Franklin IC-104 User manual

DIGITAL BOOK

Electronic Publishers
For Use with the Franklin
Digital Book System

Electronic Publishers
User’s Manual
F
Mt. Holly, NJ 08060
FOLD
IC-104
HANDBOOK
OF
ADVERSE
DRUG
INTERACTIONS
Rx
The Medical Letter


FCR 28004-00 C
P/N 7201670 Printed in China

1
Contents
Introduction .......................................................2
Getting Started ..................................................6
Seeing a Demonstration ...................................8
Entering Drug Names .......................................9
Correcting Misspellings ..................................11
Brands, Generics, and Groups ...................... 13
Finding Interactions........................................ 15
Between Many Drugs ..................................15
For a Single Drug........................................ 17
Viewing References ........................................ 19
Sending Words to Other Books..................... 21
Digital Book System ........................................22
Warranty ...........................................................27
Product Specifications ................................... 28
Key Guide .........................................................29
Index..................................................................32

2
This handbook offers a quick guide to possible adverse effects
of drug interactions, with brief recommendations for precaution-
ary measures. References are given to original reports that
provide more complete discussions of each interaction.
This book— lists adverse drug interactions, their mechanisms,
and recommendations for clinical management. These listings
are usually based on clinical reports in humans.
Reports of interactions between more than two drugs are
appearing in the medical literature with increasing frequency.
Where these have been documented, they are noted as
comments under interacting pairs of drugs. Interactions listed
for groups of drugs (such as “cephalosporins” or “antidepres-
sants, tricyclic”) may not have been reported for every drug in
the group; known exceptions to the interaction are noted.
It is not possible to determine the frequency of most interac-
tions. When an interaction is documented by one or two case
reports rather than by clinical studies or reports in many
patients, the year of each report is given as some indication of
frequency.
Omissions—Drugs for which we have no documented
interaction are not included. New adverse interactions are
continually being reported; the absence of an interaction does
not necessarily mean that drugs will not interact when given
concurrently. Interactions between general anesthetics and
drugs likely to be administered during surgery, such as
autonomic drugs and local anesthetics, are not included here.
Interactions useful in therapy, such as increased plasma
concentration of penicillin with concurrent use of probenecid,
are also not included.
Common additive effects, such as occur with the use of two
Introduction

3
antihypertensive agents or two central-nervous-system
depressants, are generally not included. Effects expected from
the mechanism of a drug’s action, such as that of potassium on
digitalis glycosides or calcium on calcium-entry blockers, and
useful antagonist effects, such as that between a poison and an
antidote, are not listed. Most interactions of drugs with foods,
beverages, or other nutrients are not included, but foods
interacting with monoamine oxidase inhibitors are included.
Mechanisms of Interaction—Genetic differences can affect
drug metabolism and interactions. Drugs can interact by
changing the metabolism of other drugs, either through
inhibition or induction of any of several hepatic enzyme
activities or through alterations in hepatic blood flow; by altering
the binding of other drugs to plasma proteins or tissue
receptors; by altering the distribution of drugs to active receptor
sites; by delaying or enhancing excretion; or by causing additive
or synergistic effects.
Recommendations—Monitoring is most important when one of
the interacting drugs is stopped or started. Some experienced
clinicians may prefer to monitor the patient’s clinical status
rather than follow serum concentration of drugs.
Important Notice: The Medical Letter Drug Interactions
Program reports interactions occurring in people, which
can be documented primarily by published reports.
These may not include interactions mentioned in other
sources, such as the manufacturer’s package insert,
which are extrapolated from animal studies or interac-
tions reported for related drugs.
Introduction

4
Introduction
What the Handbook Can Do
The Medical Letter®Handbook of Adverse Drug
Interactions
digital book is a powerful reference.
Using the
Handbook , you can. . .
• find brand name drugs, generic drugs, drug
groups, and food groups,
• correct and find drug name spellings,
• find foods that interact with MAO inhibitors,
• enter up to 20 drugs and see a list of the
interactions between them,
• enter a single drug and see a list of the drugs
with which it interacts,
• read descriptions and references about
interactions, and
• look up drugs and words in related digital books.
Read this User’s Manual to learn how. You can
follow its numbered steps using the examples
shown or drugs that interest you.

