Some US PDR Info "Risks Patients' Lives"

10 February 1997

Information in the US Physician's Desk Reference often containstreatment information that is inadequate, incorrect or outdated for managing cases of medication overdose, and this could risk patients' lives, say researchers at the University of California at San Francisco, who are part of the new California Poison Control System based at the UCSF-affiliated San Francisco General Hospital.

After reviewing PDR text for the 20 drugs most commonly linked with death due to overdose, they found serious discrepancies between PDR information and current recommendations of several widely-accepted toxicology references. Also, the PDR often does not advise doctors of treatments that could be life-saving or that could be harmful, and offers information that is as much as 25 years out of date, said study lead author, Walter Mullen. The PDR was deficient in its treatment guidelines for 16 of the 20 drugs checked.

One example quoted was the treatment for an overdose of the antidepressant Elavil (amitriptyline). The PDR recommends patients be given physostigmine, which Mr Mullen says was abandoned years ago as an antidote because it was found to increase the risk of death in these cases. The currently-recommended Elavil overdose treatment is sodium bicarbonate, which is not recommended in the PDR.

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