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 Health Board’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 tipsBNF / 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.
MHRA / Open access / Access to all SPCs and PILs for UK licensed products
Martindale (via HOWIS)
(via Athens log-in) / Use for doses, adverse effects, identifying foreign medicines. Some information about unlicensed indications.
Micromedex (via HOWIS)
(via Athens log-in) / Particularly useful for unlicensed indications, but also doses and ADRs. An American resource, there may be differences between UK and US product names, formulations and licenses.
NICE Clinical Knowledge Summaries / Open access / Helpful evidence-based summaries of treatment of common medical conditions. Intended for primary care use so mainly covers conditions treated in primary care.
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
Enteral
Handbook of Drug Administration via Enteral Feeding Tubes
(via medicines complete- 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 tipsSpecialist 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 tipsBNF-C / Open access
Evelina London Paediatric Formulary
(formerly Guy’s St Thomas’ Paediatric Formulary) / Open access / Online version does not currently contain the Treatment Guidelines that are in the coloured pages at the back of the book.
The Neonatal Formulary / A helpful book for drug doses in neonates/infants, and your Health Board may have a paper copy or access to this as an e-book.
Compatibility of injections
Name / My username and password / Top tipsHandbook on Injectable Drugs (‘Trissel’)
(via Athens log-in) / 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.
Palliative Adult Network Guidelines / 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 tipseMC / Open access / Often comprehensive for each drug but may not offer advice on management.
Stockley’s Drug Interactions
(via medicines complete- subscription needed) / Gives advice on managing interactions and their clinical importance.
Drug Interactions checker
Micromedex
(via HOWIS - Athens log-in) / Use drug interactions tab on homepage to input list of medication and then check for any interactions. Also includes some herbal medication.
Credible meds (QT prolongation) / Registration required / Information on medication that can prolong QT interval and also clinically significant medication interactions that result in QT prolongation and suggested management.
HIV Interactions Checker / Open access / A valuable site from the University of Liverpool.
Most of the General references on page 1 may also be helpful depending on what you’re asked.
Liver
Name / My username and password / Top tipseMC / 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.
UKMI Q and A
Why is the adverse effect profile of a drug relevant when prescribing for patients with liver disease
(via SPS website) / Open access / Useful Q and A written by specialists on medication use in patients with liver disease. Helpful when deciding on choice of medication for a patient with liver disease or assessing the suitability of prescribed medication.
UKMI Q and A
What pharmacokinetic and pharmacodynamic factors need to be considered when prescribing drugs for patients with liver disease
(via SPS website) / Open access / Useful Q and A written by specialists on medication use in patients with liver disease. Helpful when deciding on choice of medication for a patient with liver disease or assessing the suitability of prescribed medication.
Most of the General references above may also be helpful depending on what you’re asked.
Palliative care
Name / My username and password / Top tipsPalliative Care Formulary
(subscription needed) / Advice on drug selection, dosage and compatibility in syringes.
Palliative Adult Network Guidelines / Open access / Provides data on mixing some combinations of drugs in syringe drivers. Useful opioid dose conversion information.
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 tipsNational Poisons Information Service
0344 892 0111 / Open access / Acute poisoning should be dealt with by the Poisons Information service. The enquirer should be told to contact the service directly.
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 tipsUK Teratology Information Service
(TOXBASE) / Free but requires registration / Detailed monographs on the safety of medication and chemicals in pregnancy, intended for use by healthcare professionals.
BUMPS (best use of medicines in pregnancy) / This page provides publicly available summaries of the risks of many drugs in pregnancy (BUMPS leaflets). These are written for members of the public (ideally provided with support from a HCP).
Drugs During Pregnancy and Lactation (Schaefer) / Online access to this e-book may be available in your Health Board (via ClinicalKey). The paper version may be available.
Psychiatry
Name / My username and password / Top tipsThe Maudsley Prescribing Guidelines in Psychiatry / This is a helpful guide to clinical problem-solving, and your Health Board 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 tipseMC / 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 tipsTDM 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 Health Board.
[Last updated: 07 December 2017]