Page 1
Electronic Publishers
For Use with the Franklin
Digital Book System
IC-104
DIGITAL BOOK
The Medical Letter
R
x
HANDBOOK
OF
ADVERSE
DRUG
INTERACTIONS
F
User’s Manual
Page 2
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
Page 3
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
Page 4
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 interac-
tions reported for related drugs.
3
Page 5
Introduction
What the
The Medical Letter® Handbook of Adverse Drug
Interactions
Using the
• 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.
Handbook
digital book is a powerful reference.
Handbook
, you can. . .
Can Do
4
Page 6
Introduction
How the
The
Handbook
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,
Press . You see a description of
Press . You’re ready to find
Handbook
is easy to use. Here are the basics:
ENTER
ENTER
ENTER
ENTER
CLEAR
Works
if any, between the drugs.
the interaction.
other interactions.
ENTER
About Illustrations
The illustrations in this User’s Manual are from
the 1992 edition of the
information that you see on screen may be
different.
Handbook
. The
5
Page 7
Getting Started
If you’re using the
this section. WARNING: If you install the
with the Digital Book System on, information that you
entered in the other installed book may be erased.
Handbook
for the first time, read
Handbook
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
Page 8
Getting Started
7. Press .
This is the
ENTER
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 . When you do, the drug names
CLEAR
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 to see an appropriate help message. To scroll down help messages, press .
To exit them, press .
HELP
BACK
7
Page 9
Seeing a Demonstration
Before you start using the
to see a brief demonstration.
1. At the initial screen, press .
2. Press to highlight
3. Press to start the demonstration.
ENTER
4. To stop the demonstration, press .
Handbook
MENU
DemoDemo
Demo.
DemoDemo
, you may want
CLEAR
Resuming Where You Left Off
If you turn off the Digital Book System while
using the
ous screen when you turn the Digital Book
System on. All the drugs that you entered in
your query list are saved, too.
Handbook
, you’ll return to the previ-
8
Page 10
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
2. Press to enter the drug in the your
ENTER
METAMETA
META.
METAMETA
query list .
3. Press to clear the entry.
CLEAR
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
Page 11
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 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.
UP
DN
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
Page 12
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
To exit the spell-correction mode, press
repeatedly.
2. Press .
ENTER
PSEUDOFEDPSEUDOFED
PSEUDOFED.
PSEUDOFEDPSEUDOFED
BACK
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
Y
ENTER
11
Page 13
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,
ENTER
CIMETIDINE .
• Type CORTI* . To type the asterisk, hold
and press . Then press .
? *
ENTER
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.
12
SHIFT
Page 14
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.
SPEC
1. At the initial screen, type
2. Press .
SPEC
PENICILLIN GPENICILLIN G
PENICILLIN G.
PENICILLIN GPENICILLIN G
3. To see the brands, press repeatedly.
Or press plus .
DN
At the bottom of the list, notice that penicillin G
belongs to the drug group, penicillins.
13
Page 15
Brands, Generics, and Groups
4. Press to see the drugs in the group.
ENTER
5. Press to scroll down.
6. To return to the main drug list, press
BACK
twice.
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
MAO Inhibitor info is highlighted.
2. Press . You see a description of
avocados and MAO inhibitors.
SPEC
AVOCADOS . Then press .
ENTER
SPEC
14
Page 16
Finding Interactions
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 interactions between them. In this example, we’ll find the
interactions between alcohol and acetaminophen.
ENTER
1. At the initial screen, enter
2. Enter
3. Press . Or press and select
ACETAMINOPHENACETAMINOPHEN
ACETAMINOPHEN.
ACETAMINOPHENACETAMINOPHEN
ENTER
Query interactionsQuery interactions
Query interactions.
Query interactionsQuery interactions
ALCOHOLALCOHOL
ALCOHOL.
ALCOHOLALCOHOL
MENU
15
Page 17
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 .
BACK
5. At a highlighted interaction, press .
ENTER
This is an interaction description. The pointing
hand indicates a comment or recommendation.
6. Press or to move down.
DN
To. . . Press. . .
View the drug names of then
SPEC
BACK
the interaction description
View the next or previous + or
DN
UP
description, if any
Return to the interactions
7. Press to clear your entries.
CLEAR
BACK
16
Page 18
Finding Interactions
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
2. Press .
3. Press to see your query list.
4. Press . Or press and select
Other interacting itemsOther interacting items
Other interacting items.
