTOR OF MEDICAL INFORMATICS EDUCATION
FSU COLLEGE OF MEDICINE
Epocrates and Other PDA Reference Tools
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Objectives for Workshop
Download and Install on the PDAUse Epocrates Rx
find dosage, calculate dosages Identify if drug on formulary
Use MultiCheck to find interactionsUse Sx to get a DifferentialUse Dx to find Disease informationUse Lab to find Laboratory informationUse ID to find recommended AntibioticsUse MedMath Medical calculatorsUse Tables for guidelines and algorithms
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Handouts
PowerPointDownloading instructions for Epocrates
Essentials (yellow)Using Epocrates EssentialsUserID and Password sheet (blue)List of PDA software available and
description of uses
Consent form and evaluations
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SEE HANDOUT
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Installing Software
Links to Download Sites5
PDA Websites Page6
FSU Licensed PDA Software
Epocrates Essentials ($149/yr)Epocrates Essentials ($149/yr) Rx, Sx-Differential diagnosis, Dx-5MCC, ID, LAB, M-
interactions, tables, CME, tools and calculators InfoRetriever ($249/yr)InfoRetriever ($249/yr)
5MCC, Cochrane, InfoPOEMs, calculators, guidelines, ICD-9 and E&M coder
POCKETConsult (FIRSTConsult) ($149/yr)POCKETConsult (FIRSTConsult) ($149/yr) Differential diagnosis, medical conditions
Clinical Evidence ($99/yr)Clinical Evidence ($99/yr)- EBM treatment recommendations
DynaMed ($200/yr)DynaMed ($200/yr) Disease and conditions reference
Harrison’s Practice ($325/yr)Harrison’s Practice ($325/yr) Disease and conditions reference
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Free PDA Software Used in Curriculum
Geriatrics at Your Fingertips (GAYF)* From AGS, tools and guidelines for care of older
patient *free to students, $30 for faculty
ePSS Tool From US Preventive Services Task Force (USPSTF)
tool, enter patient’s age, gender and get latest preventive services recommendations
Archimedes Numerous handy medical calculators free from
Skyscape
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Full Installation Instructions9
Handout for Epocrates EssentialsOther program instructions on Intranet – will
require you to sign in if off campus Login: med\firstname.lastname College of Medicine UserID and Password
Updated weekly
General Steps for All Installations10
1. Go to the Library web page,
2. Log onto EZProxy
3. PDA Websites page: Follow link to product web site
4. Register and get an account
5. Pick platform (Palm, Windows Mobile 5 or PocketPC)
6. Download software to desktop
7. Run the software with the PDA connected (Serial #)
8. Tell it where to put the software (device or SD)
9. When it finishes, test the software
10.Register Product
Adding Applications11
1. Go to Product Web site
2. Register*
PDAApp
4. Run Software on Computer
PDAApp 5. Install to PDA
Device Memory or SD card
3. Download software
EPOCRATES ESSENTIALS RX(ALSO ONLINE)
Drug Information
Prescription Drug Information Alt Med Information
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Epocrates Rx
Prescription drugs and alternative medicines combined in same list
Lookup by Drug or by ClassSearch tool lets you look up drugs by
indication, adverse reactions, etc.Dosage Calculator pops up for all drugs
reported in mg/kg Formularies available with status of each
drug
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Navigation
App: Hide Alt Meds, Auto Update, Memory Mgmt
Edit: findTools: Abbreviations, Formulary Info,
Preferences, Update Email, Disclaimer and About
MultiCheck Drug Interactions Search Tool Home
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Epocrates Essentials Rx
1. Typ
e
2. Pick
drug
3. Pick
category
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How should you prescribe acyclovir for the initial episode of genital herpes? (dose)
Is acyclovir indicated for children with Chicken Pox under the age of 2?
How much does one month supply of Glucophage 850 mg bid cost?
What is the off label indication for Neurontin (gabapentin) (* indicates off label)
Exercises for PracticeExercises for Practice16
Searching for a Drug17
Dosage Calculator in Epocrates Rx
Online Dosage Calculator http://www.medcalc.com/pedidose.html
1. Peds Dosing
2. Click dose
3. Type Amt, Wt & Freq
4. Click C
alculate
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Exercises for PracticeExercises for Practice
A little boy who is eight years old just ate a bottle of FeSo4 tablets his mother had in the kitchen. She thinks he ate forty or fifty of them. You search indications and find that desferol is indicated for iron intoxication. Calculate the dosage of desferol for the child. He weighs 50 lbs.
You have a patient that is on amitriptyline, Flonase, Synthroid, Reglan, and Zyrtec. She comes in with tardive dyskinesia. Which of these drugs might be causing this? (Use Search tool for Adverse Reactions.)
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Add Drug Formularies
Go to Epocrates.comManage My AccountAdd FormulariesPick FormulariesSync to addTap for Alternatives
1. Pick
form
ulary
2. Click Code
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Exercises for PracticeExercises for Practice
I have a depressed patient with BCBS of Georgia who needs a low copay. Which of the SSRI are covered by BCBS low copay?
