1. 30 Minutes
Session 13
Physician's Desk Reference (PDR) and Other Reference Sources

2. 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.

3. 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:
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.
PDR for prescription drugs
PDR for non-prescription drugs
PDR for ophthalmology
PDR Consumer Guide to Prescription Drug
PDR for Herbal Medicines
PDR for Nutritional Supplement
PDR Nurse’s Drug Handbook

4. 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.

5. Sections of a Physician's Desk Reference (Cont.)
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.

6. Sections of a Physician's Desk Reference (Cont.)
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.

7. 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.

8. 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.

9. Other Written Sources Acceptable written examples include:
The Complete Guide to Prescription and Non-prescription Drugs 2012
The Pill Book (currently the 15th Edition)
Nursing 2013 Drug Handbook
Nurse Pocket Drug Guide 2012
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 2012
The Pill Book (currently the 15th Edition)
Nursing 2013 Drug Handbook
Nurse Pocket Drug Guide 2012
Drug Identification Bible (available at:

10. Other Written Sources (Cont.)
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)

11. Other Electronic Sources
Acceptable electronic examples include:
Drugs.com
RxList.com
WebMD.com/Drugs/Index-drugs.aspx
Eprocrates.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
Eprocrates.com
iMeds – Medical Reference for Android
Monthly Prescriber’s Reference (MPR)
PDR.net

12. Other Information Sources
National Highway Traffic Safety Administration, Enforcement and Justice Services Division
State DEC Program Coordinator
The DRE Newsletter
Phoenix City Prosecutor's Office
455 North 5th Street
Suite 400 Phoenix,
Arizona, 85004
Other Information Sources
National Highway Safety Administration, Enforcement and Justice Services Division.
State Drug Evaluation and Classification (DEC) Program Coordinator.
The DRE Newsletter. Published by the Phoenix City Prosecutor’s Office, Phoenix, Arizona.
Website:
This resource also includes past editions that are a very valuable resource for information

13. Other Information Sources
The National Traffic Law Center (NTLC)
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.

14. Other Information Sources (Cont.)
Drugs and Human Performance Fact Sheets
Various textbooks, newspaper and magazine articles
Drugs and Human Performance Fact Sheets
Produced by U.S. DOT-NHTSA, Report No. DOT , 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.
Point out that the IACP Drug Evaluation and Classification Program website is
Other texts.
Discuss some other useful and reliable texts known to you.

15. QUESTIONS?
Solicit participants’ comments or questions concerning PDR and other reference sources.