Other interacting itemsOther interacting items
ENTER
LIST
O
HEPARINHEPARIN
HEPARIN.
HEPARINHEPARIN
MENU
These are the interactions for heparin.
17
Page 19
Finding Interactions
5. Press to highlight an interaction.
6. Press to see its description.
ENTER
Using Your Query List
Whenever you enter a drug name, it’s saved in
your query list. To see your query list, press
LIST
. 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.
18
D
Q
O
A
CLEAR
Page 20
Viewing References
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
✝, hold and press .
with a
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.
ENTER
19
Page 21
Viewing References
3. To scroll down, hold .
4. To see the next reference, if any,
hold and press .
DN
If there are more references, repeat Step 4. To
see previous ones, hold and press .
UP
5. To go back to the interaction description,
press .
BACK
Viewing Next or Previous References
Once at a reference, you can see the next or
previous reference, if any, in an interaction
description by pressing plus or .
DN
UP
SPECifying Interactions
Pressing or at an interaction list,
? *
an interaction description, or a reference
displays the full names of the drugs involved in
the interaction. Then press to go back to
previous screen.
20
SPEC
BACK
Page 22
Sending Words to Other Books
You can send drug names and other words from the
Handbook
example, you could look up a drug name from the
Handbook
steps.
to other installed digital books. For
in
The Washington Manual
. Follow these
1. Highlight a word in the
Handbook
.
To. . . Press. . .
Highlight a drug or
name in a list
Highlight a word . Then
ENTER
in a description the arrow keys
Turn off highlighting
BACK
in a description
2. Hold and press .
CARD
3. Highlight the digital book you want to send
the word to. Then press .
ENTER
To look up the word, follow the instructions for that
book. In many cases, you simply press .
To return to the
Handbook
, press ,
highlight its symbol, and then press .
ENTER
CARD
ENTER
21
Page 23
Digital Book System
Installing Digital Books
NOTE: Your Digital Book System will operate only
when one or two digital books are installed.
1. Turn the Digital Book System off.
2. Align the digital book’s tabs with the
notches in either book slot on the back of
the Digital Book System.
If you install only one digital book, it doesn’t matter
which slot you use. But make sure that the digital
book’s metal contacts are facing down.
3. Gently snap the digital book into the slot.
Removing Digital Books
1. Turn the Digital Book System off.
WARNING If you install or remove digital
books while the Digital Book System is on,
you may erase information that you entered
in them.
2. Compress the digital book’s tab and lift it
from the slot.
22
Page 24
Digital Book System
Resetting the Digital Book System
If the keyboard fails to respond or the screen
performs erratically, follow these steps:
1. Press .
2. Press .
3. Hold and press .*
CLEAR
ON/OFF
CLEAR
ON/OFF
4. Using a paper clip, press the recessed reset
button on the back.*
Do not use
a pen or pencil.
* WARNING When you reset your Digital
Book System, information that you entered
in the currently installed digital books will be
erased.
23
Page 25
Digital Book System
Switching Between Digital Books
1. With two digital books installed, press
CARD
.
You see the digital book symbols.
2. Highlight a symbol by pressing or
. Then press .
You switch to the other digital book. To return to
the first digital book, repeat the steps above.
ENTER
Sending Words Between Books
Some digital books can send and receive words from
other digital books. Generally, here's how:
1. Highlight a word in a digital book.
Read its User's Manual to learn how.
2. Hold and press .
CARD
3. Highlight the other digital book symbol.
Then press .
You see its main display. You may have to press
ENTER
again to look up the word.
ENTER
24
Page 26
Digital Book System
Replacing the Batteries
Your unit uses CR2032 lithium batteries. Before
replacing them, have four new batteries ready.
1.
Turn your Digital Book System off.
2. Remove the battery cover on the back. Then
remove all batteries.
3. Promptly slide two new batteries into the
battery cavity with the metal clip over it.
Don't bend the clip; it’s an electrical contact. And
make sure the batteries’ plus (+) signs face up.
4. Slide two new batteries into the other cavity.
Then replace the battery cover.
WARNING To prevent erasing information
from installed digital books:
• Always replace the batteries before they
completely lose power, and never remove
batteries while the unit is on.
