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The Physicians' Desk Reference: Problems and Possible Improvements

The Physicians' Desk Reference: Problems and Possible Improvements Abstract The Physicians' Desk Reference (PDR) is a widely used source of drug information by American physicians and patients, but as we shall discuss, it suffers from numerous shortcomings.1 The PDR is a collection of written and pictorial information that is provided and paid for by pharmaceutical manufacturers. The written material for a given drug is a compilation of data and recommendations that are identical to those in the drug's package insert. The wording and directives that are included in these package inserts (and thus in the PDR) represent information that the pharmaceutical companies are permitted to present following discussion and approval by the Food and Drug Administration (FDA), Rockville, Md. The PDR is thus a negotiated effort of commercial enterprises and governmental regulators. References 1. Physicians' Desk Reference . 1st-49th eds. Montvale, NJ: Medical Economics Data Production Co; 1947-1995. 2. Connelly DP, Rich EC, Curley SP, Kelly JT. Knowledge resource preferences of family physicians. J Fam Pract . 1990;30:353-359. 3. American Medical Association. Drug Evaluations, Annual 1993. Chicago, Ill: American Medical Association ; 1993. 4. Greenblatt DJ. Basic pharmacokinetic principles and their application to psychotropic drugs . J Clin Psychiatry. 1993;54( (suppl) ):8-13. 5. Dawling S. Monitoring of tricyclic antidepressant therapy . Clin Biochem. 1982;15:56-61.Crossref 6. Woolsey RL, Chen Y, Freiman JP, Gillis RA. Mechanism of the cardiotoxic actions of terfenadine . JAMA. 1993;269:1532-1536.Crossref 7. McEvoy GK, ed. American Hospital Formulary Service, Drug Information 1993. Bethesda, Md: American Society of Hospital Pharmacists; 1994. 8. Brandon ML, Weiner M. Clinical investigation of terfenadine: a non-sedating antihistamine . Ann Allergy. 1980;44:71-75. 9. Brandon ML, Weiner M. Clinical studies of terfenadine (Seldane) in seasonal allergic rhinitis . Arzneimittelforschung. 1982;32:1204-1205. 10. Jick H. Evaluation of drug efficacy by a preference technic . N Engl J Med. 1966;275:1399-1403.Crossref 11. Jick H. Comparative studies with a new hypnotic under current investigation . Curr Ther Res. 1967;9:355-357. 12. Merlotti L, Roehrs T, Koshorek G, Zorick F, Lamphere J, Roth T. The dose effects of zolpidem on the sleep of healthy normals . J Clin Psychopharmacol. 1989;9:9-14.Crossref 13. Koshorek G, Roehrs T, Sicklesteel J, Merlotti L, Russo L, Roth T. Dose effects of zolpidem on transient insomnia . Sleep Res. 1988;17:47. 14. Vogel G, Thurmond A, Macintosh M, Clifton T. The effects of zolpidem (Ambien) on transient insomnia . Sleep Res. 1998;17:67. 15. Thompson M, Bell D. Further experience with ibuprofen in the treatment of arthritis . Rheumatol Phys Med. 1970;10( (suppl 10) ):100-103. 16. Chalmers TM. Clinical experience with ibuprofen in the treatment of rheumatoid arthritis . Ann Rheum Dis. 1969;28:513-517.Crossref 17. Mutru 0, Penttila M, Pesonen J, Salmela P, Suhonen O, Sonck T. Diclofenac sodium (Voltaren) and indomethacin in the ambulatory treatment of rheumatoid arthritis: a double-blind multicentre study . Scand J Rheumatol. 1978;22( (suppl) ): 51-56.Crossref 18. Ciccolunghi SN, Chaudri HA, Schubiger Bl, Red-drop R. Report on a long-term tolerability study of up to two years with diclofenac sodium (Voltaren) . Scand J Rheumatol. 1978;22( (suppl) ): 86-96.Crossref 19. Kantor TG. Use of diclofenac in analgesia . Am J Med. 1986; (suppl 4B) :64-69. 