Franklin IC-104 User Manual

	For Use with the Franklin
Electronic Publishers	Digital Book System
IC-104		F
DIGITAL BOOK
The Medical Letter
Rx
HANDBOOK
	OF
ADVERSE
DRUG
INTERACTIONS
User’s Manual

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

1

Introduction

This handbook offers a quick guide to possible adverse effects of drug interactions, with brief recommendations for precautionary 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 “antidepressants, 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 interactions. 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

2

Introduction

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 interactions reported for related drugs.

3

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.

4

Introduction

How the Handbook Works

The Handbook is easy to use. Here are the basics:

Highlight the HADI symbol. Then press ENTER .

At the main drug list, type a drug name. Then press ENTER .

As you type, the drug name is highlighted.

Type another drug		You see a prompt
name. Press ENTER .		to “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.

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.

5

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 ON/OFF .

4.To adjust the screen contrast, turn the

wheel on the side of the Digital Book System.

5.Press CARD .

6.Press or to highlight HADI.

6

Getting Started

7. Press ENTER .

This is the Handbook’s initial screen, the top of the main drug list. Here you enter drug names to find interactions.

Clearing the Screen and Backing Up

You can always return to the initial screen by pressing CLEAR . When you do, the drug names in your query list are also cleared.

You can always return to the previous display by pressing BACK .

Help is Always at Hand

If you’re ever unsure about which key to use,
press HELP to see an appropriate help mes-
sage. To scroll down help messages, press	.
To exit them, press BACK .

7

Seeing a Demonstration

Before you start using the Handbook, you may want to see a brief demonstration.

1.	At the initial screen, press MENU .
2.	Press	to highlight D e m o.

3.	Press ENTER to start the demonstration.
4.	To stop the demonstration, press CLEAR .

Resuming Where You Left Off

If you turn off the Digital Book System while using the Handbook, you’ll return to the previous screen when you turn the Digital Book System on. All the drugs that you entered in your query list are saved, too.

8

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 M E T A.

2. Press	ENTER	to enter the drug in the your
query list .
3. Press	CLEAR	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 .

9

Entering Drug Names

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

Go to the start or end of the list

DN

UP or

+ or *

* 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.

10