30 Minutes Session 13 Physician's Desk Reference (PDR) and Other Reference Sources Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Learning Objectives Explain how the various sections of the PDR can provide information that will: aid in the drug influence evaluation aid in courtroom testimony Use the PDR in a practical exercise Learn about other resources available to assist DREs Briefly review the objectives, content and activities of this session. Upon successfully completing the session, the participant will be able to: Explain how the various sections of the PDR can provide information that will: aid in the drug influence evaluation aid in courtroom testimony. Use the PDR in a practical exercise. Learn about other resources available to assist DREs. CONTENT SEGMENTS LEARNING ACTIVITIES Procedures Instructor-led Presentation Practical Exercises Other Resources Available Point out that the PDR has been admitted as a “learned treatise” (a book or treatise (a formal book) regarded as authoritative, generally of long-accepted value within a profession or field of study) in court in previous court cases. (Source: Federal Rule of Evidence 803(18) “Statements in Learned Treatises, Periodicals or Pamphlets”) Point out that we will use the PDR for prescription drugs. Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Physician's Desk Reference (PDR) Published annually Versions: Prescription Non-prescription Ophthalmology Procedures Due to the unique nature of this session, instructors teaching this session should strive to develop innovative and interactive creative learning activities. PDR: Physician's Desk Reference PDR is published annually. Many versions are published: Prescription Non-prescription Ophthalmology Exhibit copy of a PDR. PDR supplements are published periodically as new products are introduced during the year.  Function of the publisher is compilation, organization and distribution of information. Product descriptions are prepared by the manufacturer, and edited and approved by their respective medical directors. Additional information on the various drugs can be obtained from the manufacturer. Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Sections of a Physician's Desk Reference Manufacturers' index Section 2: Product name index and discontinued products Section 3: Product category index Sections of a PDR Point out that the sections are color coded for easy use. Section 1 Manufacturers Index List of manufacturers (with phone numbers) who have provided prescribing information. Section 2 Product Name Index and Discontinued Products Alphabetical listing of products available and a listing of discontinued products. Newer editions of the PDR will have a merging of Sections 2 and 4. Section 3 Product Category Index Products listed according to appropriate category. Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Sections of a Physician's Desk Reference Generic and chemical name index Section 5: Product identification section Section 6: Product information section Section 4 Generic and Chemical Name Index Products listed under generic and chemical name headings according to the principal ingredient(s). Section 5 Product Identification Section Point out that this section contains actual size, full color reproductions. Section 6 Product Information Section Point out that this section describes composition, action, uses, administration, dosage, contraindications, precautions, side effects, the form in which supplied and other information concerning use. It also includes common names, generic compositions, or chemical names. Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Sections of a Physician's Desk Reference Diagnostic product information Section 8: Poison control centers Section 9: Guide to management of drug overdose Section 7 Diagnostic Product Information Diagnostic product descriptions. Section 8 Poison Control Centers List of centers and emergency telephone numbers. Section 9 Guide to Management of Drug Overdose Information concerning drug over dosage. Use of the PDR in DEC Program To identify prescription drugs. This information is contained in the product identification section. To identify the effects of prescription drugs for comparison with observed effects. This information is contained in the product information section. How to use the PDR Identification of an unknown product. Demonstrate how to identify a tablet, capsule, etc. using the product identification section. Identification of drug pharmacology. Demonstrate how to use the product identification section. Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Product Information Section Example MS Contin tablets (Morphine Sulfate) Description Clinical pharmacology Indications and usage Warnings Precautions Dosage and administration Drug abuse and dependence How supplied Example: MS Contin tablets (Morphine Sulfate).  