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More about MIMS DrugAlert
Who
we are
Classification of drugs
MIMS DrugAlert Content
How MIMS DrugAlert works
MIMS DrugAlert limitations
Who we are
MIMS DrugAlert
is a Decision Support module and
has been developed by the MIMS editorial team.
MIMS Integrated is
a division of MIMS focusing on providing accurate and reliable
medicines information and decision support for use in
medicines prescribing,
dispensing or administering software.
MIMS DrugAlert draws
on an international knowledge base of interactions information
and is configured by our editorial team for New Zealand
conditions and terminology. .
Classification
of drugs
Within MIMS
DrugAlert medicines are grouped into Drug Interaction Classes:
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Example.
One Drug Interaction Class (Heparin and related
compounds) includes heparin
calcium, heparin sodium, nadroparin calcium and other similar
molecules. |
It is important to
note that not all medicines have been classified into specific
classes. Such generics fall into two groups: those that do
not have significant adverse interactions and those that have
not yet been evaluated for their potential interactions, e.g.
newer chemical entities. Thus if no interaction message appears
it does not necessarily mean that none applies for the medicine
selected. It is the responsibility of the end user to evaluate
all information in the clinical setting before making any
final prescribing decision.
The information provided
by this package should not be substituted for good clinical
knowledge and practice.
Although every effort
has been made in compiling and checking the information in
this database to ensure that it is accurate and up-to-date,
the authors, editors, publishers and their servants or agents
shall not be responsible for any errors, omissions or inaccuracies
in this database, whether arising from negligence or otherwise
howsoever or for any consequences arising therefrom.
MIMS DrugAlert
content
Once editors
have created the interaction classes and allocated medicines
to the classes, interactions are assigned between classes.
For example, an interaction could be defined between the Salicylates
class and the
Heparin and related compounds class.
As part of this interaction,
the severity, likelihood, precautions, observations and description
are also defined.
References to primary
and secondary sources are also included for the
benefit of the user.
How MIMS DrugAlert
works
The MIMS DrugAlert
interactions database can be used to check the documented or
theoretical
interactions between two or more nominated (selected) medicines.
When a brand of medicine containing more than one generic
component is selected, each generic component (or its allocated
class) is compared against each other generic on an individual
(paired) basis.
When more than two
medicines are chosen, the database checks the interactions
between all possible paired combinations of generics, but
it cannot provide information about the overall combination.
MIMS DrugAlert
limitations
The following
is provided to demonstrate the limitations of computer technology
and database applications. Users should be aware of the following
limitations, and it should be reinforced that there is no
substitute for good clinical knowledge and practice.
The information that
is provided by this database can help you in your decision
making, but how you apply this information in a clinical setting
for an individual patient is still your responsibility.
As described in the
'Disclaimer' the database can only allow the checking of interactions
between medicines on a paired basis and the cumulative effects
of multiple medicines or the effect of a specific resultant
interaction on all other medicines cannot possibly be provided.
Therefore, the attending clinician must assess the combined
consequences of all the displayed interactions in each patient.
Here are two examples
where the database cannot provide all the information required
for a final prescribing decision.
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Example 1
. Cumulative effects of multiple medicines
Four medicines are prescribed. MIMS DrugAlert allows
checking of the six possible combinations:
Possible
Combinations Result of Interaction
Drug 1 with
Drug 2 Moderate renal toxicity
Drug 1 with Drug 3 No interaction
Drug 1 with Drug 4 No interaction
Drug 2 with Drug 3 No interaction
Drug 2 with Drug 4 No interaction
Drug 3 with Drug 4 Moderate renal toxicity
Two interaction
messages are displayed - both for moderate renal toxicity.
The additive effects of the interactions between drugs
1 and 2 and drugs 3 and 4, i.e. moderate toxicity plus
moderate toxicity, which in a clinical situation may
result in severe renal toxicity, will not be displayed.
Example 2
. The effect of a resultant interaction (between two
medicines) on a third medicine
Three medicines are prescribed. MIMS DrugAlert will
allow the checking of the three possible combinations:
Possible
Combinations Result of Interaction
Drug 1 with
Drug 2 Hypokalaemia
Drug 1 with Drug 3 No interaction
Drug 2 with Drug 3 No interaction
In this instance,
Drug 3 causes arrhythmias in the presence of hypokalaemia.
However, in this case, the only warning to be displayed
is that hypokalaemia may occur if prescribing Drug 1
and Drug 2 together. The clinician must apply this information
to the patient being treated and any other medicine
being prescribed.
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In summary, only drug/drug
combinations can be checked and not resultant interaction/drug
or resultant interaction/resultant interaction combinations.
MIMS DrugAlert and
the advice contained herein is updated on a regular basis.
This reflects the availability of new case reports and clinical
studies published in acknowledged primary and secondary sources.
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