Online Edition | Washington State University | Pullman, Washington | Friday, February 8, 2001

Drug Information Center 
prepares better pharmacists, 
while strengthening region’s 
health-care community
By Rod Foss, WSU Today

Quick! Try to answer the following questions:

• What is the bioequivalence of the various diltiazem formulations?

• Do the various flu vaccines contain bisulfites?

• What can be used to treat severe pain in a patient with a pinched spinal nerve and adverse reactions to various opioid analgesics?

Good grief! Answering cartoonist Larson’s classic question, "What’s the average rainfall of the Amazon basin" would be easier.

But these are the kinds of questions the staff and pharmacy students research and answer at the Drug Information Center in the College of Pharmacy, WSU Spokane.

A service and a school
The College of Pharmacy founded the center in 1973 in Pullman. In 1988, it moved to the 12th floor of the WSU Spokane building downtown. Today the center is in a quiet, spacious L-shaped room — three times bigger than the downtown location — on the second floor of the new Health Science Building (HSB). Seven PCs, linked to the Internet and online databases, and bookcases loaded with hardbacks and periodicals serve as the reference tools.

The center, which is consultative rather than authoritative, specializes in answering questions about drugs and diseases, informing pharmacists, physicians, nurses and other health-care professionals. And it is not just an information service bureau. It is the site of a six-week rotation elective, where fourth-year pharmacy students, like Anh Tran and Tyson Henderson, get real-world experience doing much of the research for callers. Graduates face a variety of career options, but Tran and Henderson both hope to be community pharmacists.

"Each day is rewarding," says Danial Baker, Pharm.D., director of the center since 1983. "The information we provide to the health professionals directly influences the care of their patients and provides an educational experience for students."

Students in the third year of the doctor of pharmacy program will relocate to the college’s Spokane location in the fall of 2002. Drug information pharmacist Terri Levien, Pharm.D, says this "increases opportunities for our students to have greater contact with practitioners in the community and to be employed in the field. This move would not be possible without the new HSB and the Riverpoint campus."

Caller ID?
The center does not advertise itself, yet it averages 3,300 requests per year (about 13 per day).

So who’s doing the asking?

WSU alumni know of the place, as do the local hospitals, pharmacies and the Washington State Pharmacists Association. Word gets around, and referrals happen, says Levien. Most callers are Washington state pharmacists, physicians and nurses, or WSU health-care alumni from around the country.

Levien says the center has received calls from as far away as Hawaii and Alaska. She even got a call from an alum in the military who was aboard ship off the coast of Japan. However, out-of-state calls are getting fewer, since most states are setting up their own information centers.

Levien says they serve anyone looking for help, but don’t want to make a habit of handling public calls.

A potpourri of information
Scientific mind-benders aren’t the only types of questions the center handles. Baker and his staff dig up information on adverse reactions to drugs, drug interactions and interference, compatibilities/incompatibilities, parameters of drugs, identification of foreign drugs (and U.S. comparables) and stability (how long will a compound last once mixed). Identifying unknown capsules and tablets by code and color is a common task.

Baker, a professor in pharmacotherapy, and Levien, a clinical assistant professor in pharmacotherapy, are qualified to advise, confirm or comment on drug therapy and doses. They can offer opinions on whether a patient’s symptoms are drug related.

Many callers want information on a drug mentioned in the news media, or they want to know what the FDA is doing with particular drugs. The Internet has made that much easier, Baker said. He starts his day monitoring news media for drug reports, which are indicators of the type of questions the center may get.

And while the incoming requests are serious and can be complex, the center remains low pressure, even on a hectic day, because most questions don’t require, or can’t get, an immediate answer. Most are I’ll-get-back-to-you situations.

The environment is educational, not like a high-pressure telephone service center, says Baker. "Answers come from a team effort."

Levien agrees. "This is research education," she says. "We’re not Poison Control."

Reluctance for the quick answer is understandable, considering the necessary process to produce desired results. This procedure is typical for researching a problem related to a patient’s drug therapy:

1. Get caller and request information.

2. Get the details of the case. This includes patient history and data, and a maze of specifics on the drug therapy.

3. Conduct a systematic search. This is a hierarchical procedure going from basic to specific texts in the reference materials.

4. Formulate a response that ensures the statements and conclusions are accurate and verifiable with referenced literature.

Dollars and cents
WSU does not support the center directly. However, Baker notes that the library system and services provide indirect support, especially through electronic access to full-text journals. Without the WSU library, the center could not complete its mission, Baker asserts.

The center is primarily funded by the College of Pharmacy as a teaching laboratory and support center for WSU students and teachers. Gifts and contracts provide additional funding.

The center is also a consultant to the Washington State Department of Social and Health Services Medical Assistance Administration’s Drug Utilization and Education Council. It charges a fee for services to lawyers and insurance companies.

Other fish to fry
Baker and Levien have their hands full.

Running the center is only part of Baker’s job with WSU. He has charge of the pharmacy continuing education program, serves as vice chair of the department of pharmacy practice, and teaches in the classroom.

Both he and Levien contribute to the body of drug knowledge. They write reviews and evaluations for "The Formulary Monograph Service" each month. During the past five years, they have published over 600 articles and monographs in various pharmacy databases, textbooks, and pharmacy and medical journals. They serve as reviewers on several editorial boards.

And if one of the six-week rotation blocks happens to be devoid of students, Levien handles calls and research. But she is content with her career; the center is a goal fulfillment.

Baker is also attached to center, not surprising after 19 years of service. "The center provides me a direct opportunity to be involved with patient care and to provide lots of one-on-one teaching of our students," he says.

"The center has come a very long way," reflects Baker. "It provides essential information to various health care practitioners to help improve the care of their patients. Its activities influence the decision process of some governmental agencies and health care plans. And most importantly, it serves as a teaching laboratory, where the mission of this world-class university is accomplished by giving face-to-face instruction to our students and by serving the citizens of the state."

With all that expertise, one would think they could research a way to cover up the nasty taste of most medicines. How about Hershey’s chocolate syrup?

Levien’s eyes light up. "Hershey’s works just great," she grins. Hmm…