Medication Scheme Implementation Guide
1.0.0 - draft
Medication Scheme Implementation Guide, published by TEHIK. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TEHIK-EE/ig-ee-medication-scheme/ and changes regularly. See the Directory of published versions
<ClinicalUseDefinition xmlns="http://hl7.org/fhir">
<id value="renal-function-failure"/>
<meta>
<profile
value="https://fhir.ee/StructureDefinition/ee-tis-renal-failure-ds"/>
</meta>
<language value="et"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml" xml:lang="et" lang="et"><p class="res-header-id"><b>Generated Narrative: ClinicalUseDefinition renal-function-failure</b></p><a name="renal-function-failure"> </a><a name="hcrenal-function-failure"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Language: et</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-ee-tis-renal-failure-ds.html">EETISRenalFailureDS</a></p></div><p><b>ExtensionEETISAffectedMedicationStatements</b>: <a href="MedicationStatement-MedicationStatement-metformin.html">MedicationStatement: extension = ,100,2023-11-07,,,Avalik,order,; status = recorded; category = Pidev,Tavaretsept,3-kordne; effective[x] = 2015-02-07 13:28:17-0500 --> (ongoing); note = patsient peaks iga päev veresuhkrut mõõtma</a></p><p><b>ExtensionEETISAdditionalInformationLink</b>: www.synbase.ee/metformin-neerufunktsioon</p><p><b>ExtensionEETISNephrotoxic</b>: false</p><blockquote><p><b>ExtensionEETISDosageModification</b></p><ul><li>dosageIntervalMin: 6</li><li>dosageIntervalMax: 12</li><li>recommendation: Siin on soovitused</li></ul></blockquote><p><b>ExtensionEETISRelatedObservationOrCondition</b>: <a href="Observation-observation-egfr1.html">Observation 62238-1</a></p><p><b>type</b>: Undesirable Effect</p><p><b>category</b>: <span title="Codes:{https://fhir.ee/drug-form-group 2}">Kirjeldus siia text alla, kui on veel vaja midagi lisada</span>, <span title="Codes:{https://fhir.ee/failure-degree 1}">Kirjeldus siia text alla, kui on veel vaja midagi lisada</span>, <span title="Codes:">Kuna vosoritiidi ohutust ja efektiivsust neerukahjustuse korral ei ole hinnatud [(1)],[(2)], ei saa tõenduspõhiseid soovitusi anda. Siiski, tuginedes eliminatsioonimehhanismile, ei mõjuta neerupuudulikkus ilmselt vosoritiidi farmakokineetikat. Vosoritiid on modifitseeritud C-tüüpi natriureetiline peptiid. Vosoritiidi metabolism toimub eeldatavasti kataboolsete radade kaudu ja laguneb väikesteks peptiidideks ja aminohapeteks [(1)], [(2)].</span></p><p><b>subject</b>: <a href="#hcrenal-function-failure/metformin">Medication: extension = metformiin; identifier = https://fhir.ee/CodeSystem/tis-fhir-identifikaatorid#ravimiregister-pakend#123456; doseForm = tablett+õhukese polümeerikattega tablett; totalVolume = 120</a></p><p><b>status</b>: <span title="Codes:">active</span></p><h3>UndesirableEffects</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Classification</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://fhir.ee/synbase-warning-classification C}">Kui on veel vaja midagi lisada</span></td></tr></table><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Medication #metformin</b></p><a name="renal-function-failure/metformin"> </a><a name="hcrenal-function-failure/metformin"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Language: et</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-ee-tis-medication-epc.html">EETISMedicationEPC</a></p></div><p><b>ExtensionEETISMedicinalProductClassification</b>: <span title="Codes:{https://fhir.ee/CodeSystem/atc-ee A10BA02}">metformiin</span></p><p><b>identifier</b>: <code>https://fhir.ee/CodeSystem/tis-fhir-identifikaatorid#ravimiregister-pakend</code>/123456</p><p><b>doseForm</b>: <span title="Codes:{https://fhir.ee/CodeSystem/ravimvormid 1518}">tablett+õhukese polümeerikattega tablett</span></p><p><b>totalVolume</b>: 120</p><blockquote><p><b>ingredient</b></p><h3>Items</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Concept</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://fhir.ee/CodeSystem/toimeained 11354}">metformiin</span></td></tr></table><p><b>isActive</b>: true</p><p><b>strength</b>: 500(unit MG from https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik)<span style="background: LightGoldenRodYellow"> (Details: retsept-mahu-ja-massiyhik codeMG = 'MG')</span>/1(unit TABL from https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik)<span style="background: LightGoldenRodYellow"> (Details: retsept-mahu-ja-massiyhik codeTABL = 'TABLETTI')</span></p></blockquote></blockquote></div>