5
ENTER
ENTER
ENTER
ENTER
CLEAR
How the Handbook Works
The Handbook is easy to use. Here are the basics:
Highlight the HADI symbol. Then press .
At the main drug list, As you type, the drug
type a drug name. name is highlighted.
Then press .
Type another drug You see a prompt
name. Press . to “show interactions.”
Press . You see the interactions,
if any, between the drugs.
Press . You see a description of
the interaction.
Press . You’re ready to find
other interactions.
ENTER
Introduction
About Illustrations
The illustrations in this User’s Manual are from
the 1992 edition of the
Handbook . The
information that you see on screen may be
different.

6
Getting Started
If you’re using the Handbook for the first time, read
this section. WARNING: If you install the
Handbook
with the Digital Book System on, information that you
entered in the other installed book may be erased.
1. Turn the Digital Book System off.
2. Put the
Handbook in either slot on the
back of the Digital Book System.
Align the book’s tabs with the notches in the slot.
Make sure its metal contacts face down.
3. Press .
4. To adjust the screen contrast, turn the
wheel on the side of the Digital Book System.
5. Press .
6. Press or to highlight HADI.
ON/OFF
CARD

7
7. Press .
This is the Handbook’s initial screen, the top of
the main drug list. Here you enter drug names to
find interactions.
Getting Started
ENTER
CLEAR
BACK
HELP
BACK
Clearing the Screen and Backing Up
You can always return to the initial screen by
pressing . When you do, the drug names
in your query list are also cleared.
You can always return to the previous display by
pressing .
Help is Always at Hand
If you’re ever unsure about which key to use,
press to see an appropriate help mes-
sage. To scroll down help messages, press .
To exit them, press .

8
Seeing a Demonstration
Before you start using the Handbook , you may want
to see a brief demonstration.
1. At the initial screen, press .
2. Press to highlight DemoDemo
DemoDemo
Demo.
3. Press to start the demonstration.
4. To stop the demonstration, press .
MENU
CLEAR
ENTER
Resuming Where You Left Off
If you turn off the Digital Book System while
using the
Handbook , you’ll return to the previ-
ous screen when you turn the Digital Book
System on. All the drugs that you entered in
your query list are saved, too.

9
Entering Drug Names
You enter drug names by typing them at the main
drug list. The main drug list contains brand and
generic names, foods, and drug and food groups. In
this User’s Manual, “drug name” refers to any name
on the main drug list. Try this example.
1. At the initial screen, type METAMETA
METAMETA
META.
2. Press to enter the drug in the your
query list .
3. Press to clear the entry.
Tips for Entering Drug Names
• Usually you need type only the first few letters
to highlight a drug name.
• You don’t need to type capitals or punctuation.
• To type numbers, hold and press the
numbered keys.
• To erase letters, press .
BACK
ENTER
CLEAR

10
Entering Drug Names
UP
DN
Moving Up and Down Lists
You can use these keys to move up and down
the main drug list, the query list, and other
lists:
To. . . Press. . .
Scroll up and down Hold or
Page up and down or
Go to the start or + or *
end of the list
* Hold while pressing the other key, or
press and then the other key. The
second way displays a G at the bottom of the
screen.
Follow the Arrows
Blinking arrows at the top right of the screen
indicate which direction keys you can press to
move around the screen. Look for them.

11
Correcting Misspellings
When you type letters that don’t match any drug name
on the main drug list, you activate the spell-correction
mode. Try this example.
1. At the initial screen, type PSEUDOFEDPSEUDOFED
PSEUDOFEDPSEUDOFED
PSEUDOFED.
To exit the spell-correction mode, press
repeatedly.
2. Press .
3. Press to highlight a drug name.
4. Press to enter the drug in your query
list. Then press to add the related drug.
5. Press to clear your entry.
ENTER
ENTER Y
ENTER
BACK

