Information entered in order to make a drug interaction request.
Sequence Number (required) | The order in which the drug pair relate the two options are 1 or 2. |
Request Assigned To (optional) | Who the request is assigned. |
Interaction Description (required) | Description of the interaction. What the two pair of drugs causing the interaction. |
Severity Level Code (required) | The level of severity. |
Monograph ID (optional) | The Professional Monograph ID associated with the drug interaction pair. |
Clinical Effect Code 1 (required) | Clinical effect code |
Clinical Effect Code 2 (optional) | Clinical effect code |
EDI Number (optional) | The severity level from the Evaluations of Drug Interactions (EDI) system. |
EDI Text (optional) | The interaction text found in EDI. |
DI Facts Number (optional) | Severity number of interaction found in DI Facts. |
DI Facts Onset (optional) | The onset of the interaction as found in DI facts. |
DI Facts Severity (optional) | The severity level of the interaction found in DI facts. |
DI Facts Documentation (optional) | Documentation of the interaction found in the DI Facts. |
DI Facts Text (optional) | The text of the interaction from DI facts. |
Micromedex Severity (optional) | The severity found in Micromedex. |
Micromedex Onset (optional) | The onset of the interaction as found in MicoMedex. |
Micromedex Substantiation (optional) | Level of documentation of the interaction found in the Micromedex. |
Micromedex Text (optional) | If the interaction is found in Micromedex record the text. A summary is acceptable. |
Medline Hits (optional) | Is the interaction documented in the literature? |
Medline Text (optional) | Brief description of literature results. |
Package Insert (optional) | Is the interaction found in the package insert. |
Package Insert Text (optional) | Text information related to the package insert. |
PBM Criteria (optional) | Is the interaction documented in PBM criteria for use. |
PBM Criteria Text (optional) | Text information related to PBM criteria. |
Aids Guidelines (optional) | A dropdown list to select. |
Aids Guidelines Text (optional) | Text information for Aids guideline. |
Interaction Source (optional) | Source of the original request. |
Interaction Type (optional) | What type of interact Pharmacokinetic or Pharmacodynamic. |
Highest Level of Evidence (optional) | Highest evidence from which information was derived such as case report, clinical trial, normal volunteer or etc. |
Group Discussion (optional) | General comment from meeting. |
Current Action Reason (optional) | Reason for change |