HEALTHCARE SERIES FROM THOMSON MICROMEDEX Thomson Micromedex Healthcare

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Thomson Micromedex® Healthcare Series (HCS) 長亨文化事業有限公司 1

HEALTHCARE SERIES FROM THOMSON MICROMEDEX What Is Micromedex? • 醫療照護系列臨床資料庫 衛教 另類 醫療 藥物 毒物 2

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Who uses MDX ? 5

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Micromedex系統 - 子資料庫 Drug Information Disease Information DRUGDEX® System DRUG-REAX® System MARTINDALE Physicians' Desk Reference®(PDR®) P & T QUIK® Reports IV INDEX® System MSDS Index Nominum IDENTIDEX® System REPRORISK® System KINETIDEX® System DISEASEDEXTM General Medicine DISEASEDEXTM Emergency Med. Lab adviser. TM Visual DX® Alternative Medicine Free Resources Alt. Med. Dex® System Alt. Med. Dex® Protocols Herbal Medicines Dosing & Therapeutic Tools mobile. MICROMEDEX™ System Current Concepts® CE Program Patient Education Alt. Care. Dex® Alternative Medicine Education Care. Notes. TM System Toxicology Information IDENTIDEX® System POISINDEX® System TOMES® System REPRORISK® System 6

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 目前院內訂購狀況 Drug Information Disease Information DRUGDEX® System DRUG-REAX® System MARTINDALE IV INDEX® System MSDS Index Nominum DISEASEDEXTM General Medicine DISEASEDEXTM Emergency Med. Patient Education Alt. Care. Dex® Alternative Medicine Education Care. Notes. TM System Toxicology Information POISINDEX® System Alternative Medicine Free Resources Dosing & Therapeutic Tools mobile. MICROMEDEX™ System Current Concepts® CE Program 7

HEALTHCARE SERIES FROM THOMSON MICROMEDEX® Healthcare Series介面 13

HEALTHCARE SERIES FROM THOMSON MICROMEDEX® Healthcare Series介面: 整合搜尋 – 關鍵字查詢頁面 2 例如：檢索 Warfarin. 1 關鍵字查詢設定為 “Exactly Match” 快速找到想要的結果 14

HEALTHCARE SERIES FROM THOMSON MICROMEDEX® Healthcare Series介面: 檢索結果頁面 Go To: 跳到使用者立 即想要的內容類型： Summary Documents, Drugs, Disease, Labs, Toxicology…等 左邊欄位是合乎結果的 資料庫選項 右邊欄位為搜尋結果和筆數 就下面幾個例子， 使用者可以在檢索 結果頁面中點選不 同連結： (a) Drug Summary Information: Warfarin Sodium; (b) DRUGDEX® Evaluations: Warfarin; 15

HEALTHCARE SERIES FROM THOMSON MICROMEDEX a Drug Summary Information: Warfarin Sodium 點選 see detail in DRUGDEX 進入完整 DRUGDEX資料庫 亦可利用移動式文件 大綱快速點擊欲瀏覽 之章節 為達成這些結果，使 用者必須在檢索結果 頁面點選“Drug Summary Information: Warfarin Sodium” 的 連結進入。 16

HEALTHCARE SERIES FROM THOMSON MICROMEDEX® Healthcare Series介面: 檢索結果頁面 2 Go To: 跳到使用者立 即想要的內容類型： Summary Documents, Drugs, Disease, Labs, Toxicology…等 b 1 左邊欄位是合乎結果的 右邊欄位為搜尋結果和筆數 資料庫選項 3 就下面幾個例子， 使用者可以在檢索 結果頁面中點選不 同連結： (a) Drug Summary Information: Warfarin Sodium; (b) DRUGDEX® Evaluations: Warfarin; 17

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 若點選下方的其他選項 DRUGDEX® Evaluations: Related Terms & Products 2 1 檢索詞 Warfarin 陳列指出相關主題。 例如點選 “interaction” 將會帶使用者跳到 Interaction (321) results的標題。 點選文件連結將會帶使 用者直接進入文件章節 中有檢索詞 “warfarin” 出現的部分。例如點選 ACETAMINOPHEN。 為達成這些結果，使 用者必須在檢索結果 頁面點選“DRUGDEX Evaluations: Related Terms & Products” 的 連結進入。 20

HEALTHCARE SERIES FROM THOMSON MICROMEDEX DRUGDEX® Evaluations: Related Terms & Products (continued) 1 使用者會被直接帶入 ACETAMINOPHEN 專題 論文，並直接進入文件章 節中有出現“warfarin” 的段 落。注意warfarin將會以粗 黑體的方式呈現。 為達成這些結果，使 用者必須在檢索結果 頁面點選“DRUGDEX Evaluations: Related Terms & Products ” 的連結進入。 21

