Drug-drug interaction between prescription and medication statement
{
"resourceType" : "DetectedIssue",
"id" : "ddi",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Severity: High</b> - Risk of internal bleeding</p>\n <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>\n <ul>\n <li><a href=\"MedicationStatement/tylenol\">500 mg Acetaminophen tablet 1/day, PRN since 2010</a></li>\n <li><a href=\"MedicationRequest/warfarin\">Warfarin 1 MG TAB prescribed Jan. 5, 2014</a></li>\n </ul>\n <p>Mitigation: Jan 5, 2014 by Dr. Adam Careful: </p>\n <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>\n </div>"
},
"status" : "final",
"category" : [{
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "DRG",
"display" : "Drug Interaction Alert"
}]
}],
"code" : {
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "DRG",
"display" : "Drug Interaction Alert"
}]
},
"severity" : "high",
"subject" : {
"reference" : "Device/example"
},
"identifiedDateTime" : "2014-01-05",
"implicated" : [{
"reference" : "MedicationStatement/example001",
"display" : "500 mg Acetaminophen tablet 1/day, PRN since 2010"
},
{
"reference" : "MedicationRequest/medrx0331",
"display" : "Warfarin 1 MG TAB prescribed Jan. 15, 2015"
}],
"detail" : "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" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "13",
"display" : "Stopped Concurrent Therapy"
}],
"text" : "Asked patient to discontinue regular use of Tylenol and to consult with clinician if they need to resume to allow appropriate INR monitoring"
},
"date" : "2014-01-05",
"author" : {
"reference" : "Practitioner/example",
"display" : "Dr. Adam Careful"
}
}]
}
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.