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Drug Facts And Comparisons

Drug Facts & Comparisons. 57th ed. St. Louis, Mo: Facts & Comparisons; 2002: 2461pp, $194.95 (hardcover).

Drug Facts and Comparisons is the flagship publication of Facts and Comparisons® (St. Louis), and is perhaps the drug information reference most widely used by practicing pharmacists. The 2003 (57th) edition is an annual compilation of drug monographs and related information published in the 2002 edition. The concise, well-written publication is considered by many to be a must-have reference for pharmacists in drug distribution settings.

The publication is focused on providing product-oriented information in a monograph format. Drugs are categorized into 14 groupings, based primarily upon therapeutic use. sections are also devoted to orphan drugs, as well as investigational compounds. A small group of useful appendices includes descriptions of the FDA new drug classifications, controlled substance categories, and pregnancy categories. General management principles (eg, acute overdosage, acute hypersensitivity), international system of units, normal laboratory values, calculations, medical abbreviations, and a manufacturer/distributor index round out the appendices. Entries are indexed alphabetically, with listings for generic and brand names, synonyms, common abbreviations, and therapeutic group names. Generic names are prominently displayed in bold type face for easy identification. The index of Canadian drugs provides "a comprehensive listing of drug trade names unique to Canada."

The first page of each drug chapter is a detailed outline with page references for individual drug monograph listings. Single drug monographs are partnered with comparisons of related agents. However, chemical entities with similarities (eg, same drug class) are often listed together in a group monograph to facilitate comparisons. Each monograph begins with specific product listings. Drug products are further grouped by dosage form and strength. Distributor name, package size, product imprint code, controlled substance schedule, and prescription status follow. Sugar-free products are specifically designated. Product listings for combination products are generally depicted in tables to make comparison easier.

Each monograph contains a section devoted to drug indication, including PDA-approved uses as well as some unlabeled uses. The list is by no means exhaustive, but generally contains uses commonly observed in practice. Drug administration and dosage details include dosing for adults, pediatrics (as information is available), and other special populations. Parenteral product information, including stability and storage details, is often incorporated in the monographs; however, this is not a significant feature of the monograph. The drug actions section focuses on compound pharmacology and pharmacokinetics. Product safety information includes contraindications, warnings and precautions, and suggested monitoring parameters. Documented, clinically significant drug-drug interactions are listed, with a description of the anticipated clinical outcome. Laboratory test and nutrient interactions are also listed. A large focus on adverse reactions is representative of most monographs. Reactions generally are displayed according to body system affected, with relative frequencies often included. Group monographs generally have comparative tables of potential adverse drug effects, allowing the reader to select a similar agent less likely to cause the undesired reaction. A small section is dedicated to overdosage, with information centered around clinical manifestations and treatment of acute exposure. Patient counseling information concludes the sections of each monograph; however, the information listed is generally not extensive.

A relatively new feature of Drug Facts and Comparisons is the Drug Identifier CD ROM. This new tool aids in identifying drug products based upon their appearance. Users are able to sort drug products based on drug name, imprint code, and NDC number. The additional option to sort by product characteristic (ie, color, shape, scoring, coating, clarity, flavor) is extremely beneficial, particularly in comparison to similar drug product references that lack such a feature.

Users should be familiar with the limitations of the reference's content. The major concepts in each drug monograph are explained fairly well. However, the reference is not the best source of information for newly reported or relatively rare adverse reactions and drug interactions, as well as novel indications. A request for information regarding drug interactions with dietary supplements is generally not satisfied by this publication. Detailed information regarding product stability, as well as overdose management principles, generally must be obtained elsewhere. Entries are not referenced, leading the reader to conduct his or her own literature search if original material is desired. Additionally, the hardbound reference contains nearly 2500 pages which are not updated until the subsequent edition's publication. This is an obvious limitation of the reference, as product information is constantly evolving. The pharmacy practitioner would have a greater need for contemporary information, making the traditional loose-leaf or on-line versions of the reference more practical.

The editorial advisory and contributing review panels of Drug Facts and Comparisons are composed of pharmacists, physicians, and other healthcare professionals from a variety of practice settings. Clearly, the intent of the reference is to assist practitioners in product selection, and the reference succeeds in doing so. An extensive use of comparative tables contributes to the utility of the material. Incorporation of the reference in professional curricula is important to prepare students for practical settings in which Drug Facts and Comparisons may be one of but a few drug references available. However, an emphasis on the limitations of the reference is important, as continued use of a familiar reference may lead to complacency when information (eg, safety concerns) is not listed.

Reviewed by: Kelly Smith, PharmD

College of Pharmacy, University of Kentucky

Corresponding Author: Kelly Smith, PharmD. College of Pharmacy, University of Kentucky, Rose Street, Lexington, KY 40536. Tel: 859-257-2521. Fax: 859-323-2049. E-mail: ksmitl@uky.edu

Copyright American Association of Colleges of Pharmacy 2003
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