20. Siegmeth W, Placheta P. Long-term comparative study: diclofenac (Voltaren) and naproxen (Proxen) in arthritis . J Suisse Med. 1978;108:349-353. 21. Wernicke JF, Dunlop SR, Dornseif BE, Bosomworth JC, Humbert M. Low-dose fluoxetine therapy for depression . Psychopharmacol Bull. 1988;24:183-188. 22. Altamura AC, Montgomery SA, Wernicke JF. The evidence for 20 mg a day of fluoxetine as the optimal dose in the treatment of depression . Br J Psychiatry. 1988;153( (suppl 3) ):109-112. 23. Langman MJ, Henry DA, Ogilvie A. Ranitidine and cimetidine for duodenal ulcer . Scand J Gastroenterol. 1981;69( (suppl) ):115-117. 24. Dobrilla G, de Pretis G, Felder M, Chilovi F. Endoscopic double-blind controlled trial of ranitidine vs placebo in the short-term treatment of duodenal ulcer . Hepatogastroenterology. 1981; 28:49-52. 25. Berstad A, Kett K, Aadland E, et al. Treatment of duodenal ulcer with ranitidine, a new histamine H2-receptor antagonist . Scand J Gastroenterol. 1980;15:637-639.Crossref 26. Lauritsen K, Andersen BN, Havelund T, et al. Effect of 10 mg and 20 mg omeprazole daily on duodenal ulcer: double-blind comparative trial . Aliment Pharmacol Ther. 1989;3:59-67.Crossref 27. Kessler DA, Rose JL, Temple RJ, Schapiro R. Griffin JP. Therapeutic-class wars—drug promotion in a competitive marketplace . N Engl J Med. 1994;331:1350-1353.Crossref 28. Cain JW. Poor response to fluoxetine: underlying depression, serotonergic overstimulation, or a 'therapeutic window'? J Clin Psychiatry. 1992; 53:272-277. 29. Clark WG, Brater DC, Johnson AR. Goth's Medical Pharmacology. 12th ed. St Louis, Mo: Mosby— Year Book; 1992. 30. Melmon KL, Morrelli HF, Hoffman BB, Nierenberg DW. Melmon and Morrelli's Clinical Pharmacology: Basic Principles in Therapeutics. 3rd ed. New York. NY: McGraw-Hill International Book Co; 1993. 31. Physicians' Desk Reference. 49th ed. Montvale, NJ: Medical Economics Data Production Co; 1995. 32. Beck TM, Ciociola AA, Jones SE, et al. Efficacy of oral ondansetron in the prevention of emesis in outpatients receiving cyclophosphamide-based chemotherapy . Ann Intern Med. 1993; 118:407-413.Crossref 33. Beck TM. Efficacy of ondansetron tablets in the management of chemotherapy-induced emesis: review of clinical trials . Semin Oncol. 1992;19 ( (suppl 15) ):20-25. 34. Cubeddu LX, Pendergrass K, Ryan T, et al. Efficacy of oral ondansetron, a selective antagonist of 5-HT3 receptors, in the treatment of nausea and vomiting associated with cyclophosphamide-based chemotherapies . Am J Clin Oncol. 1994; 17:137-146.Crossref 35. Oh VM. Multiple medication: problems of the elderly patient . Int Dent J. 1991;41:348-358. 36. Brawn LA, Castleden CM. Adverse drug reactions: an overview of special considerations in the management of the elderly patient. Drug Saf. 1990;5:421-435. 37. Recchia AG, Shear NH. Organization and function of an adverse drug reaction clinic . J Clin Psychiatry. 1994;34:68-79. 38. Office of the Inspector General, Health and Human Services. Medical Drug Utilization Review . (April) 1989. 39. Minotti V, Patoia L, Roila F, et al. Double-blind evaluation of analgesic efficacy of orally administered diclofenac, nefopam, and acetylsalicylic acid (ASA) plus codeine in chronic cancer pain . Pain. 1989;36:177-183.Crossref 40. Nuutinen LS, Wuolijoki E, Pentikainen IT. Diclofenac and oxycodone in treatment of postoperative pain: a double-blind trial . Acta Anaesthesiol Scand. 1986;30:620-624.Crossref 41. Machtey I. Diclofenac in the treatment of painful joints and traumatic tendinitis (including strains and sprains): a brief review . Semin Arthritis Rheum. 