Medicationrequest0317.xml

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

<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="medrx0317"/>
    <text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: medrx0317</p><p><b>contained</b>: </p><p><b>identifier</b>: 12345689 (OFFICIAL)</p><p><b>status</b>: completed</p><p><b>stage</b>: original-order <span>(Details : {[not stated] code 'original-order' = 'original-order)</span></p><p><b>medication</b>: id: med0303; Alemtuzumab 10mg/ml (Lemtrada) <span>(Details : {RxNorm code '1594660' = '1594660', given as 'Alemtuzumab 10mg/ml (Lemtrada)'})</span></p><p><b>patient</b>: <a>Donald Duck</a></p><p><b>dateWritten</b>: 15/01/2015</p><p><b>requester</b>: <a>Patrick Pump</a></p><p><b>reasonCode</b>: Chronic Lymphoid Leukemia (disorder) <span>(Details : {SNOMED CT code '92814006' = 'Chronic lymphoid leukaemia, disease', given as
           'Chronic Lymphoid Leukemia (disorder)'})</span></p><p><b>dosageInstruction</b>: , , </p></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 10mg/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"/>
    <stage>
        <coding>
            <code value="original-order"/>
        </coding>
    </stage>
    <medicationReference>
        <reference value="#med0303"/>
    </medicationReference>
    <patient>
        <!--    Linked to the resource patient who needs the medication    -->
        <reference value="Patient/pat1"/>
        <display value="Donald Duck"/>
    </patient>
    <dateWritten value="2015-01-15"/>
    <requester>
        <reference value="Practitioner/f007"/>
        <display value="Patrick Pump"/>
    </requester>
    <reasonCode>
        <coding>
            <system value="http://snomed.info/sct"/>
            <code value="92814006"/>
            <display value="Chronic Lymphoid Leukemia (disorder)"/>
        </coding>
    </reasonCode>
    <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"/>
        <additionalInstructions>
            <text value="Rapidly increase dose until tolerated"/>
        </additionalInstructions>
        <additionalInstructions>
            <text value="Administer on alternate days"/>
        </additionalInstructions>
        <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 (qualifier value)"/>
            </coding>
        </route>
        <method>
            <coding>
                <system value="http://snomed.info/sct"/>
                <code value="422145002"/>
                <display value="Inject - dosing instruction imperative (qualifier value)"/>
            </coding>
        </method>
        <doseQuantity>
            <value value="3"/>
            <unit value="mg"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="mg"/>
        </doseQuantity>
    </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"/>
        <additionalInstructions>
            <text value="Rapidly increase dose until tolerated"/>
        </additionalInstructions>
        <additionalInstructions>
        <text value="Administer on alternate days"/>
        </additionalInstructions>
        <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 (qualifier value)"/>
            </coding>
        </route>
        <method>
            <coding>
                <system value="http://snomed.info/sct"/>
                <code value="422145002"/>
                <display value="Inject - dosing instruction imperative (qualifier value)"/>
            </coding>
        </method>
        <doseQuantity>
            <value value="10"/>
            <unit value="mg"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="mg"/>
        </doseQuantity>
    </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"/>
        <additionalInstructions>
            <text value="Rapidly increase dose until tolerated"/>
        </additionalInstructions>
        <additionalInstructions>
        <text value="Administer on alternate days"/>
        </additionalInstructions>
        <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 (qualifier value)"/>
            </coding>
        </route>
        <method>
            <coding>
                <system value="http://snomed.info/sct"/>
                <code value="422145002"/>
                <display value="Inject - dosing instruction imperative (qualifier value)"/>
            </coding>
        </method>
        <doseQuantity>
            <value value="30"/>
            <unit value="mg"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="mg"/>
        </doseQuantity>
    </dosageInstruction>
</MedicationRequest>