Overdose advice

I read with interest the findings of the study published recently in CMAJ1 examining the quality of poison management information in the 2001 edition of the Compendium of Pharmaceuticals and Specialties (CPS).2 As a member of the CPS editorial advisory panel, I am familiar with the process by which the content of product monographs is determined. This is pertinent to understanding the appropriate use of the information contained in those monographs.

The product monographs, which are printed in the white section of CPS, are created by drug manufacturers and approved by Health Canada, and the Canadian Pharmacists Association (CPhA) has no authority to change or update their content. It is incumbent on pharmaceutical manufacturers to update their own monographs and to apply for approval of the changes; alternatively, such changes can be requested by Health Canada.

As mentioned by the authors,1 one step that the CPhA has taken to augment this resource is to provide its own evidence-based drug monographs, written by staff pharmacists and reviewed by a panel of expert Canadian physicians and pharmacists. Some of these cover single drugs, whereas others cover drug classes. These more general monographs are printed on grey pages to differentiate them from the manufacturers' product monographs. The content of the CPhA-generated monographs, including the overdose treatment section, is owned by CPhA and is regularly reviewed and updated. Contact information for poison control centres is also listed in the CPS (in the yellow pages).

CPhA recognizes that product monographs may not be the best source of poison management information. Therefore, CPhA is working with the Canadian Association of Poison Control Centres to explore other ways of improving the quality of advice about overdoses contained within CPS. In the interim, however, physicians treating patients with a suspected drug overdose, especially for a drug with which they are unfamiliar, should contact the local poison centre to ensure that the care they are initiating is optimal.

David W. Johnson Associate Professor Departments of Pediatrics and of Pharmacology and Therapeutics Calgary, Alta.