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(v3.3.0:
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| Clinical Decision Support Work Group | Maturity Level : N/A | Ballot Status : Informative | Compartments : Device , Patient , Practitioner |
Drug-drug interaction between prescription and medication statement (id = "ddi")
<DetectedIssue xmlns="http://hl7.org/fhir"> <id value="ddi"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p> <b> Severity: High</b> - Risk of internal bleeding</p> <p> Those who take acetaminophen along with the widely used blood-thinning drug warfarin may face the risk of serious internal bleeding. People on warfarin who take acetaminophen for at least seven days in a row should be closely watched for bleeding.</p> <ul> <li> <a href="MedicationStatement/tylenol">500 mg Acetaminophen tablet 1/day, PRN since 2010</a> </li> <li> <a href="MedicationRequest/warfarin">Warfarin 1 MG TAB prescribed Jan. 5, 2014</a> </li> </ul> <p> Mitigation: Jan 5, 2014 by Dr. Adam Careful: </p> <p> Asked patient to discontinue regular use of Tylenol and to consult with clinician if they need to resume to allow appropriate INR monitoring</p> </div> </text> <status value="final"/> <category> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="DRG"/> <display value="Drug Interaction Alert"/> </coding> </category> <severity value="high"/> <date value="2014-01-05"/> <author> <reference value="Device/software"/> </author> <implicated> <reference value="MedicationStatement/example001"/> <display value="500 mg Acetaminophen tablet 1/day, PRN since 2010"/> </implicated> <implicated> <reference value="MedicationRequest/medrx0331"/> <display value="Warfarin 1 MG TAB prescribed Jan. 15, 2015"/> </implicated> <detail value="Risk of internal bleeding. Those who take acetaminophen along with the widely used blood-thinning drug warfarin may face the risk of serious internal bleeding. People on warfarin who take acetaminophen for at least seven days in a row should be closely watched for bleeding."/> <mitigation> <action> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="13"/> <display value="Stopped Concurrent Therapy"/> </coding> <text value="Asked patient to discontinue regular use of Tylenol and to consult with clinician if they need to resume to allow appropriate INR monitoring"/> </action> <date value="2014-01-05"/> <author> <reference value="Practitioner/example"/> <display value="Dr. Adam Careful"/> </author> </mitigation> </ DetectedIssue >
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.