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Dispense for Intravenous Chemotherapy (inpatient order) - Alemtuzumab (RxNorm Code) - completed with multiple dosageInstruction lines (id = "meddisp0306")
<?xml version="1.0" encoding="UTF-8"?>
<MedicationDispense xmlns="http://hl7.org/fhir">
<id value="meddisp0306"/>
<contained>
<Medication>
<id value="med0303"/>
<code>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="1594660"/>
<display value="alemtuzumab 10 MG/ML [Lemtrada]"/>
</coding>
</code>
</Medication>
</contained>
<status value="in-progress"/>
<medication>
<reference>
<reference value="#med0303"/>
<display value="alemtuzumab 10 MG/ML [Lemtrada]"/>
</reference>
</medication>
<subject>
<reference value="Patient/pat1"/>
<display value="Donald Duck"/>
</subject>
<performer>
<actor>
<reference value="Practitioner/f006"/>
</actor>
</performer>
<authorizingPrescription>
<reference value="MedicationRequest/medrx0317"/>
</authorizingPrescription>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="DF"/>
<display value="Daily Fill"/>
</coding>
</type>
<quantity>
<value value="5"/>
<system value="http://snomed.info/sct"/>
<code value="415818006"/>
</quantity>
<daysSupply>
<value value="7"/>
<unit value="Day"/>
<system value="http://unitsofmeasure.org"/>
<code value="d"/>
</daysSupply>
<whenPrepared value="2015-01-15T10:20:00Z"/>
<dosageInstruction>
<sequence value="1"/>
<text value="Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to
the recommended maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate
days for up to 12 wk"/>
<additionalInstruction>
<text value="Rapidly increase dose until tolerated"/>
</additionalInstruction>
<additionalInstruction>
<text value="Administer on alternate days"/>
</additionalInstruction>
<timing>
<repeat>
<duration value="12"/>
<durationUnit value="wk"/>
<frequency value="3"/>
<period value="1"/>
<periodUnit value="wk"/>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="47625008"/>
<display value="Intravenous route"/>
</coding>
</route>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="422145002"/>
<display value="Inject - dosing instruction imperative (qualifier value)"/>
</coding>
</method>
<doseAndRate>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/>
<code value="calculated"/>
<display value="Calculated"/>
</coding>
</type>
<doseQuantity>
<value value="3"/>
<unit value="mg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mg"/>
</doseQuantity>
</doseAndRate>
</dosageInstruction>
<dosageInstruction>
<sequence value="2"/>
<text value="Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to
the recommended maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate
days for up to 12 wk"/>
<additionalInstruction>
<text value="Rapidly increase dose until tolerated"/>
</additionalInstruction>
<additionalInstruction>
<text value="Administer on alternate days"/>
</additionalInstruction>
<timing>
<repeat>
<duration value="12"/>
<durationUnit value="wk"/>
<frequency value="3"/>
<period value="1"/>
<periodUnit value="wk"/>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="47625008"/>
<display value="Intravenous route"/>
</coding>
</route>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="422145002"/>
<display value="Inject - dosing instruction imperative (qualifier value)"/>
</coding>
</method>
<doseAndRate>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/>
<code value="calculated"/>
<display value="Calculated"/>
</coding>
</type>
<doseQuantity>
<value value="10"/>
<unit value="mg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mg"/>
</doseQuantity>
</doseAndRate>
</dosageInstruction>
<dosageInstruction>
<sequence value="3"/>
<text value="Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to
the recommended maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate
days for up to 12 wk"/>
<additionalInstruction>
<text value="Rapidly increase dose until tolerated"/>
</additionalInstruction>
<additionalInstruction>
<text value="Administer on alternate days"/>
</additionalInstruction>
<timing>
<repeat>
<duration value="12"/>
<durationUnit value="wk"/>
<frequency value="3"/>
<period value="1"/>
<periodUnit value="wk"/>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="47625008"/>
<display value="Intravenous route"/>
</coding>
</route>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="422145002"/>
<display value="Inject - dosing instruction imperative (qualifier value)"/>
</coding>
</method>
<doseAndRate>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/>
<code value="calculated"/>
<display value="Calculated"/>
</coding>
</type>
<doseQuantity>
<value value="30"/>
<unit value="mg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mg"/>
</doseQuantity>
</doseAndRate>
</dosageInstruction>
</MedicationDispense>
Usage note: every effort has been made to ensure that the
examples are correct and useful, but they are not a normative part
of the specification.
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