Look up drugs By Class> psychiatric> SSRIs.I have a depressed patient with no health insurance
who is indigent. Which SSRI can they get assistance to pay for (Needy Meds)?
A 58 yr old female with osteoporosis is on Boniva. CHP Basic has stopped covering it. Which of the calcium metabolism class drugs do they cover?
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EPOCRATES MULTICHECK
Drug Interactions22
MultiCheck
Find all drugs patient is onSelect one at a timeRun the Drug Interaction
Contraindicated Avoid/Use Alternatives Monitor Caution
Also checks IV solubilityUse Back to add more drugs
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MultiCheck Drug Interactions
1. Typ
e
2. Pick
drug
3. Repeat until all drugs in list
4. Clic
k Dru
gs
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Epocrates MultiCheck
Click i
nteraction
Use to
add more
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Exercises for PracticeExercises for Practice
What interactions exist for the following combinations of drugs?
Lexapro, Lortab, Xanax and ZocorNitrobid and ViagraGlucophage, Lopressor, itraconazole
(Sporonox), and simvastatin (Zocor)
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DIFFERENTIAL DIAGNOSIS ENGINE
Epocrates Essentials Sx27
DxPlain
Included in ePocrates Essentials (Sx)
From HarvardAge, gender and durationAllows for multiple
symptoms and lab resultsResults: in decreasing
order of likelihood Online on library web
page
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A 22 year old girl has a dry cough, chest pain, weight loss, and erythema nodosum.
She has been feeling “poorly” for over a month.
What might she have?
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Exercises for PracticeExercises for Practice
DISEASE QUICK REFERENCE
Epocrates Essentials Dx30
5 Minute Clinical Consult
In Epocrates Essentials PDA under Dx tab
Not in Epocrates online – in InfoRetriever online
Author: Mark R Dambro, MD, updated annually
600 common problems, bottom line, quick info, shallow content, ICD-9s
Treatment section linked to Rx,
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What is the incidence and prevalence of and the latest treatment recommendations for acute otitis media?
What imaging test is becoming procedure of choice for kidney stones?
What is the ICD-9 code for psoriatic arthritis?What OTC is drug of choice for sphincter
incompetence in urinary incontinence? (not approved by FDA)
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Exercises for PracticeExercises for Practice
DIAGNOSTIC LABORATORY INFORMATION
Epocrates Lab33
Original Lab Content34
View by Name, Specimen Type or Panels only.
Interpretation: diseases linked to Dx section, drugs linked to Rx section
Cost/Billing tells ICD-9 codes to justify test
A basic metabolic panel reveals that a 30 year old man suffering from bipolar disorder has a serum calcium level of 10.9 mg/dL. He is taking lithium and valproate. Could his medications be a factor?
Which ICD-9 codes would decrease your chances of being denied payment for a Growth Hormone test?
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Exercises for PracticeExercises for Practice
ANTIBIOTICS GUIDE
Epocrates ID Tool36
ABX Guide
Look up by Bug, Drug or System
Antibiotics linked to Rx section
Age and Gender specific
Emperic treatment before culture
Specific treatment for known pathogen
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Which antibiotics should be used for a neonate with empyema, etiology unknown?
The culture comes back with Haemophylius influenzae in the same neonate. What antibiotic should I use? Using the PDA, find the antibiotic, calculate the dose for a 2.84 kg baby.
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Exercises for PracticeExercises for Practice
MEDICAL CALCULATORS
Epocrates MedMath39
MedMath
Small number of handy calculators
Many more in Epocrates online
Most in InfoRetrieverInfo gives you
parameters
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Calculate your own Body Mass Index, Ideal Body Weight, Basal Energy Expenditure, and Body Surface Area.
What is the predicted peak flow for a 60 year old woman with asthma? She is 5’2”.
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Exercises for PracticeExercises for Practice
ODDS AND ENDS
Epocrates Tables42
Tables
Text based content of value to clinicians
Online and PDAGuidelines (HIV,
HTN, Vaccinations…)Dosing equivalents
(ACE, insulins, steroids…)
Algorithms (PALS, ACLS…)
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Patient has planned a trip touring Mayan ruins in the jungles of Belize. What immunizations does she need?
Patient walks in with an inhaler with no labels attached. It is gray with a green cap. Which inhaled steroid is this?
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Exercises for PracticeExercises for Practice
MEDTOOLS
Epocrates Free Add-Ons45
Manage Your Account
www.epocrates.comMy AccountLog inFree Add-onsPick your tools, formulariesTakes memory; puts in main
memoryIncludes free CME,
international drug name directory, clinical decision calculators
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CONTACT INFORMATION FOR HELP
Nancy Clark [email protected] (850)644-9706
Kenneth [email protected] (850)644-7473
CoM IT Help [email protected]
(850) 644-3664
Please Complete your Evaluations
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FYI – What to Buy
Cell Phone/PDAs AT&T – Tilt (WM6, 128/256 memory, 802.11, BT) Sprint - Mogul Verizon – XV6800
Pocket PC/Windows Mobile PDA HP iPAQ hx2795 PocketPC
Palm PDA Palm T|X
Most Important Features: Large screen, memory, speed
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AT&T Tilt