On-call information resources

The weblinks below may be helpful to you when on-call. We're not endorsing any of these resources as essential for providing an on-call service, simply drawing attention to their potential value if you have access. Some of these websites require username/passwords and you can record these below.

In addition to these sites, you will need access to your Trust’s local guidelines. Also, if you have an MI centre at your hospital you may find it helpful to arrange for access toMiDatabank, the database that archives all the clinical enquiries that have been answered.

General references

Name / My username and password / Top tips
BNF / Open access / Quick , concise and useful answers for many problems.
eMC / Open access / SPCs are good for a range of problems including dose, administration, adverse reactions and interactions.
Martindale
[subscription needed] / Use for doses, adverse effects, identifying foreign medicines. Some information about unlicensed indications.
AHFS Drug Information
[subscription needed] / Use for doses, adverse effects, and administration. An American resource so note differences between US and UK product names, formulations and licences.
Micromedex
[subscription needed] / Particularly useful for unlicensed indications, but also doses and ADRs. An American resource so note differences between US and UK as above.
NICE Clinical Knowledge Summaries / Open access / Helpful evidence-based summaries of treatment of common medical conditions.
Specialist Pharmacy Service (SPS) / Open access / Has Medicines Q&As about various clinical subjects and information about items left out of the fridge.


Administration of medicines

Name / My username and password / Top tips
Enteral
Handbook of Drug Administration via Enteral Feeding Tubes [subscription needed] / Use for questions about patients with enteral feeding tubes, but also has information regarding interaction with feeds.
The NEWT Guidelines
[subscription needed] / Similar to above, but has additional information about patients with swallowing difficulties. Note that some guidance may be based on local practice rather than published research.
Intravenous
eMC / Open access / For advice on injection methods, dilution, preparation and dose.
Injectable Medicines Guide (‘Medusa’)
[subscription needed] / Useful for most aspects of administering injectable medicines.
UKCPA Minimum Infusion Guidelines 2012 / Open access / For guidance on administering parenteral medicines to fluid-restricted patients.

Breastfeeding

Although it’s not very likely you’ll be asked about this subject when on-call, there are two very good free websites that will help you with most problems:

Name / My username and password / Top tips
Specialist Pharmacy Service / Open access / Type medicine into search engine and select it from the drop down list, then scroll to bottom of the page to look at the 'Lactation Safety Information' section.
Lactmed / Open access / Note this is an American site.

Children

There are two websites that provide quick, concise and useful information for most clinical problems involving children:

Name / My username and password / Top tips
BNF-C / Open access
Evelina London Paediatric Formulary (formerly Guy’s St Thomas’ Paediatric Formulary) / Open access
The Neonatal Formulary / A helpful book for drug doses in neonates/infants, and your Trust may have a paper copy or access to this as an e-book.

Compatibility of injections

Name / My username and password / Top tips
Handbook on Injectable Drugs (‘Trissel’) [subscription needed] / Helpful for mixing parenteral medicines together. A US resource so not all UK medicines are covered.
Palliative Care Formulary [subscription needed] / Provides data on mixing some combinations of drugs in syringe drivers.
The Syringe Driver (Dickman and Schneider) / Available in paper form not online, but has information about mixing medicines in syringe drivers.

Interactions

Name / My username and password / Top tips
eMC / Open access / Often comprehensive for each drug but may not offer advice on management.
Stockley’s Drug Interactions
[subscription needed] / Gives advice on managing interactions and their clinical importance.
Transformer Cytochrome p450 Database / Open access / This site is a database of medicines that are metabolised by this group of enzymes or which inhibit or induce them. It mayhelp you predict metabolic interactions dependent upon their interaction with cytochrome p450.
HIV Interactions Checker / Open access / A valuable site from the University of Liverpool.

Most of the General references above may also be helpful depending on what you’re asked.

Liver

Name / My username and password / Top tips
eMC / Open access / This may give data on dose adjustment in liver disease and/or notable hepatic side effects.
LiverTox / Open access / Has information on drug-induced liver disease and its management; indexed by name of medicine, herbal product, street drug etc. An American site.

Most of the General references above may also be helpful depending on what you’re asked.

Palliative care

Name / My username and password / Top tips
Palliative Care Formulary [subscription needed] / Advice on drug selection, dosage and compatibility in syringes.
The Syringe Driver (Dickman and Schneider) / Available in paper form not online, but has information about mixing medicines in syringe drivers.

Poisoning

Name / My username and password / Top tips
National Poisons Information Service (NPIS) / Open access / Pharmacists are not experts on poisonings, so you should normally ask the person contacting you to ring theservice themselves.
Toxbase / Free but requires registration / Has clinical advice on poisonings including antidotes.

Pregnancy

Certain pregnancy enquiries may be able to wait until the next working day for a more considered opinion from e.g. an MI centre, but two helpful online resources are:

Name / My username and password / Top tips
UK Teratology Information Service / Free but requires registration / This page provides publicly available summaries of the risks of many drugs in pregnancy, but for more detailed information you will need to log into Toxbase as described on the site.
Drugs in Pregnancy and Lactation (Briggs) [subscription needed] / Your Trust may have online access to this via e.g. thepublisherorMedicinesComplete.

Psychiatry

Name / My username and password / Top tips
The Maudsley Prescribing Guidelines in Psychiatry / This is a helpful guide to clinical problem-solving, and your Trust may have a paper copy or access to the e-book.
Psychotropic Drug Directory (Stephen Bazire) / This is a valuable book covering all aspects of the use of medicines in psychiatry, but it is only available in paper format.

Renal

Name / My username and password / Top tips
eMC / Open access / This may give data on dose adjustment in renal disease and/or notable renal side effects.
The Renal Drug Database [subscription needed] / May offer advice on dosing in renal disease if the eMC cannot help.

Most of the General references above may also be helpful depending on what you’re asked.

Therapeutic Drug Monitoring

Name / My username and password / Top tips
TDM Guide / Open access / This may help you with basic details about monitoring, if you don't have local guidelines to operate by. But guidance may vary per Trust.

[Last updated: 07 June 2017]