Location and acquisition of agency’s PDR(s) Point out that PDRs can be obtained from physicians, hospitals, etc. It is not essential to have the current version for typical enforcement. Solicit participants’ questions and comments concerning procedures for using a PDR. B. Practical Exercise Assign students to small groups and provide photographs or examples of typical prescription drugs encountered during enforcement contacts. Have the group identify the drugs and describe typical “actions” or symptoms that can be observed and documented during a drug influence evaluation. Small group exercise. Each group must have a PDR. Group reports. Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Suggested Criteria for Identifying a Non-PDR Source Be less than five years old (by copyright date) Be readily available in print or online Be periodically updated Be utilized by practitioners in the scientific and healthcare fields At a minimum, contain information on a particular drug’s: name, forms, actions and side effects C. Other Resources Suggested criteria to identify a non-PDR drug reference When selecting an acceptable drug reference DRE’s should consult references that meet the below criteria: Be less than five years old (by copyright date). Be readily available in print or online. Be periodically updated. Be utilized by practitioners in the scientific and healthcare fields. At a minimum, contain information on a particular drug’s: Trade (brand), generic, and alternate common names. Available forms (liquid, pill, injectable, etc.). Pharmacologic / therapeutic actions (as used clinically, both “on” and “off” label). Adverse reactions and side effects. The reason for this is to keep from consulting references that have become outdated and inaccurate. Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Other Written Sources Acceptable written examples include: The Complete Guide to Prescription and Non-prescription Drugs The Pill Book Nursing Drug Handbook Nurse Pocket Drug Guide Drug Identification Bible Acceptable resources may be in-print, electronic, or a combination. Non-representative, non- ranked. Acceptable written examples include: The Complete Guide to Prescription and Non-prescription Drugs The Pill Book Nursing Drug Handbook Nurse Pocket Drug Guide Drug Identification Bible (available at: http://www.drugidbible.com) Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Other Written Sources Acceptable written examples include: Davis’s Drug Guide for Nurses Tarascon Pocket Pharmacopoeia The Monthly Prescriber’s Reference (MPR) Disposition of Toxic Drugs and Chemicals in Man Acceptable written examples include (Cont): Davis’s Drug Guide for Nurses Tarascon Pocket Pharmacopoeia (for those with some pharmacology education) The Monthly Prescriber’s Reference (MPR) Disposition of Toxic Drugs and Chemicals in Man, (Source: Randall C. Baselt. Biomedical Publications) Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Other Electronic Sources Acceptable electronic examples include: Drugs.com RxList.com WebMD.com/Drugs/Index-drugs.aspx Epocrates.com iMeds – Medical Reference for Android Monthly Prescriber’s Reference (MPR) PDR.net Acceptable electronic examples include: Drugs.com RxList.com WebMD.com/Drugs/Index-drugs.aspx Epocrates.com iMeds – Medical Reference for Android Monthly Prescriber’s Reference (MPR) PDR.net Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Other Information Sources National Highway Traffic Safety Administration, Enforcement and Justice Services Division Office of National Drug Control Policy State DEC Program Coordinator Governor’s Office of Highway Safety Other Information Sources National Highway Safety Administration (NHTSA), Enforcement and Justice Services (EJS) Division, Washington, D.C. Office of National Drug Control Policy (ONDCP) State Drug Evaluation and Classification (DEC) Program Coordinator. Governor’s Office of Highway Safety (GOHS) Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Other Information Sources The National Traffic Law Center (NTLC) http://www.ndaa.org/ntlc_home.html Local poison control center Medical dictionary The National Traffic Law Center (NTLC). NTLC is part of the American Prosecutors Research Institute (APRI). Local Poison Control Center. Medical Dictionaries. Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

Other Information Sources Drugs and Human Performance Fact Sheets Various textbooks, newspaper and magazine articles IACP DEC Program http://www.decp.org Drugs and Human Performance Fact Sheets Produced by U.S. DOT-NHTSA, Report No. DOT 809 725, March 2004. Newspaper and magazine articles on drugs and drug impaired driving, including counter- culture magazines such as “High Times.” Software programs such as Pharmacists, Body Works, Mosby's Medical Dictionary and other programs are available on disks and CDs. Various resources are available through online services and the Internet. The IACP Drug Evaluation and Classification Program website is http://www.decp.org Other texts. Discuss some other useful and reliable texts known to you. Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources

QUESTIONS? Solicit participants’ comments or questions concerning PDR and other reference sources. Revised: 04-08-2014 Drug Recognition Expert Course Physician’s Desk Reference and Other Reference Resources