Franklin IC-168 User manual

FOLD
User’s Manual
HANDBOOK
OF
ADVERSE
DRUG
INTERACTIONS
Rx
The Medical Letter

DIGITAL BOOK
F
IC-168

Electronic Publishers
For Use with the Franklin
Digital Book System

Electronic Publishers


1
READ THIS LICENSE AGREEMENT BEFORE USING THE
DIGITAL BOOK. YOUR USE OF THE DIGITAL BOOK DEEMS
THAT YOU ACCEPT THE TERMS OF THIS LICENSE. IF YOU
DO NOT AGREE WITH THESE TERMS, YOU MAY RETURN
THIS PACKAGE WITH PURCHASE RECEIPT TO THE DEALER
FROM WHICH YOU PURCHASED THE DIGITAL BOOK AND
YOUR PURCHASE PRICE WILL BE REFUNDED. DIGITAL BOOK
means the software product and documentation found in this
package and FRANKLIN means Franklin Electronic Publishers, Inc.
LIMITED USE LICENSE
All rights in the DIGITAL BOOK remain the property of FRANKLIN.
Through your purchase, FRANKLIN grants you a personal and
nonexclusive license to use the DIGITAL BOOK on a single
FRANKLIN Digital Book System at a time. You may not make any
copies of the DIGITAL BOOK or of the data stored therein, whether
in electronic or print format. Such copying would be in violation of
applicable copyright laws. Further, you may not modify, adapt,
disassemble, decompile, translate, create derivative works of, or in
any way reverse engineer the DIGITAL BOOK. You may not export
or reexport, directly or indirectly, the DIGITAL BOOK without
compliance with appropriate governmental regulations. The
DIGITAL BOOK contains Franklin’s confidential and propriety
information which you agree to take adequate steps to protect from
unauthorized disclosure or use. This license is effective until
terminated. This license terminates immediately without notice from
FRANKLIN if you fail to comply with any provision of this license.
This digital book was developed for use by medical professionals.
No other use of this digital book can substitute for consultation with
yourphysician.
LicenseAgreement

2
Contents
Introduction to the HADI...................................3
Overview of Operation......................................5
Installing the Digital Book ................................7
Viewing a Demonstration .................................9
Selecting Drugs................................................10
Correcting Misspellings ..................................12
Finding Brands, Generics, Groups ................14
Finding Interactions........................................ 16
Between Many Drugs ..................................16
For a Single Drug........................................ 18
Viewing References ........................................ 20
Sending Words to Other Books..................... 22
Digital Book System®.......................................23
Limited Warranty............................................. 25
Product Specifications ................................... 26
Key Guide .........................................................27
Index..................................................................30

3
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.
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—New adverse interactions are continually being
reported; the absence of a listing in this digital book does not
necessarily mean that drugs will not interact when given
concurrently. Drugs for which we have no documented
interactions in people are usually not listed; interactions
extrapolated from animal studies or interactions reported
with related drugs, frequently mentioned in other sources,
such as the manufacturer’s package insert, may therefore
not be included here.
Interactions between general anesthetics and drugs likely to be
administered during surgery, such as autonomic drugs and
Introduction to the HADI

4
Introduction to the HADI
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 use of two
antihypertensive agents or two central nervous system
depressants, are generally not listed. 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 also not included. Most interactions of drugs with
foods, beverages, or other nutrients are not listed, 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 concentrations of drugs. Concurrent
use of drugs from the same group, e.g., aspirin and other
NSAIDS, should be avoided.