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 文件章節全文搜尋 22

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Specific Topics Search 可以在下列標籤下執行文件章節全文搜尋功能：Drugs, Toxicology, Disease, Labs。Available only for Micromedexproprietary documents (DRUGDEX, POISINDEX, Disease. Dex, etc), 加上 PDR®和Martindale。 23

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Drugs Tab: 比較藥物總覽和治療分類 27

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Drugs Tab drop-down menu 28

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Compare Drug Summaries 1 輸入藥名或是部份藥名然後點選“Search” 29

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Compare Drug Summaries (continued) 1 如果檢索有多個條件符合，請選擇特 定的物質。然後點選 “ Display Comparison” 30

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Compare Drug Summaries (continued) 1 檢索結果以表格形式呈現，剛好如同單一 藥物的Drug. Point® Summary呈現方式一樣。 31

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 治療分類表Therapeutic Classes 32

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Therapeutic Classes - found under the Drugs Tab 1 在 Anti-Infective Agent class，開啟 “Antibiotic” 資料夾，然後點選 “Fluoroquinalone (class). ” 33

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Therapeutic Classes (continued) 1 在‘Fluoroquinolone”分類下有九個藥物。勾選四 個藥物後點選“Compare Selected Drugs” 瀏覽這 四個所勾選藥物的結果。 34

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Therapeutic Classes (continued) 1 勾選的四個藥物，在Compare Drug Summaries 特色功能中，可以同時 一起兩兩比較。 2 如果要比較其他藥物，先從“Display in Column One”下拉選單中選擇其他藥物，然 後在“Display in Column Two”下拉選單中選 擇其他藥物，最後點選“Display” 35

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Therapeutic Classes (continued) 1 回到 Therapeutic Classes 結果頁面，使用者也可以點選單一藥 物 (例如：Ciprofloxacin) 瀏覽單一藥物 Drug. Points 的 結果 36

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Therapeutic Classes (continued): Drug. Points results for Ciprofloxacin 37

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Drugs/Toxicology Tabs: 藥物鑑定和有毒物質清單 38

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Drug Identification 藥物毒物鑑定 39

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Drug Identification: IDENTIDEX 可以在 Drugs或Toxicology標籤下查詢 1 Drug Identification 預設的檢索條件是IDENTIDEX Imprint Code查詢，或 者使用者可以依據物質描述例如：圖案、形狀、顏色查詢。這裡，我們以 查詢 All Patterns, Five-sided, and Blue為例子。點選 “Search. ” 40

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Drug Identification (continued): 檢索結果頁面。點選 “Decadron” 41

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Drug Identification (continued): 檢索結果頁面，包含藥物圖片 1 從藥物結果中，點 選Search按鈕，查 詢POISINDEX中 有毒物質清單。. 42

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Drug Identification / Toxic Substance Lists (continued): 檢閱“Decadron. ” 在POISINDEX 有毒物質清單檢索結果，請選擇 “DECADRON TABLET 0. 75 MG from MERCK & COMPANY. ” 1 從這個頁面使用者可以直接進 入Poisindex Management。 2 使用者也可以進入 Poisindex Product Document 如果在Poisindex Management中有多個選項， 當滑鼠移到想要連結的選項， 文字將會變成紅色，清楚地強 調您的選擇。 43

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Toxic Substance Lists (continued): POISINDEX 產品清單文件結果。 點選 “CORTICOSTEROIDS” 進入 POISINDEX Management document. 1 從這裡使用者可以選擇進入 Poisindex Management 或是 Drug. Dex evaluation。 2 有相關圖片也可以由此觀看 44

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Toxic Substance Lists (continued): Resulting POISINDEX Toxicologic Management document for CORTICOSTEROIDS. 45

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Disease Tab 46

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HEALTHCARE SERIES FROM THOMSON MICROMEDEX Features • Full-text databases 全文資料庫 – Fully referenced 完整的文獻 – Peer reviewed 同儕評鑑 – Written by clinicians 醫生撰寫 • Updates 更新 – Internet (Weekly), 網路版每週更新 – CD (Quarterly) CD版（每季更新） – Urgent cases (Daily) 緊急的案例（每日更新） • Synonymous 同於全球EBM臨床知識 48

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Disease Database Search： 預設的是summaries的資料庫內容 50

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 疾病檢索結果頁面 51

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 首先進入最快速的瀏覽—摘要模式 DISEASEDEX™ General Medicine Summary - Titles & Synonyms DISEASEDEX General Medicine 的內容區 分為三部分 1. 急性Acute：最常見的緊急狀況或是直接 照護的建議方式，可在Emergency以及 General Medicine兩個資料庫至中查到。 2. 慢性Chornic：持續存在的疾病和議題， 只能在General Medicine資料庫中找到。 3. 預防及監測Prevention & Screening：可 在DISEASEDEXTMGeneral Medicine以 及預防及監測的Clinical. Points和臨床回顧 的文件找到相關的資料。 52

