mediQ.ch User guide for the mediQ interaction program

1. www.mediQ.chUser guide for the mediQ interaction program

2. Welcome Page: Structure and Elements • The Logo with link on the welcome page • All about mediQ • Link to the registration form, information about subscription types and prices • The latest interaction puzzle to test your knowledge • Link to screenshots and presentations • Search field and other tools • More about mediQ • The latest news

3. Login instructions • Type here your Username and Password and click Anmelden.Please note that this is capital sensitive! • Not registered yet?Click Neuer Benutzer and enter your details on the registration form that will pop up. Also choose the type of license that you want. You will receive an automatic e-mail from the mediQ team that the entry data area accepted. Following that you are able to login.

4. Start page following login: Elements • This button leads to the Interaction Check • The main chapters • The latest comments on combinations • Other new information, for example substances (active treatment ingredients, food and drinks, etceteras. • Links for Help functions, screenshots and tips • Your username and settings

5. Interaction-Check: the entry form • Combine here Substances, Trade names and genetic polymorphisms • Enter the first letters of the substances, trade name, or polymorphism in the corresponding search field till the searched name is marked in the list. • Add your choice by clicking ENTER or click the button „Einfügen“. • When your combination is complete click the button „Jetzt checken“; the program will now search the required information.

6. Interaction-Check: results (1) • Links: change request or start a new search and a link to mail this specific page • List with links to requested substances • Link to show all trade names of products that contain one or more of the combined substances • Overview of all combinations, where the coloured boxes indicate the strength of a possible interaction: gray = strength 0 (no interaction expected) yellow = strength 1 orange = strength 2 red = strength 3 (strong interaction)

7. Interaction-Check: results (2) • Information on the substances:N, L, Q, K ... • ... Definitions N = Dose adjustment with renal insufficiency L = Dose adjustment with liver insufficiency Q = This substance is known to prolong the QT- time K = This substance can lower the convulsion threshold • This combination has not yet been described by mediQ; as part of the online consulting services, you can request the missing description. Please use the contact form.

8. Interaction-Check: results (3) • All comments of the requested combinations are listed below the table • You are able to sort the comments by interaction strength. Click one time on „IA-Stärke“ to list the weaker interactions; a second click shows the stronger interactions on top. • Click the title of a comment to retrieve the complete information. • This link brings you to the individual descriptions of the substances.

9. An example of a combination comment: Metoprolol and Paroxetine • As described on the previous page, you can click on the title of a combination comment; In this example you get the following information: • Title of the comment and the substances in the combination. • You can list all products that contain one or both substances • The strength of the interaction: in this example red (strength 3 of 3)

10. An example of a combination comment: Metoprolol and Paroxetine • Description and main text • Links to scientific publications • Links to the prescriber’s information of several countries

11. Interaction-Check: Results – Metabolism and Transport paths • Listing of the CYP450 interactions between the combined elements (rough estimation) • Information on the metabolism and transport paths and the ways the combined elements influence each other Example: Paroxetine causes a plasma level increase of Metoprolol (affected substance). Example: Paroxetine is mainly metabolised by CYP2D6 („is a substrate of“) und inhibits this enzyme at the same time strongly.

12. Chapter „Substances“ • List of active substances, food and lifestyle substances as well as herbal medication. • Search field: enter the first letters of the substance you are looking for and press the search button; you can also click on one of the capitals below this field, which will show all substances starting with this letter. • The substances are in alphabetical order; click on the name of a substance to get the detailed description. • Links to therapeutic classes.

13. Example of a substance: paroxetine (1) • The name of the substance with synonyms (when available). • Basic information: half-life, reference plasma level, QT- prolongation, pregnancy category, etceteras. • Here you can list all medication that contain paroxetine. • Main description with links to scientific literature and prescriber’s information.

14. Example of a substance: paroxetine (2) • Information about the metabolism and modulating effects. • When you click on the Info button, you will get links to scientific source information. • Listing of all combination comments that have been described so far for Paroxetine. The comments are in alphabetical order,…. • ... However, you can sort them by strength of the interaction: Click on „IA-Stärke“ (one time to start with the weaker interactions, at a second click to start with the stronger interactions. Example: Paroxetine is a strong inhibitor of CYP2B6, but is not metabolized by this enzyme (it is not a substrate of CYP2B6).

15. Chapter „Medications“ • Here are the medical products listed (trade names) that are available in Switzerland, Germany or Austria. • Search field: enter the first letters of the medication you are looking for and press the search button; you can also click on one of the capitals below this field, which will show all medications starting with this letter. • The medicines are listed in alphabetical order; click on the name of a product to get the detailed description. • Links to therapeutic classes and active substances.