5
Overview of Operation
What this HADI Can Do
The Medical Letter®Handbook of Adverse Drug
Interactions
is a powerful reference. Using this
digital book, you can. . .
• find brand name drugs, generic drugs, drug
groups, and food groups,
• correct drug name misspellings,
• find foods that interact with MAO inhibitors,
• select up to 20 drugs and view a list of their
interactions,
• select a single drug and view a list of the drugs
with which it interacts,
• read descriptions and references about drug
interactions, and
• look up drugs and words in related digital books.
Read this User’s Manual to learn how.
▼

6
How this HADI Works
The Handbook is easy to use. Here are the basics:
Highlight the HADI symbol and press
ENTER
.
• At the main drug list, As you type, the drug
type a drug name. name is highlighted.
Then press
ENTER
.
• Type another drug You see a message to
name. Press
ENTER
. ✻ SHOW INTERACTIONS ✻ .
• Press
ENTER
.You see the interactions,
if any, between the drugs.
• Press
ENTER
.You see a description of
the interaction.
• Press
CLEAR
.You’re ready to find
other interactions.
Overview of Operation
✓About the Screen Illustrations
Some screen illustrations in this User’s Manual
may vary slightly from what you see on screen.
These variations do not mean that this digital
book or your Digital Book System is malfunctioning.
▼

7
Before you can use this digital book, you must install
it. Warning: If you install a digital book
while the
Digital Book System is on, information that you en-
tered in other currently installed digital books may be
erased.
1. Turn the Digital Book System off.
2. Install the digital book into a slot on the
back of the Digital Book System.
Align the tabs on the digital book with the notches
in the slot. Make sure its metal contacts face
down.
3. Press
ON/OFF
.
4. Turn the wheel on the side of the Digital Book
System to adjust the screen contrast.
5. Press CARD .
6. Press or to highlight the HADI icon.
Installing the Digital Book

8
7. Press
ENTER
.
This is the main drug list, where you select drugs
to find interactions.
Installing the Digital Book
✓Resuming Where You Left Off
While using this digital book, you can turn off the
Digital Book System at any time. When you turn
the Digital Book System on again, the screen that
you last viewed appears. Any drugs entered in
your query list are saved, too.
✓Clearing the Main Drug List
You can always return to the main drug list by
pressing
CLEAR
. Note: When you do, the drugs
in your query list are also cleared.
You can return to the previous screen without
clearing your query list by pressing
BACK
.

9
Before you start using this digital book, you may
want to view a brief demonstration of its features and
functionality.
1. Press MENU at the main drug list.
2. Press to highlight
Demo .
3. Press
ENTER
to start the demonstration.
4. Press
CLEAR
to stop the demonstration.
Viewing a Demonstration
✓ Help is Always at Hand
You can view a help message at any screen
(except during the demonstration) by pressing
HELP
. To read the help message, press .
To exit it, press
BACK
.
✓ Auto-shutoff
If you forget to turn this digital book off, don’t
worry. It will automatically shut off in four minutes.

10
The main drug list contains brand and generic drugs,
foods, as well as drug and food groups. You select
an item from the main drug list by typing it, or scroll-
ing to it, and then pressing
ENTER
. Usually you need
to type only a few letters to highlight an item. Try this
example.
1. Type META at the main drug list.
To go back a letter, press
BACK
.
2. Press
ENTER
to select the drug and add it to
the query list.
3. To clear the query press
CLEAR
.
Selecting Drugs
✓Drug Selecting Tips
You do not need to type capital letters or punc-
tuation. However, you can type numbers at the
main drug list. Note: In this User’s Manual, “drug”
refers to any item on the main drug list.

11
Selecting Drugs
✓Using the Direction Keys
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 or
Page up and down
UP
or
DN
Zoom to the top or * + or
bottom of a list
* Hold while pressing the other key, or press
and then the other key. The second method
flashes a Gat the bottom of the screen.
✓ Follow the Arrows
The flashing arrows at the bottom right of the
screen indicate which direction keys you can
press to move around the screen.

12
Correcting Misspellings
Don’t worry if you misspell a word. The spell-
correction mode automatically appears. Try this.
1. Type KLOROMBUSIL at the main drug list.
To exit spell-correction, press
BACK
repeatedly.
2. Press
ENTER
.
Spell correction is done automatically.
3. Press to highlight a drug, if needed.
4. Press
ENTER
to select the drug and add it to
your query list.
5. To clear the query press
CLEAR
.

