Drug-drug interaction between prescription and medication statement (id = "ddi")
<?xml version="1.0" encoding="UTF-8"?>
<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://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="DRG"/>
<display value="Drug Interaction Alert"/>
</coding>
</category>
<code>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="DRG"/>
<display value="Drug Interaction Alert"/>
</coding>
</code>
<severity value="high"/>
<subject>
<reference value="Device/example"/>
</subject>
<identifiedDateTime value="2014-01-05"/>
<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://terminology.hl7.org/CodeSystem/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.