</text>
<contained>
<Medication>
<id value="metformin"/>
<meta>
<profile
value="https://fhir.ee/StructureDefinition/ee-tis-medication-epc"/>
</meta>
<language value="et"/>
<extension
url="https://fhir.ee/StructureDefinition/ee-tis-medicinal-product-classification">
<valueCodeableConcept>
<coding>
<system value="https://fhir.ee/CodeSystem/atc-ee"/>
<code value="A10BA02"/>
<display value="metformiin"/>
</coding>
</valueCodeableConcept>
</extension>
<identifier>
<system
value="https://fhir.ee/CodeSystem/tis-fhir-identifikaatorid#ravimiregister-pakend"/>
<value value="123456"/>
</identifier>
<doseForm>
<coding>
<system value="https://fhir.ee/CodeSystem/ravimvormid"/>
<code value="1518"/>
<display value="tablett+õhukese polümeerikattega tablett"/>
</coding>
</doseForm>
<totalVolume>
<value value="120"/>
</totalVolume>
<ingredient>
<item>
<concept>
<coding>
<system value="https://fhir.ee/CodeSystem/toimeained"/>
<code value="11354"/>
<display value="metformiin"/>
</coding>
</concept>
</item>
<isActive value="true"/>
<strengthRatio>
<numerator>
<value value="500"/>
<system
value="https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik"/>
<code value="MG"/>
</numerator>
<denominator>
<value value="1"/>
<system
value="https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik"/>
<code value="TABL"/>
</denominator>
</strengthRatio>
</ingredient>
</Medication>
</contained>
<extension
url="https://fhir.ee/StructureDefinition/ee-tis-affected-medication-statements">
<valueReference>🔗
<reference value="MedicationStatement/MedicationStatement-metformin"/>
</valueReference>
</extension>
<extension
url="https://fhir.ee/StructureDefinition/ee-tis-additional-information-link">
<valueString value="www.synbase.ee/metformin-neerufunktsioon"/>
</extension>
<extension url="https://fhir.ee/StructureDefinition/ee-tis-nephrotoxic">
<valueBoolean value="false"/>
</extension>
<extension
url="https://fhir.ee/StructureDefinition/ee-tis-dosage-modification">
<extension url="dosageIntervalMin">
<valueQuantity>
<value value="6"/>
</valueQuantity>
</extension>
<extension url="dosageIntervalMax">
<valueQuantity>
<value value="12"/>
</valueQuantity>
</extension>
<extension url="recommendation">
<valueString value="Siin on soovitused"/>
</extension>
</extension>
<extension
url="https://fhir.ee/StructureDefinition/ee-tis-related-observation-or-condition">
<valueReference>🔗
<reference value="Observation/observation-egfr1"/>
</valueReference>
</extension>
<type value="undesirable-effect"/>
<category>
<coding>
<system value="https://fhir.ee/drug-form-group"/>
<code value="2"/>
<display value="süsteemne"/>
</coding>
<text value="Kirjeldus siia text alla, kui on veel vaja midagi lisada"/>
</category>
<category>
<coding>
<system value="https://fhir.ee/failure-degree"/>
<code value="1"/>
<display value="GFR 30-59 ml/min (mõõdukas neerupuudulikkus)"/>
</coding>
<text value="Kirjeldus siia text alla, kui on veel vaja midagi lisada"/>
</category>
<category>
<text
value="Kuna vosoritiidi ohutust ja efektiivsust neerukahjustuse korral ei ole hinnatud [(1)],[(2)], ei saa tõenduspõhiseid soovitusi anda. Siiski, tuginedes eliminatsioonimehhanismile, ei mõjuta neerupuudulikkus ilmselt vosoritiidi farmakokineetikat. Vosoritiid on modifitseeritud C-tüüpi natriureetiline peptiid. Vosoritiidi metabolism toimub eeldatavasti kataboolsete radade kaudu ja laguneb väikesteks peptiidideks ja aminohapeteks [(1)], [(2)]."/>
</category>
<subject>
<reference value="#metformin"/>
</subject>
<status>
<coding>
<code value="active"/>
</coding>
</status>
<undesirableEffect>
<classification>
<coding>
<system value="https://fhir.ee/synbase-warning-classification"/>
<code value="C"/>
<display value="Annust või annustamise vahemikku tuleb kohandada"/>
</coding>
<text value="Kui on veel vaja midagi lisada"/>
</classification>
</undesirableEffect>
</ClinicalUseDefinition>