Genomics Reporting Implementation Guide, published by HL7 International / Clinical Genomics. This guide is not an authorized publication; it is the continuous build for version 3.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/genomics-reporting/ and changes regularly. See the Directory of published versions
<Observation xmlns="http://hl7.org/fhir">
<id value="TxImp05"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Poor metabolizer of Amitriptyline</div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact">
<valueRelatedArtifact>
<type value="citation"/>
<url
value="https://cpicpgx.org/guidelines/guideline-for-tricyclic-antidepressants-and-cyp2d6-and-cyp2c19/"/>
</valueRelatedArtifact>
</extension>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="GE"/>
</coding>
</category>
<code>
<coding>
<system
value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
<code value="therapeutic-implication"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/CGPatientExample01"/>
</subject>
<effectiveDateTime value="2019-04-01"/>
<performer>🔗
<reference value="Organization/ExampleOrg"/>
</performer>
<derivedFrom>🔗
<reference value="Observation/Pgx-geno-1001"/>
</derivedFrom>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="51963-7"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="704"/>
<display value="amitriptyline"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
<code value="therapeutic-implication"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA9657-3"/>
<display value="Poor metabolizer"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
<code value="conclusion-string"/>
</coding>
</code>
<valueString
value="For amitriptyline, a 50% reduction in starting dose is recommended with therapeutic drug monitoring to guide dose adjustment. Refer to current guidelines for dosage and recommendations at https://cpicpgx.org/guidelines/guideline-for- tricyclic-antidepressants-and-cyp2d6-and-cyp2c19/. If CYP2D6 genotyping is available, refer to the current guidelines for dosing recommendations."/>
</component>
</Observation>