HEALTHCARE SERIES FROM THOMSON MICROMEDEX DISEASEDEX™ General Medicine Summary 53

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 連結到全文資料 55

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 若對於專題有興趣，再進入第二層資料閱讀 56

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 進入第二層資料 文獻一樣可以超連結 其他專題的超連結 57

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 實證內容 58

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HEALTHCARE SERIES FROM THOMSON MICROMEDEX 評估和治療方法的實證醫學資料內容 60

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Disease Categories Browse 1 2 先選取科別 再選取相關文件 61

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 預設的搜尋結果是summrries的文件內容 62

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Scenario–Disease. Dex General Medicine • 一位母親帶著三歲的小孩來求診，經診斷後發現為急性中耳 炎，是否應立即施予抗生素治療? • Select – Acute otitis media – Disease. Dex-Gen Med Clinical Review – Otitis media - Acute – Drug Therapy – Antibiotics 63

HEALTHCARE SERIES FROM THOMSON MICROMEDEX For uncomplicated infection in patients 2 years of age or older that are afebrile and without significant ear pain, observation for 48 to 72 hours without antibiotic treatment is an option [33][25]. Antibiotics are given for 10 days in patients under 2 years of age, and 5 to 7 days (or longer for severe disease) in those 2 years or older. High-dose amoxicillin is prescribed initially. Macrolides may be used in patients with urticaria or anaphylactic reactions to penicillin. The initial antibiotic choice may be different if the patient has had antibiotics in the preceding month [33]. 64

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Scenario–Disease. Dex Emergency Medicine • 一個懷孕婦女在急診室，因發生車禍，有一個明顯的外傷。 他的白血球數white blood cell (WBC) 是 21, 000. 這樣是胎 盤早剝的徵狀嗎(placenta tearing away to result in fetal demise) Select Placental Abruption Disease. Dex Emergency Medicine Clinical Reviews Abruptio placentae-Acute Clinical Reviews Tests & Procedures White blood cell count Lab Advisor™ 65

HEALTHCARE SERIES FROM THOMSON MICROMEDEX In pregnant trauma patients, an elevated WBC count on admission (>20, 000/mm(3)) is an indicator of ongoing placental abruption and requires close monitoring (Shah, 2002). 66

HEALTHCARE SERIES FROM THOMSON MICROMEDEX IV Compatibility Tab 67

HEALTHCARE SERIES FROM THOMSON MICROMEDEX IV Compatibility (continued)：單一藥物查詢檢索結果預設為Solution相容性。 其他資訊包含Y-Site, Admixture, Syringe, and TPN/TNA 相容性。 首先，這個檢索結果頁 面是Compatibility Overview。在Solution檢 索下，一般的Solution會 在左側表格呈現。其它 Solution則是在右側表格 中顯示。 您可以點選超連結研究 Solution跟藥物檢驗的詳 細資料。 Compatibility key清楚地 解釋您在Compatibility Overview中看到的結果。 當您的滑鼠移到每個項 目的Compatibility key上， 會出現完整的解釋。 69

HEALTHCARE SERIES FROM THOMSON MICROMEDEX IV Compatibility (continued) a 點選 “More Details” 連 結，緊鄰著藥物名稱將 會跳到頁面底端瀏覽藥 物概要資訊。這包含藥 物商品名、其他名稱、 p. H range。 70

HEALTHCARE SERIES FROM THOMSON MICROMEDEX IV Compatibility (continued)：點選參考文獻連結，您將會跳到頁面底端找到適當 的參考文獻資訊。 72

HEALTHCARE SERIES FROM THOMSON MICROMEDEX IV Compatibility (continued)：例如點選 Ampicillin Sodium (Caution：Variable) 所產生的結果。有些檢驗相容，有些則是不相容。 在這個例子中，Notes欄位( 用紅色字型)提供使用者可能 造成不同結果的原因。 Admixture 和 syringe 相容性 查詢也是如同Y-Site的方法查 詢。 74

HEALTHCARE SERIES FROM THOMSON MICROMEDEX IV Compatibility (continued)：點選TPN/ TNA文字超連結進入相容性詳細資料。 詳細資料內重複TPN / TNA名字、 構成、相容性指示和傳送方式。 76

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Interactions Tab: 單一和多樣藥物交互作用查詢 80

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Single Drug Interactions ：輸入Kaletra 並點選 “Search” 。使用者也可以輸入過敏 藥物和在Filter By下拉選單中選擇Severity和Documentation的條件。 81