• Never mix old and new batteries. And, once
batteries have been removed, install new
ones within two minutes.
25
Page 27
Digital Book System
Protecting Your Digital Book System
• Don't touch the metal contacts on the back of your
digital books or the rubber contacts in the book
slots of the Digital Book System.
WARNING Touching the contacts with
statically charged objects, including your
fingers, could erase information that you
entered in your installed digital books.
• Don't put excessive pressure or weight on your
digital books or Digital Book System.
• Don't expose your digital books to extreme or
prolonged heat, cold, or other adverse conditions.
When you're not using your Digital Book System,
keep two digital books or dummy books in its slots to
prevent dust build-up.
To clean the digital books, apply isopropyl alcohol
with cotton swab. To clean the Digital Book System,
apply a mild household cleaner onto a soft cloth.
WARNING Spraying liquids directly on your
Digital Book System could damage its
circuitry.
26
Page 28
Limited Warranty (U.S.A only)
FRANKLIN warrants to you that the DIGITAL BOOK will be free from defects in
materials and workmanship for one year from purchase. In the case of such a defect
in your DIGITAL BOOK, FRANKLIN will repair or replace it without charge on return,
with purchase receipt, to the dealer from which you made your purchase or Franklin
Electronic Publishers, Inc., 122 Burrs Road, Mt. Holly, NJ 08060, within one year of
purchase. Alternatively, FRANKLIN may, at its option, refund your purchase price.
Data contained in the DIGITAL BOOK may be provided under license to FRANKLIN.
FRANKLIN makes no warranty with respect to the accuracy of data in the DIGITAL
BOOK. No warranty is made that the DIGITAL BOOK will run uninterrupted or error
free. You assume all risk of any damage or loss from your use of the DIGITAL BOOK.
This warranty does not apply if, in the sole discretion of FRANKLIN, the DIGITAL
BOOK has been tampered with, damaged by accident, abuse, misuse, or misapplication,
or as a result of service or modification by any party, including any dealer, other than
FRANKLIN. This warranty applies only to products manufactured by or for FRANKLIN.
Batteries, corrosion or battery contacts and any damage caused by batteries are not
covered by this warranty. NO FRANKLIN DEALER, AGENT, OR EMPLOYEE IS
AUTHORIZED TO MAKE ANY ADDITIONAL WARRANTY IN THIS REGARD OR TO
MAKE ANY MODIFICATION OR EXTENSION OF THIS EXPRESS WARRANTY.
THE FOREGOING WARRANTY IS EXCLUSIVE AND IS IN LIEU OF ALL OTHER
EXPRESS OR IMPLIED WARRANTIES, WRITTEN OR ORAL, INCLUDING, BUT
NOT LIMITED TO, WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A
PARTICULAR PURPOSE. YOUR SOLE AND EXCLUSIVE REMEDY SHALL BE
FRANKLIN’S OBLIGATION TO REPLACE OR REFUND AS SET FORTH ABOVE IN
THIS WARRANTY. Some States do not allow the exclusion of implied warranties, or
limitations on how long a warranty lasts. This warranty gives you specific rights; you
may also have additional rights which vary from State to State. This warranty shall not
be applicable to the extent that enforcement of any provision may be prohibited by
applicable law.
FRANKLIN SHALL IN NO EVENT BE LIABLE TO YOU OR TO ANY OTHER
PERSON FOR ANY SPECIAL, INCIDENTAL, OR CONSEQUENTIAL DAMAGES,
OR ANY OTHER INDIRECT LOSS OR DAMAGE, ARISING OUT OF YOUR
PURCHASE, THE MANUFACTURE OR SALE OF THE DIGITAL BOOK, THIS
LICENSE, OR ANY
OBLIGATION RESULTING THEREFROM OR THE USE OR PERFORMANCE OF
THE DIGITAL BOOK UNDER ANY LEGAL THEORY, WHETHER BREACH OF
CONTRACT, TORT, STRICT LIABILITY OR ANY OTHER CAUSE OF ACTION OR
PROCEEDING, WHICH DAMAGES SHALL INCLUDE, BUT NOT BE LIMITED TO,
LOST PROFITS, DAMAGES TO PROPERTY, OR PERSONAL INJURY (BUT ONLY
TO THE EXTENT PERMITTED BY LAW). FRANKLIN’S ENTIRE LIABILITY FOR
ANY CLAIM OR LOSS, DAMAGE, OR EXPENSE FROM ANY SUCH CAUSE SHALL
IN NO EVENT EXCEED THE PRICE PAID FOR THE DIGITAL BOOK. THIS CLAUSE
SHALL SURVIVE FAILURE OF AN EXCLUSIVE REMEDY.
