Drug Info Center

Obtaining Requester Information

Medication information (doses, schedule, etc)
Medical history of the patient
Patient specific information
Has the patient received the medication previously? Was the response similar?
Has the patient been compliant?
What other therapies have been used? Where they maximized? What other therapies are being considered?
What monitoring parameters have been followed?

Current medication information
Patient specific information
What is the temporal relationship with the drug?
Has the patient experienced this adverse event with the drug (or a similar drug) previously?
Was the suspected drug ever administered before? Why was it discontinued then?
What were the events that characterize this ADR (onset, duration)?
Has any intervention been given at this time?
Does the patient have any food intolerances?
Is there a family history for this ADR and/or drug allergies?
What medications has the patient received in the last 2 weeks?

Is the patient currently receiving the drug? Have samples been drawn? When?
What medical conditions does the patient have? If an infection, what organism is known / suspected?
What is the source of the sample? (blood, urine)
When was the sample taken in relation to the time of last drug administration?
What was the administration rate of the drug?
What were the previous concentrations? Was the patient on the same dose?
How long has the patient been on the drug? Were they at steady-state?

What form / preparation is being used? (e.g., multiple salt forms may be available)
What is the ordered dose? One-time or standing order?
What is the status of the patient? Can they tolerate a fluid push? Any sodium/water restrictions? Does the patient have CHF or edema?
What delivery routes are available?
What other drugs is the patient receiving? Route?

What is the generic/trade name?
Who is the manufacturer?
What is the country of origin?
What is the dosage form, color, markings, size, shape, etc?
What is the suspected use of the medication? How often is the patient taking it?
Is the patient visiting or planning on staying?

Why do you need the information? Is the patient in need of the drug or currently enrolled in the study?
See Drug identification questions
Why was the patient receiving the drug? What was their response? What are the patient’s medical conditions?
If a drug is desired, what approved or accepted therapies have been tried? Was therapy maximized before discontinuation?

What is your name, relationship to patient, and telephone number?
Patient specific information
Is this a suspected ingestion or exposure?
What is the product suspected to be ingested? What is the strength of the product and the possible quantity ingested?
How long ago did the ingestion occur?
How much is on the child or surrounding floor?
How much was removed from the child’s hands/mouth? Was the ingestion in the same room where the product was stored?
What has been done for the patient already? Has the poison control center or ER been called?
What is the patient’s condition?
Does the patient have any known illnesses or organ dysfunction?

What was the drug the patient received and what was the dose? What was the duration of therapy?
Is the patient pregnant or planning to become pregnant?
When during pregnancy was the exposure?
Patient specific information
Why was the drug being prescribed? Was the patient compliant?

What are the drug and the dose? Duration?
How long has the infant been breast-feeding?
Has the infant ever received non-maternal nutrition? Is bottle-feeding an option?
What is the frequency of breast-fed? What is the milk volume?
How old is the infant?
Does the mother have renal/hepatic insufficiency?
What was the indication of the drug? Was this initial or alternative therapy?
Has the mother breast-feed previously on the drug?

Up dated Oct 11