12
Correcting Misspellings
Finding Spellings with ? and ✽
You can find spellings even when you don’t
know all the letters in the names.
Simply type a question mark for each letter that
you don’t know in a name. Or type an asterisk
for a series of unknown letters. For example. . .
• Type CIM?T?DINE and press .
You’ll see the correct spelling, CIMETIDINE .
• Type CORTI* . To type the asterisk, hold
and press . Then press .
You’ll see a list of drugs and groups starting
with CORTI.
You can type more than one question mark or
asterisk in a drug name. And you can type both
in one name.
ENTER
SHIFT
? *ENTER

13
Brands, Generics, and Groups
By highlighting a drug name on the main drug list
and pressing , you can see its generic or
brand names and any drug or food groups to which it
belongs. In this example, we’ll find the brand names
and drug group of penicillin G.
1. At the initial screen, type PENICILLIN GPENICILLIN G
PENICILLIN GPENICILLIN G
PENICILLIN G.
2. Press .
3. To see the brands, press repeatedly.
Or press plus .
At the bottom of the list, notice that penicillin G
belongs to the drug group, penicillins.
SPEC
DN
SPEC

14
4. Press to see the drugs in the group.
5. Press to scroll down.
6. To return to the main drug list, press
twice.
Brands, Generics, and Groups
ENTER
BACK
Finding MAO Inhibitor Interactions
When you highlight a food on the main drug list,
pressing shows if it interacts with MAO
inhibitors. For example. . .
1. Type AVOCADOS . Then press .
MAO Inhibitor info is highlighted.
2. Press . You see a description of
avocados and MAO inhibitors.
SPEC
SPEC
ENTER

15
You can see adverse interactions by entering drug
names at the main drug list and pressing at
*SHOW INTERACTIONS* . Then you can read a
description of each interaction.
Between Many Drugs
You can enter up to 20 drugs at time to find interac-
tions between them. In this example, we’ll find the
interactions between alcohol and acetaminophen.
1. At the initial screen, enter ALCOHOLALCOHOL
ALCOHOLALCOHOL
ALCOHOL.
2. Enter ACETAMINOPHENACETAMINOPHEN
ACETAMINOPHENACETAMINOPHEN
ACETAMINOPHEN.
3. Press . Or press and select
Query interactionsQuery interactions
Query interactionsQuery interactions
Query interactions.
Finding Interactions
ENTER MENU
ENTER

16
Finding Interactions
4. If there is more than one interaction, press
to highlight an interaction.
To return to the main drug list (for example, if there
are no interactions), press .
5. At a highlighted interaction, press .
This is an interaction description. The pointing
hand indicates a comment or recommendation.
6. Press or to move down.
To. . . Press. . .
View the drug names of then
the interaction description
View the next or previous + or
description, if any
Return to the interactions
7. Press to clear your entries.
ENTER
DN
DN
SPEC
BACK
BACK
UP
CLEAR
BACK

17
For a Single Drug
You can enter a single drug and quickly see the
drugs with which it interacts. In this example, we’ll
find the interactions for heparin.
1. At the initial screen, type HEPARINHEPARIN
HEPARINHEPARIN
HEPARIN.
2. Press .
3. Press to see your query list.
4. Press . Or press and select
Other interacting itemsOther interacting items
Other interacting itemsOther interacting items
Other interacting items.
These are the interactions for heparin.
Finding Interactions
ENTER
LIST
OMENU

18
5. Press to highlight an interaction.
6. Press to see its description.
Finding Interactions
Using Your Query List
Whenever you enter a drug name, it’s saved in
your query list. To see your query list, press
. At the query list, use these keys:
To. . . Press. . .
Delete a highlighted drug
See the interactions
between all the drugs
See all the interactions
for a highlighted drug
Go to the initial screen
and save the query list
Go to the initial screen
and clear the query list
NOTE: Your query list is saved between sessions
unless you reset the Digital Book System or
remove its batteries.
ENTER
LIST
A
CLEAR
O
Q
D

19
Whenever you see a reference mark —✝— in an
interaction description, you can view a journal
reference for that description.
1. At the start of an interaction description
with a ✝, hold and press .
Notice that the ✝is highlighted.
If you’re below or to the left of the ✝, hold
and press . If the description has other
reference marks, hold and press to
highlight the next mark.
2. Press to see the reference.
Viewing References
ENTER