On-call information resources

Last updated: Wednesday, June 12, 2024

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 providing a convenient list and drawing attention to their potential value if you have access. Some of these websites require log ins and passwords. You can download a Word version of this list which allows you to record your log ins/passwords or add other local information if you want to.

We will keep these links up-to-date, but please contact us if any are broken or if there are additional sites that you think should be included. The sites below are free to access unless indicated otherwise.

In addition to the links below, your Trust's guidelines should be accessible to you when on-call. Also, if you have an MI centre at your hospital you may find it helpful to arrange for access to MiDatabank, the database that archives all the clinical enquiries that have been answered.

General references

• BNF - quick, concise and useful answers for many problems.
• emc and MHRA - SmPCs are good for a range of problems including dose, administration, adverse reactions and interactions.
• Martindale - subscription needed. Use for doses, adverse effects, and identifying foreign medicines. Contains 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 marketing authorisations (‘product 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 - helpful evidence-based summaries of the treatment of common medical conditions.
• Specialist Pharmacy Service - has guidance about various clinical subjects and information about items left out of the fridge. This site hosts NHS England supply shortage information, but you'll need to create a free account to access this.
• Trip Pro Medical Database - free to access on NHS computers. A database of evidence-based medicine that includes systematic reviews, guidelines and regulatory documents. You can filter the results by country/continent (e.g. only UK or European guidelines).
• UpToDate – subscription required but some Trusts subscribe so check if you have access. North American database of evidence-based medicine where the authors will sometimes share their practice in areas where studies are lacking.

Administration of medicines

• Handbook of Drug Administration via Enteral Feeding Tubes - subscription needed. Use for questions about patients with enteral feeding tubes, but also has information regarding interactions with feeds. You have free access to this via the RPS website if you are a member.
• 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.
• emc and MHRA - for SmPC advice on injection methods, dilution, preparation, and dose.
• Injectable Medicines Guide ('Medusa') - useful for most aspects of administering injectable medicines.
• UKCPA Minimum Infusion Volume guide - for guidance on administering parenteral medicines to fluid restricted patients.
• UCKPA Handbook of Perioperative Medicines - for guidance on managing medicines around surgery.

Breastfeeding

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

• Specialist Pharmacy Service (SPS) 
• Lactmed - note this is an American site.

Children

There are a few sources that provide quick, concise and useful information for most clinical problems involving children:

• BNF-C 
• Evelina London Paediatric Formulary (formerly Guy's and St Thomas's Formulary) - registration is required but access is free. This is local guidance from the Evelina Children's Hospital in London.
• Medicines for Children - this is aimed at parents/carers but can be useful on-call as it has practical information on how to administer medicines to children.
• The Neonatal Formulary is 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

• Injectable Drug Information  (ASHP) - subscription needed. Use for advice about mixing in same line, bag or syringe. Note it is an American resource so formulations may differ to those used in the UK.
• Drug Compatibility Checker - subscription needed. Provides data on mixing medicines in syringe drivers and at Y-sites etc.
• Andrew Dickman and Jennifer Schneider’s book The Syringe Driver is available in paper form not online. Has information about mixing medicines in syringe drivers.

Interactions

• emc and MHRA – for SmPC advice on potential interactions but may not give information on the clinical significance or how to manage a patient - 
• Stockley's Drug Interactions - subscription needed. Gives advice on managing interactions and their clinical importance.
• HIV Interactions Checker, Hepatitis Interactions Checker and COVID-19 Drug Interactions Checker - valuable sites from the University of Liverpool. Also has some information on crushing these medicines in the 'Prescribing Resources' sections
• Most of the General references, above, may also be helpful depending on what you're asked.

Liver

• emc and MHRA - SmPCs may give data on dose adjustment in liver disease and/or notable hepatic side effects.
• Livertox - information on drug-induced liver disease and its management; indexed by name of medicine, herbal product, street drug etc. An American site.
• Medicines Learning Portal; Medicines and the liver - scroll down to the section on prescribing in liver disease to guide your decision-making if ask about the choice of a medicine in a patient with liver disease.
• Most of the General references, above, may also be helpful depending on what you're asked.

Mental health

• The Maudsley Prescribing Guidelines in Psychiatry is a helpful guide to clinical problem-solving, and your Trust may have a paper copy or access to the e-book. It is also available to NHS staff via the NHS Knowledge and Library Hub (you will need an OpenAthens account).
• Psychotropic Drug Directory (Stephen Bazire) - subscription needed. A valuable resource covering all aspects of the use of medicines in psychiatry. 

Palliative care

• Palliative Care Formulary - subscription needed. Covers the management of many conditions and prescribing in special patient groups.
• Andrew Dickman and Jennifer Schneider’s book The Syringe Driver is available in paper form not online. Has information about mixing medicines in syringe drivers.

Poisoning

• Pharmacists are not experts on poisonings, and you should normally ask the person contacting you to ring the National Poisons Information Service themselves.
• Toxbase - free but registration required. 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:

• UK Teratology Information Service - this page provides publicly available summaries of the risks of many drugs in pregnancy, but for more detailed information you will need to log in. 
• Drugs in Pregnancy and Lactation ('Briggs') - subscription needed. Your Trust may have online access to this via e.g. the publisher.

Renal

• emc and MHRA - SmPCs may give data on dose adjustment in renal disease and/or notable renal side effects.
• Renal Drug Database - subscription needed. May offer advice on dosing in renal disease if the SmPC cannot help. Remember that the advice may differ to the SmPC which means it may be unlicensed.
• Most of the General references, above, can also be helpful depending on what you're asked.