1985;15( (suppl 1) ):87-92.Crossref 42. Zuinen C. Diclofenac/misoprostol vs diclofenac/ placebo in treating acute episodes of tendinitis/ bursitis of the shoulder . Drugs. 1993;45( (suppl 1) ):17-23.Crossref 43. Johnson MS. Response of ventricular arrhythmias to propranolol in mitral valve prolapse . Ala Med. 1988;58:14-16. 44. Nierenberg AA, Keck PE Jr. Management of monoamine oxidase inhibitor-associated insomnia with trazodone . J Clin Psychopharmacol. 1989;9:42-45.Crossref 45. Nierenberg AA, Adler LA, Peselow E, Zornberg G, Rosenthal M. Trazodone for antidepressant-associated insomnia . Am J Psychiatry. 1994; 151:1069-1072. 46. Metz A, Shader RI. Adverse interactions encountered when using trazodone to treat insomnia associated with fluoxetine . Int Clin Psychopharmacol. 1990;5:191-194.Crossref 47. Stern RS. Drug promotion for a unlabeled indication—the case of topical tretinoin . N Engl J Med. 1994;331:1348-1349.Crossref 48. Gilman AG, Rall TW, Nies AS, Taylor P. Goodman and Gilman's The Pharmacological Basis of Therapeutics . Elmsford, NY: Pergamon Press Inc; 1990. 49. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine . J Clin Psychiatry. 1992;53:119-122. 50. Eckman MH, Levine HJ, Pauker SG. Effect of laboratory variation in the prothrombin-time ratio on the results of oral anticoagulant therapy . N Engl J Med. 1993;329:696-670.Crossref 51. Hull R, Hirsh J, Jay R, et al. Different intensities of anticoagulation in the long-term treatment of proximal venous thrombosis . N Engl J Med. 1982; 307:1676-1681.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

The Physicians' Desk Reference: Problems and Possible Improvements

Archives of Internal Medicine , Volume 156 (13) – Jul 8, 1996

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American Medical Association
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Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1996.00440120021003
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Abstract

Abstract The Physicians' Desk Reference (PDR) is a widely used source of drug information by American physicians and patients, but as we shall discuss, it suffers from numerous shortcomings.1 The PDR is a collection of written and pictorial information that is provided and paid for by pharmaceutical manufacturers. The written material for a given drug is a compilation of data and recommendations that are identical to those in the drug's package insert. The wording and directives that are included in these package inserts (and thus in the PDR) represent information that the pharmaceutical companies are permitted to present following discussion and approval by the Food and Drug Administration (FDA), Rockville, Md. The PDR is thus a negotiated effort of commercial enterprises and governmental regulators. References 1. Physicians' Desk Reference . 1st-49th eds. Montvale, NJ: Medical Economics Data Production Co; 1947-1995. 2. Connelly DP, Rich EC, Curley SP, Kelly JT. Knowledge resource preferences of family physicians. J Fam Pract . 1990;30:353-359. 3. American Medical Association. Drug Evaluations, Annual 1993. Chicago, Ill: American Medical Association ; 1993. 4. Greenblatt DJ. Basic pharmacokinetic principles and their application to psychotropic drugs . J Clin Psychiatry. 1993;54( (suppl) ):8-13. 5. Dawling S. Monitoring of tricyclic antidepressant therapy . Clin Biochem. 