This license and warranty is governed by the laws of the United States and the State
of New Jersey.
27
Page 29
Product Specifications
Model IC-104
• Data: More than 1,150 interactions; 2,600 refer ences; 2,400 brand names; 800 drug, food, and
group names; and 31 MAO inhibitor/food reactions.
• Alpha-numeric searching
• A user query list holding up to 20 drug names
• Spelling correction
• Self-demonstration.
• Context-sensitive help messages
• ROM size: 4 megabits
Copyrights, Trademarks, and Patents
© 1993 Franklin Electronic Publishers, Inc.. All rights
reserved. This manual is copyrighted 1993 by
Franklin.
© 1993 The Medical Letter, Inc. All rights reserved.
MatchMaker is a trademark of Franklin Electronic
Publishers, Inc. The Medical Letter is a registered
trademark of the Medical Letter, Inc.
U.S. Patent 4,490, 811; 4,830,618; 5,113,340
European Patent 0 136 379 PAT. PENDING
ISBN 1-56712-028-8
28
Page 30
Function Keys
Key Guide
CLEAR
Clear the query list and
go to the initial screen.
MENU
GAMES
MORE
LIST
SPEC
CARD
Show the menu.
Doesn’t apply.
Doesn’t apply.
Show the query list.
Specify names and related drugs.
Exit the
Handbook
.
Gold Key Combinations
+ number keys Type numbers.
+
CARD
+ Go to the start or end of a list,
+ Go to next or previous
DN
+ Highlight a reference mark in a
Send a word to another book.
section, description, or reference.
UP
description or reference.
description.
29
Page 31
Key Guide
Direction Keys
DN
UP
MatchMaker™ Key
Move the highlight.
Scroll through lists and text,
or move the highlight.
Page up or down.
? *
SHIFT
+ At the main drug list, stand for a
At the main drug list, stand for
an unknown letter.
? *
series of letters.
Query List Keys
These functions apply only in the query list.
A
D
O
Q
30
Go to the initial screen.
Delete a highlighted drug.
Show interactions for a drug.
Show all the interactions
between the drugs.
Page 32
Other Keys
Key Guide
A
BACK
ENTER
HELP
ON/OFF
, -
? *
SHIFT
SPACE
Z
:
;
Type letters.
Erase a letter, back up, delete
an entry, or turn off the highlight
in interaction descriptions.
Make an entry. In descriptions,
highlight a word.
Show a help message.
Turn unit on or off.
Type punctuation.
Except at the main drug list,
the same as .
Shift keys.
Type a space.
SPEC
31
Page 33
Index
Arrows 10
Backing up 7
Brand names 13
Clearing
to initial screen 7
your query list 18
Comments 16
Deleting
drugs from query list 18
entries 9
Demonstration 8
Drug groups 13
Drug names
brand and generic 13
correcting spellings 11
displaying full names 16
entering 9
finding 13
finding spellings 12
specifying 20
Erasing letters 9
Finding
brand names 13
comments & recommenda-
tions 16
drug groups 13
foods 9
food groups 13
generic names 13
help messages 7
inhibitors 13
interactions
between many drugs 15
for a single drug 17
32
references 19
Foods 9, 13, 14
Food groups 13
Generic names 13
Help messages 7
Highlighting
drug names 21
words in descriptions &
references 21
Installation 6
Interactions
between many drugs 15
for a single drug 17
specifying 20
MAO inhibitors 14
Menu 8
Query list 18
clearing 18
deleting a drug 18
entering a drug 9
returning to initial screen 18
seeing interactions from 18
Recommendations 16
References 19
Resuming sessions 10
Scrolling 8, 16
descriptions 16
lists 10
references 20
Sending words to books 21
Spellings
correcting 11
finding 12
Page 34
Electronic Publishers
Mt. Holly, NJ 08060
FCR 28004-00 C
P/N 7201670
Printed in China
Loading...