This page is part of the Genetic Reporting Implementation Guide (v1.1.0: STU 2 Ballot 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions
<Observation xmlns="http://hl7.org/fhir">
<id value="TxImp05"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"/>
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<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/TbdCodes therapeutic-implication}">Therapeutic Implication</span></p><p><b>derivedFrom</b>: <a href="Observation-Pgx-geno-1001.html">Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>; <span title="Codes: {http://loinc.org 84413-4}">Genotype display name</span>; effective: 2020-01-01; <span title="Codes: {http://www.ncbi.nlm.nih.gov/clinvar 638797}">CYP2C19*2/*2</span></a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://loinc.org 51963-7}">Medication assessed [ID]</span></p><p><b>value</b>: <span title="Codes: {http://ncimeta.nci.nih.gov C0002600}">amitriptyline</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://loinc.org 53040-2}">Genetic variation's effect on drug metabolism</span></p><p><b>value</b>: <span title="Codes: {http://loinc.org LA9657-3}">Poor metabolizer</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/TbdCodes conclusion-string}">Conclusion text</span></p><p><b>value</b>: For amitriptyline, a 50% reduction in starting dose is recommended with therapeutic drug monitoring to guide dose adjustment. Refer to current guidelines for dosage and recommendations at https://cpicpgx.org/guidelines/guideline-for- tricyclic-antidepressants-and-cyp2d6-and-cyp2c19/. If CYP2D6 genotyping is available, refer to the current guidelines for dosing recommendations.</p></blockquote></div>
</text>
<status value="final"/>
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<code value="laboratory"/>
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<coding>
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value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/TbdCodes"/>
<code value="therapeutic-implication"/>
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<derivedFrom>
<reference value="Observation/Pgx-geno-1001"/>
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<coding>
<system value="http://loinc.org"/>
<code value="51963-7"/>
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<coding>
<system value="http://ncimeta.nci.nih.gov"/>
<code value="C0002600"/>
<display value="amitriptyline"/>
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<component>
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<coding>
<system value="http://loinc.org"/>
<code value="53040-2"/>
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<coding>
<system value="http://loinc.org"/>
<code value="LA9657-3"/>
<display value="Poor metabolizer"/>
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<component>
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<coding>
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value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/TbdCodes"/>
<code value="conclusion-string"/>
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value="For amitriptyline, a 50% reduction in starting dose is recommended with therapeutic drug monitoring to guide dose adjustment. Refer to current guidelines for dosage and recommendations at https://cpicpgx.org/guidelines/guideline-for- tricyclic-antidepressants-and-cyp2d6-and-cyp2c19/. If CYP2D6 genotyping is available, refer to the current guidelines for dosing recommendations."/>
</component>
</Observation>