1982;15:56-61.Crossref 6. Woolsey RL, Chen Y, Freiman JP, Gillis RA. Mechanism of the cardiotoxic actions of terfenadine . JAMA. 1993;269:1532-1536.Crossref 7. McEvoy GK, ed. American Hospital Formulary Service, Drug Information 1993. Bethesda, Md: American Society of Hospital Pharmacists; 1994. 8. Brandon ML, Weiner M. Clinical investigation of terfenadine: a non-sedating antihistamine . Ann Allergy. 1980;44:71-75. 9. Brandon ML, Weiner M. Clinical studies of terfenadine (Seldane) in seasonal allergic rhinitis . Arzneimittelforschung. 1982;32:1204-1205. 10. Jick H. Evaluation of drug efficacy by a preference technic . N Engl J Med. 1966;275:1399-1403.Crossref 11. Jick H. Comparative studies with a new hypnotic under current investigation . Curr Ther Res. 1967;9:355-357. 12. Merlotti L, Roehrs T, Koshorek G, Zorick F, Lamphere J, Roth T. The dose effects of zolpidem on the sleep of healthy normals . J Clin Psychopharmacol. 1989;9:9-14.Crossref 13. Koshorek G, Roehrs T, Sicklesteel J, Merlotti L, Russo L, Roth T. Dose effects of zolpidem on transient insomnia . Sleep Res. 1988;17:47. 14. Vogel G, Thurmond A, Macintosh M, Clifton T. The effects of zolpidem (Ambien) on transient insomnia . Sleep Res. 1998;17:67. 15. Thompson M, Bell D. Further experience with ibuprofen in the treatment of arthritis . Rheumatol Phys Med. 1970;10( (suppl 10) ):100-103. 16. Chalmers TM. Clinical experience with ibuprofen in the treatment of rheumatoid arthritis . Ann Rheum Dis. 1969;28:513-517.Crossref 17. Mutru 0, Penttila M, Pesonen J, Salmela P, Suhonen O, Sonck T. Diclofenac sodium (Voltaren) and indomethacin in the ambulatory treatment of rheumatoid arthritis: a double-blind multicentre study . Scand J Rheumatol. 1978;22( (suppl) ): 51-56.Crossref 18. Ciccolunghi SN, Chaudri HA, Schubiger Bl, Red-drop R. Report on a long-term tolerability study of up to two years with diclofenac sodium (Voltaren) . Scand J Rheumatol. 1978;22( (suppl) ): 86-96.Crossref 19. Kantor TG. Use of diclofenac in analgesia . Am J Med. 1986; (suppl 4B) :64-69. 20. Siegmeth W, Placheta P. Long-term comparative study: diclofenac (Voltaren) and naproxen (Proxen) in arthritis . J Suisse Med. 1978;108:349-353. 21. Wernicke JF, Dunlop SR, Dornseif BE, Bosomworth JC, Humbert M. Low-dose fluoxetine therapy for depression . Psychopharmacol Bull. 1988;24:183-188. 22. Altamura AC, Montgomery SA, Wernicke JF. The evidence for 20 mg a day of fluoxetine as the optimal dose in the treatment of depression . Br J Psychiatry. 1988;153( (suppl 3) ):109-112. 23. Langman MJ, Henry DA, Ogilvie A. Ranitidine and cimetidine for duodenal ulcer . Scand J Gastroenterol. 1981;69( (suppl) ):115-117. 24. Dobrilla G, de Pretis G, Felder M, Chilovi F. Endoscopic double-blind controlled trial of ranitidine vs placebo in the short-term treatment of duodenal ulcer . Hepatogastroenterology. 1981; 28:49-52. 25. Berstad A, Kett K, Aadland E, et al. Treatment of duodenal ulcer with ranitidine, a new histamine H2-receptor antagonist . Scand J Gastroenterol. 1980;15:637-639.Crossref 26. Lauritsen K, Andersen BN, Havelund T, et al. Effect of 10 mg and 20 mg omeprazole daily on duodenal ulcer: double-blind comparative trial . Aliment Pharmacol Ther. 1989;3:59-67.Crossref 27. Kessler DA, Rose JL, Temple RJ, Schapiro R. Griffin JP. Therapeutic-class wars—drug promotion in a competitive marketplace . N Engl J Med. 1994;331:1350-1353.Crossref 28. Cain JW. Poor response to fluoxetine: underlying depression, serotonergic overstimulation, or a 'therapeutic window'? J Clin Psychiatry. 1992; 53:272-277. 29. Clark WG, Brater DC, Johnson AR. Goth's Medical Pharmacology. 12th ed. St Louis, Mo: Mosby— Year Book; 1992. 