13
✓Finding Letters in Words
If you are not sure how to spell a word, type a
question mark in place of each unknown letter or
an asterisk in place of a series of unknown letters.
Here are two examples.
• Type
PHEN?LBUT?ZONE and press
ENTER
.
The correct spelling,
PHENYLBUTAZONE ,
appears.
• Type CORTI ✻ . To type the asterisk, hold SHIFT
and press
? *
. Then press
ENTER
. A list of drug
and group names beginning with
CORTI appears.
Note: You can type more than one question mark
or asterisk in a word, and you can type both in the
same word. However, it is not necessary to type
two consecutive asterisks in one word.
Correcting Misspellings

14
By highlighting a drug name on the main drug list
and pressing SPEC , 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. Type PENICILLIN G at the main drug list.
2. Press SPEC .
3. Press repeatedly to view the brands.
Or hold and press to go to the
bottom of the list.
At the bottom of the list, notice that penicillin G
belongs to the drug group, “penicillins.”
4. Press
ENTER
to view the drugs in the group.
Finding Brands,Generics,Groups

15
5. Press to scroll down.
6. Press
BACK
twice to go back to the main drug
list.
Finding Brands, Generics, Groups
✓Finding MAO Inhibitor Interactions
When you highlight a food name on the main drug
list, pressing SPEC shows if that food interacts
with MAO inhibitors. Try this example.
1. Type
AVOCADOS .
2. Press SPEC .
MAO Inhibitor info is highlighted.
3. Press
ENTER
. A description of avocados and
MAO inhibitors appears.
(To read the cross-references (✝), see “Viewing
References.”)

16
You can find adverse interactions by selecting drugs
from the main drug list and then pressing
ENTER
at
✻ SHOW INTERACTIONS ✻ . Here is where you can
view a description of each interaction.
Between Many Drugs
You can select up to 20 drugs at time to find interac-
tions between. In this example, we’ll find the interac-
tions between alcohol and acetaminophen.
1. Select ALCOHOL from the main drug list.
2. Then select
CAFFEINE .
You can add more drugs here, if you wish.
3. Press
ENTER
to view the interactions. Or
press MENU and select
Query interactions .
Finding Interactions
▼

17
4. Highlight the interaction you want to view, if
needed.
Note: You can return to the main drug list now by
pressing
BACK
.
5. Press
ENTER
to select the highlighted
interaction.
This is an interaction description. The hand
points to a comment or recommendation.
6. Press or
DN
to move down.
To. . . Press. . .
View the drug names of SPEC
the interaction description
View the next or previous +
DN
or
UP
description, if any
Return to the interactions
BACK
7. Press
CLEAR
to clear the queries.
Finding Interactions

18
Finding Interactions
▼
For a Single Drug
You can select a single drug from the main drug list
and quickly find the drugs with which it interacts. In
this example, we’ll find the interactions for heparin.
1. Type HEPARIN at the main drug list.
2. Press
ENTER
.
3. Press
LIST
to view your query list.
4. Press , or press MENU and select Other
interacting items
.
These are the interactions for heparin .
5. Press to highlight an interaction.
6. Press
ENTER
to view its description.
O

19
Finding Interactions
✓Using the Query List
Whenever you select a drug from the main drug
list, it is saved in the query list. To view your
queries, press
LIST
. Once at the query list, you
can use these keys.
To. . . Press. . .
Delete a highlighted item
View the interactions
between all the items
View all the interactions
for a highlighted item
Go to the main drug list
and
save your queries
Go to main drug list
CLEAR
and clear your queries
Note: Your queries are saved between sessions
unless you reset the Digital Book System or
remove its batteries.
Note: Press
BACK
to return to the query list each
time after selecting one of the above options
(except for
CLEAR
).
A
O
Q
D