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Example MedicationDispense/meddisp0306 (XML)

Pharmacy Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Encounter, Patient, Practitioner

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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"/> 
    <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: MedicationDispense</b> <a name="meddisp0306"> </a> <a name="hcmeddisp0306"> </a> </p> <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">Resource MedicationDispense &quot;meddisp0306&quot; </p> </div> <p> <b> status</b> : in-progress</p> <h3> Medications</h3> <table class="grid"><tr> <td style="display: none">-</td> <td> <b> Reference</b> </td> </tr> <tr> <td style="display: none">*</td> <td> <a name="hcmed0303"> </a> <blockquote> <p/>  <p> <a name="med0303"> </a> </p> <p> <a name="hcmed0303"> </a> </p> <p> <b> code</b> : alemtuzumab 10 MG/ML [Lemtrada] <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-rxNorm.html">RxNorm</a> #1594660)</span> </p> </blockquote> </td> </tr> </table> <p> <b> subject</b> : <a href="patient-example-a.html">Patient/pat1: Donald Duck</a>  &quot;Donald DUCK&quot;</p> <h3> Performers</h3> <table class="grid"><tr> <td style="display: none">-</td> <td> <b> Actor</b> </td> </tr> <tr> <td style="display: none">*</td> <td> <a href="practitioner-example-f006-rvdb.html">Practitioner/f006</a>  &quot;Rob VAN DEN BERK&quot;</td> </tr> </table> <p> <b> authorizingPrescription</b> : <a href="medicationrequest0317.html">MedicationRequest/medrx0317</a> </p> <p> <b> type</b> : Daily Fill <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html">ActCode</a> #DF)</span> </p> <p> <b> quantity</b> : 5(unit 415818006 from http://snomed.info/sct)<span style="background: LightGoldenRodYellow"> (Details: SNOMED CT code 415818006 = 'Vial')</span> </p> <p> <b> daysSupply</b> : 7 Day<span style="background: LightGoldenRodYellow"> (Details: UCUM code d = 'd')</span> </p> <p> <b> whenPrepared</b> : 2015-01-15T10:20:00Z</p> <blockquote> <p> <b> dosageInstruction</b> </p> <p> <b> sequence</b> : 1</p> <p> <b> text</b> : 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</p> <p> <b> additionalInstruction</b> : Rapidly increase dose until tolerated <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span> , Administer on alternate days <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span> </p> <p> <b> timing</b> : Duration 12weeks, 3 per 1 weeks</p> <p> <b> route</b> : Intravenous route <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #47625008)</span> </p> <p> <b> method</b> : Inject - dosing instruction imperative (qualifier value) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #422145002)</span> </p> <blockquote> <p> <b> doseAndRate</b> </p> </blockquote> </blockquote> <blockquote> <p> <b> dosageInstruction</b> </p> <p> <b> sequence</b> : 2</p> <p> <b> text</b> : 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</p> <p> <b> additionalInstruction</b> : Rapidly increase dose until tolerated <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span> , Administer on alternate days <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span> </p> <p> <b> timing</b> : Duration 12weeks, 3 per 1 weeks</p> <p> <b> route</b> : Intravenous route <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #47625008)</span> </p> <p> <b> method</b> : Inject - dosing instruction imperative (qualifier value) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #422145002)</span> </p> <blockquote> <p> <b> doseAndRate</b> </p> </blockquote> </blockquote> <blockquote> <p> <b> dosageInstruction</b> </p> <p> <b> sequence</b> : 3</p> <p> <b> text</b> : 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</p> <p> <b> additionalInstruction</b> : Rapidly increase dose until tolerated <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span> , Administer on alternate days <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span> </p> <p> <b> timing</b> : Duration 12weeks, 3 per 1 weeks</p> <p> <b> route</b> : Intravenous route <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #47625008)</span> </p> <p> <b> method</b> : Inject - dosing instruction imperative (qualifier value) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #422145002)</span> </p> <blockquote> <p> <b> doseAndRate</b> </p> </blockquote> </blockquote> <hr/>  <blockquote> <p> <b> Generated Narrative: Medication #med0303</b> <a name="med0303"> </a> <a name="hcmed0303"> </a> </p> <p> <b> code</b> : alemtuzumab 10 MG/ML [Lemtrada] <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-rxNorm.html">RxNorm</a> #1594660)</span> </p> </blockquote> </div> </text> <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> 
            <!--    Linked to a RESOURCE Medication    -->
        <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.