30. Melmon KL, Morrelli HF, Hoffman BB, Nierenberg DW. Melmon and Morrelli's Clinical Pharmacology: Basic Principles in Therapeutics. 3rd ed. New York. NY: McGraw-Hill International Book Co; 1993. 31. Physicians' Desk Reference. 49th ed. Montvale, NJ: Medical Economics Data Production Co; 1995. 32. Beck TM, Ciociola AA, Jones SE, et al. Efficacy of oral ondansetron in the prevention of emesis in outpatients receiving cyclophosphamide-based chemotherapy . Ann Intern Med. 1993; 118:407-413.Crossref 33. Beck TM. Efficacy of ondansetron tablets in the management of chemotherapy-induced emesis: review of clinical trials . Semin Oncol. 1992;19 ( (suppl 15) ):20-25. 34. Cubeddu LX, Pendergrass K, Ryan T, et al. Efficacy of oral ondansetron, a selective antagonist of 5-HT3 receptors, in the treatment of nausea and vomiting associated with cyclophosphamide-based chemotherapies . Am J Clin Oncol. 1994; 17:137-146.Crossref 35. Oh VM. Multiple medication: problems of the elderly patient . Int Dent J. 1991;41:348-358. 36. Brawn LA, Castleden CM. Adverse drug reactions: an overview of special considerations in the management of the elderly patient. Drug Saf. 1990;5:421-435. 37. Recchia AG, Shear NH. Organization and function of an adverse drug reaction clinic . J Clin Psychiatry. 1994;34:68-79. 38. Office of the Inspector General, Health and Human Services. Medical Drug Utilization Review . (April) 1989. 39. Minotti V, Patoia L, Roila F, et al. Double-blind evaluation of analgesic efficacy of orally administered diclofenac, nefopam, and acetylsalicylic acid (ASA) plus codeine in chronic cancer pain . Pain. 1989;36:177-183.Crossref 40. Nuutinen LS, Wuolijoki E, Pentikainen IT. Diclofenac and oxycodone in treatment of postoperative pain: a double-blind trial . Acta Anaesthesiol Scand. 1986;30:620-624.Crossref 41. Machtey I. Diclofenac in the treatment of painful joints and traumatic tendinitis (including strains and sprains): a brief review . Semin Arthritis Rheum. 1985;15( (suppl 1) ):87-92.Crossref 42. Zuinen C. Diclofenac/misoprostol vs diclofenac/ placebo in treating acute episodes of tendinitis/ bursitis of the shoulder . Drugs. 1993;45( (suppl 1) ):17-23.Crossref 43. Johnson MS. Response of ventricular arrhythmias to propranolol in mitral valve prolapse . Ala Med. 1988;58:14-16. 44. Nierenberg AA, Keck PE Jr. Management of monoamine oxidase inhibitor-associated insomnia with trazodone . J Clin Psychopharmacol. 1989;9:42-45.Crossref 45. Nierenberg AA, Adler LA, Peselow E, Zornberg G, Rosenthal M. Trazodone for antidepressant-associated insomnia . Am J Psychiatry. 1994; 151:1069-1072. 46. Metz A, Shader RI. Adverse interactions encountered when using trazodone to treat insomnia associated with fluoxetine . Int Clin Psychopharmacol. 1990;5:191-194.Crossref 47. Stern RS. Drug promotion for a unlabeled indication—the case of topical tretinoin . N Engl J Med. 1994;331:1348-1349.Crossref 48. Gilman AG, Rall TW, Nies AS, Taylor P. Goodman and Gilman's The Pharmacological Basis of Therapeutics . Elmsford, NY: Pergamon Press Inc; 1990. 49. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine . J Clin Psychiatry. 1992;53:119-122. 50. Eckman MH, Levine HJ, Pauker SG. Effect of laboratory variation in the prothrombin-time ratio on the results of oral anticoagulant therapy . N Engl J Med. 1993;329:696-670.Crossref 51. Hull R, Hirsh J, Jay R, et al. Different intensities of anticoagulation in the long-term treatment of proximal venous thrombosis . N Engl J Med. 1982; 307:1676-1681.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 8, 1996

References