Medicationrequest0317.json

Request for Intravenous Chemotherapy (inpatient order) - Alemtuzumab - completed with multiple dosageInstruction lines

{
  "resourceType": "MedicationRequest",
  "id": "medrx0317",
  "text": {
    "status": "generated",
    "div": "<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>intent</b>: order</p><p><b>medication</b>: id: med0303; Alemtuzumab 10mg/ml (Lemtrada) <span>(Details : {RxNorm code '1594660' = 'alemtuzumab 10 MG/ML [Lemtrada]', given as 'Alemtuzumab 10mg/ml (Lemtrada)'})</span></p><p><b>subject</b>: <a>Donald Duck</a></p><p><b>authoredOn</b>: Jan 15, 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 leukemia', given as 'Chronic Lymphoid Leukemia (disorder)'})</span></p><p><b>dosageInstruction</b>: , , </p></div>"
  },
  "contained": [
    {
      "resourceType": "Medication",
      "id": "med0303",
      "code": {
        "coding": [
          {
            "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code": "1594660",
            "display": "Alemtuzumab 10mg/ml (Lemtrada)"
          }
        ]
      }
    }
  ],
  "identifier": [
    {
      "use": "official",
      "system": "http://www.bmc.nl/portal/prescriptions",
      "value": "12345689"
    }
  ],
  "status": "completed",
  "intent": "order",
  "medicationReference": {
    "reference": "#med0303"
  },
  "subject": {
    "reference": "Patient/pat1",
    "display": "Donald Duck"
  },
  "authoredOn": "2015-01-15",
  "requester": {
    "reference": "Practitioner/f007",
    "display": "Patrick Pump"
  },
  "reasonCode": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "92814006",
          "display": "Chronic Lymphoid Leukemia (disorder)"
        }
      ]
    }
  ],
  "dosageInstruction": [
    {
      "sequence": 1,
      "text": "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",
      "additionalInstruction": [
        {
          "text": "Rapidly increase dose until tolerated"
        },
        {
          "text": "Administer on alternate days"
        }
      ],
      "timing": {
        "repeat": {
          "duration": 12,
          "durationUnit": "wk",
          "frequency": 3,
          "period": 1,
          "periodUnit": "wk"
        }
      },
      "route": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "47625008",
            "display": "Intravenous route (qualifier value)"
          }
        ]
      },
      "method": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "422145002",
            "display": "Inject - dosing instruction imperative (qualifier value)"
          }
        ]
      },
      "doseAndRate": [
        {
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                "code": "ordered",
                "display": "Ordered"
              }
            ]
          },
          "doseQuantity": {
            "value": 3,
            "unit": "mg",
            "system": "http://unitsofmeasure.org",
            "code": "mg"
          }
        }
      ]
    },
    {
      "sequence": 2,
      "text": "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",
      "additionalInstruction": [
        {
          "text": "Rapidly increase dose until tolerated"
        },
        {
          "text": "Administer on alternate days"
        }
      ],
      "timing": {
        "repeat": {
          "duration": 12,
          "durationUnit": "wk",
          "frequency": 3,
          "period": 1,
          "periodUnit": "wk"
        }
      },
      "route": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "47625008",
            "display": "Intravenous route (qualifier value)"
          }
        ]
      },
      "method": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "422145002",
            "display": "Inject - dosing instruction imperative (qualifier value)"
          }
        ]
      },
      "doseAndRate": [
        {
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                "code": "ordered",
                "display": "Ordered"
              }
            ]
          },
          "doseQuantity": {
            "value": 10,
            "unit": "mg",
            "system": "http://unitsofmeasure.org",
            "code": "mg"
          }
        }
      ]
    },
    {
      "sequence": 3,
      "text": "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",
      "additionalInstruction": [
        {
          "text": "Rapidly increase dose until tolerated"
        },
        {
          "text": "Administer on alternate days"
        }
      ],
      "timing": {
        "repeat": {
          "duration": 12,
          "durationUnit": "wk",
          "frequency": 3,
          "period": 1,
          "periodUnit": "wk"
        }
      },
      "route": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "47625008",
            "display": "Intravenous route (qualifier value)"
          }
        ]
      },
      "method": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "422145002",
            "display": "Inject - dosing instruction imperative (qualifier value)"
          }
        ]
      },
      "doseAndRate": [
        {
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                "code": "ordered",
                "display": "Ordered"
              }
            ]
          },
          "doseQuantity": {
            "value": 30,
            "unit": "mg",
            "system": "http://unitsofmeasure.org",
            "code": "mg"
          }
        }
      ]
    }
  ]
}