Request for Intravenous Chemotherapy (inpatient order) - Alemtuzumab - completed with multiple dosageInstruction lines (id = "medrx0317")

<?xml version="1.0" encoding="UTF-8"?>

<MedicationRequest xmlns="http://hl7.org/fhir">
  <id value="medrx0317"/> 
  <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> 
  <identifier> 
    <use value="official"/> 
    <system value="http://www.bmc.nl/portal/prescriptions"/> 
    <value value="12345689"/> 
  </identifier> 
  <status value="completed"/> 
  <intent value="order"/> 
  <medication> 
    <reference> 
      <reference value="#med0303"/> 
    </reference> 
  </medication> 
  <subject> 
    <!--   Linked to the resource patient who needs the medication   -->
    <reference value="Patient/pat1"/> 
    <display value="Donald Duck"/> 
  </subject> 
  <authoredOn value="2015-01-15"/> 
  <requester> 
    <reference value="Practitioner/f007"/> 
    <display value="Patrick Pump"/> 
  </requester> 
  <reason> 
    <concept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="92814006"/> 
        <display value="Chronic lymphoid leukemia, disease (disorder)"/> 
      </coding> 
    </concept> 
  </reason> 
  <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="ordered"/> 
          <display value="Ordered"/> 
        </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="ordered"/> 
          <display value="Ordered"/> 
        </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="ordered"/> 
          <display value="Ordered"/> 
        </coding> 
      </type> 
      <doseQuantity> 
        <value value="30"/> 
        <unit value="mg"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="mg"/> 
      </doseQuantity> 
    </doseAndRate> 
  </dosageInstruction> 


</

MedicationRequest

>