16. Example of a medication: Tramal • Name of the medication. • Basic information: therapeutic class(es) and active substance(s). • Main description with links to galenic forms. • Composition of the product and other information including links to the prescriber’s information of the different countries.

17. Chapter „Genetics“ • In this chapter you find a listing of genetic polymorphisms. • Search field: Enter the first few letters of the genetic polymorphism that you are looking for and click the ‚search‘ button; alternatively you can click on one of the letters below to find all polymorphisms starting with that letter. • The genetic polymorphisms are in alphabetical order; click on one of the names to find the full description.

18. Example of a genetic polymorphism: CYP2D6 Poor Metabolizer • Name of the genetic polymorphism with synonyms. • Description and details. • Information regarding inhibiting or inducing action. • List of all the combination comments that have been made so far about this specific genetic polymorphism. • Links to substance descriptions.

19. Chapter „Therapeutic Classes“ • In this chapter you find a listing of therapeutic classes. • Search field: Enter the first few letters of the therapeutic class that you are looking for and click the ‚search‘ button; alternatively you can click on one of the letters below to find all therapeutic classes starting with that letter. • The therapeutic classes are in alphabetical order; click on one of the names to find the full description.

20. Example of a therapeutic class • Name of the class • Here you find all substances that belong to the chosen therapeutic class. Click on a substance to get the full description. • This lists all medical products containing one of the substances. Click on a product to view all information.

21. Chapter „Enzymes und Transport proteins“ • In this chapter you find a listing of enzymes and transport proteins. • Search field: Enter the first few letters of the enzyme or transport protein that you are looking for and click the ‚search‘ button; alternatively you can click on one of the letters below to find all enzymes or transport proteins starting with that letter. • When you search for a specific type, you can choose this here.

22. Chapter „Enzymes und Transport proteins“ • The listing is in alphabetical order; click on one of the names to find the full description. • This column shows the type of the enzyme of transport protein.

23. An example of an Enzyme: CYP 1A2 • Name of the enzyme • Basic information: enzyme type • Description and most important text with links to scientific publications. • Listing of all substances that are either metabolized by this enzyme or inhibit or induce it. • Links to relevant substances.

24. Chapter „Neurotransmitters and Receptors“ • In this chapter you find a listing of neurotransmitters and receptors. • Search field: Enter the first few letters of the neurotransmitters or receptors that you are looking for and click the ‚search‘ button; alternatively you can click on one of the letters below to find all neurotransmitters and receptors starting with that letter. • When you search for a specific type, you can choose this here.

25. Chapter „Neurotransmitters and Receptors“ • The listing of the neurotransmitters and receptors is in alphabetical order; click on a name to view the description. • This column shows the receptor type.

26. Example of a Receptor: 5-HT1B • Name of the receptor • Basic information: Receptor type • Description and main text • Substances that have a affinity to this receptor • Description of the action on the neurotransmitter system (agonistic/ antagonistic) • Links to the relevant substances

27. Chapter „Scientific Comments on Specific Combinations “ • In this chapter you find all scientific comments on combinations of treatments.. • Search field: Enter the first few letters of the substance for which you want to list the comments that you are looking for and click the ‚search‘ button; alternatively you can click on one of the letters below to find all comments starting with that letter. • When you search for a specific comment relating to a strength of an interaction, you can search that here (for example type only moderate interactions).

28. Chapter „Scientific Comments on Specific Combinations “ • The scientific comments on combinations are listed in alphabetical order of the first substance in the title. Click on the title to view the entire text. • Links to relevant substances and genetic polymorphisms.

29. Chapter „Glossary/ Documentation“ • In this chapter you find definitions and explanations of medical scientific terminology. • Search field: enter the first letters of the term you are looking for and press the search button; you can also click on one of the capitals below this field, which will show all terms starting with this letter. • The terms are listed in alphabetical order; Click on the term to get the detailed description.

30. Example of the Glossary: Bio-availability • Description and main text… • ...with several links to other glossary terms (marked in color)

31. „HELP!?“ • On this page you find help functions for several topics and items,….. • ... For example what to do with an error message • Click on „mehr lesen“ to view the entire text.

32. Chapter „mediQ – Info's and Services“ • Overall information on the interaction program, description of the special patient consultation hours: • Consultation hours for pharmacological problems • Consultation hours for early recognition of psychosis • Several other links, for example: „Test your interaction knowledge“, „Latest news“ or „Information-sources“ and also a link the contact form or to the price list

33. Contact mediQ – Qualitätszentrum für Medikamentensicherheit & Diagnostik Psychiatrische Dienste Aargau AG Klinik Königsfelden Postfach 432 CH-5201 Brugg Tel. +41 / (0)56 462 27 69 Fax +41 / (0)56 462 27 66 mediQ@mediQ.ch www.mediQ.ch