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Single Drug Interactions (continued)：選擇特殊物質 (在此案例中不用，因為此 案例精確檢索到 KALETRA) ，然後點選 “Check Interactions. ” 82

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 左上方方格：包含搜尋條件(包含 Severities 和 Documentation)和一 般名稱。 右上方方格：包含跳躍至不同單一 交互作用的連結。 Single Drug Interactions (continued): 檢索結果頁面。 點 選 KALETRA連結瀏覽詳細結果。 83

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Single Drug Interactions (continued): 詳細結果 內容： 交互作用不良影響 臨床處理方式 作用時間 嚴重度 文獻 藥理機制 總結 文獻討論 84

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Multiple Drug Interactions：輸入triazolam 和 ritonavir 並點選 “Search”。 85

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Multiple Drug Interactions (continued): 從下拉選單中選擇特定的物質，然後點選 “Check Interactions. ” 86

左上方方格：包含搜尋條件(包含 Severities 和 Documentation)、一 般名稱和單一交互作用連結。 右上方方格：包含跳躍至不同多樣 交互作用的連結。 HEALTHCARE SERIES FROM THOMSON MICROMEDEX Multiple Drug Interactions (continued)：檢索結果頁面。 點選 TRIAZOLAM - RITONAVIR 連結進入詳細結果中。 87

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Multiple Drug Interactions (continued)：TRIAZOLAM – RITONAVIR 詳細交互作用 結果 內容： 交互作用不良影響 臨床處理方式 作用時間 嚴重度 文獻 藥理機制 總結 文獻討論 88

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Formulary & Handheld Tab: mobile. MICROMEDEX™ 89

HEALTHCARE SERIES FROM THOMSON MICROMEDEX 下載mobile. MICROMEDEX 到 PDA：從“Handheld PDA” 標籤點選 mobile. MICROMEDEX連結，進一步取得下載網址和Customer Number。跟著簡 易的操作說明。 1 免費下載mobile. MICROMEDEX 到您的PDA中 90

HEALTHCARE SERIES FROM THOMSON MICROMEDEX mobile. MICROMEDEX 提供: • Drug information • Diagnosis tool • Acute care information • Toxicology information • Alternative medicine information • Drug interaction tool (included with DRUG-REAX®) 91

HEALTHCARE SERIES FROM THOMSON MICROMEDEX mobile. MICROMEDEX Drug Information: Covers 2, 900+ drugs with valuable, point-of-care information. Searchable by trade name, generic name, or drug class. • Generic names • Common trade names • Class • Dosage, adult and pediatric • Dose adjustments • Administration • Monitoring • How supplied • Indications • Contraindications • Precautions • Adverse effects • Drug interactions • Pregnancy • Breast feeding 92

HEALTHCARE SERIES FROM THOMSON MICROMEDEX mobile. MICROMEDEX Diagnosis Tool: Access information on more than 1, 000 disease and conditions. • Definitions • Signs and symptoms • Differential diagnosis • Predisposing factors • Testing • Treatment 93

HEALTHCARE SERIES FROM THOMSON MICROMEDEX mobile. MICROMEDEX Acute Care Information: 320+ emergency conditions, discussing: • Diagnosis • Treatment • Key points 94

HEALTHCARE SERIES FROM THOMSON MICROMEDEX mobile. MICROMEDEX Toxicology Information: Management for 200+ of the most common poisonings and drug overdoses: • Clinical effects • Treatment • Range of toxicity 95

HEALTHCARE SERIES FROM THOMSON MICROMEDEX mobile. MICROMEDEX Alternative Medicine Information: Covers 300+ of the most popular herbal and dietary supplements: • Class • Dosage, adult and pediatric • Administration • How supplied • Indications • Contraindications • Adverse effects • Drug interactions • Pregnancy • Breast feeding 96

HEALTHCARE SERIES FROM THOMSON MICROMEDEX mobile. MICROMEDEX What’s New Feature: Provides the latest news and alerts on: • FDA announcements • Disease information • Clinical updates from Micromedex 97

HEALTHCARE SERIES FROM THOMSON MICROMEDEX mobile. MICROMEDEX Drug Interaction Tool: Available in conjunction with the desktop version of DRUG-REAX®. Check a patient’s list of medications (up to 32 at once) for potential interactions. Warning information includes: • Severity • Documentation • Onset • Adverse effect • Clinical management • Probable mechanism 98

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HEALTHCARE SERIES FROM THOMSON MICROMEDEX 相關網站 • 長亨文化事業有限公司 – http: //www. igroupnet. com. tw • Micromedex – http: //www. micromedex. com/ 113

HEALTHCARE SERIES FROM THOMSON MICROMEDEX Thanks For Your Attentions 114