Medication reconciliation

Discussion in 'Synapse' started by Graham, Jan 9, 2011.

  1. Graham

    Graham Developer Staff Member

    I'm not prescribing necessarily ... I'm documenting. There's a difference.
    And I prefer to use branded drugs .. and not some generic where the bioavailability differs by 10% from batch to batch.

    Jerry, would you do a movie to show us how quick your favs work for you?
  2. Graham

    Graham Developer Staff Member

    next you'll be asking to only show syrups for patients with MND .. just not a priority.
  3. Graham

    Graham Developer Staff Member

    I don't think it's feasible to remember hundreds of shortcuts .. so maybe it's best to just use the drug name as the shortcut. Currently if Synapse can't find the typed name in the shortcuts, it then looks in the other database eg. RxTerms or whatever.

    If it finds the shortcut, you then have a selection of prescriptions to choose from.
  4. Graham

    Graham Developer Staff Member

    I know it sounds a good idea to match a drug to a diagnosis, but it's an extra step that I don't think is worthwhile.

    Do you really want to indicate which drug you prescribe is for what diagnosis??
  5. Jason

    Jason Developer / Handyman Staff Member

    It isn't feasible.

    It's not an extra step if the shortcut for the drug includes the predominant use for it.
    I think it is good for the patients to know what the drugs are for.
    I want a medication list on the portal.

    For insurance purposes, don't American MDs have to tie a drug to a ICD diagnosis ?
  6. Jason

    Jason Developer / Handyman Staff Member

    if the drugs were categorized, you might be able to have an ORDER to the medication List ... such as:
    group all the cardiac drugs
    group all the diabetes drugs
    group all the mood drugs
  7. Graham

    Graham Developer Staff Member

    If we link the RxCUI to the ATC code, we don't need to do this .. it's done already.
  8. Jason

    Jason Developer / Handyman Staff Member

    what's ATC code ?
  9. Graham

    Graham Developer Staff Member

    The Anatomical Therapeutic Chemical (ATC) Classification System is used for the classification of drugs. It is controlled by the WHO Collaborating Centre for Drug Statistics Methodology (WHOCC), and was first published in 1976.[1]
    The classification system divides drugs into different groups according to the organ or system on which they act and/or their therapeutic and chemical characteristics. Each bottom-level ATC code stands for a pharmaceutically used substance in a single indication (or use). This means that one drug can have more than one code: acetylsalicylic acid (aspirin), for example, has A01AD05 as a drug for local oral treatment, B01AC06 as a platelet inhibitor, and N02BA01 as an analgesic and antipyretic. On the other hand, several different brands share the same code if they have the same active substance and indications.


    Attached Files:

  10. Jason

    Jason Developer / Handyman Staff Member

    Do the RXCUIs map automatically to the ATC classification ?
    Is that readily available ?

    Prescribing fast and codified is priority #1. Having some LOGICAL grouping sure would add some icing on the cake.

  11. Jason

    Jason Developer / Handyman Staff Member

    Categories ... More common for Primary Care.

    • C Cardiovascular system
    • M Musculo-skeletal system (NSAIDS,
    • N Nervous system
    • J Antiinfectives for systemic use
    • G Genito-urinary system and sex hormones
    • A Alimentary tract and metabolism

    Less Common:
    • D Dermatologicals
    • R Respiratory system
    • H Systemic hormonal preparations, excluding sex hormones and insulins
    • S Sensory organs
    Not as often:
    • B Blood and blood forming organs
    • L Antineoplastic and immunomodulating agents
    • P Antiparasitic products, insecticides and repellents
    • V Various

    Gastrointestinal tract/metabolism (A)
    stomach acid (Antacids, H2 antagonists, Proton pump inhibitors) • Antiemetics • Laxatives • Antidiarrhoeals/Antipropulsives • Anti-obesity drugs • Anti-diabetics • Vitamins • Dietary minerals

    Blood and blood forming organs (B)
    Antithrombotics (Antiplatelets, Anticoagulants, Thrombolytics/fibrinolytics) • Antihemorrhagics (Platelets, Coagulants, Antifibrinolytics)

    Cardiovascular system (C)
    cardiac therapy/antianginals (Cardiac glycosides, Antiarrhythmics, Cardiac stimulants)
    Antihypertensives • Diuretics • Vasodilators • Beta blockers • Calcium channel blockers • renin-angiotensin system (ACE inhibitors, Angiotensin II receptor antagonists, Renin inhibitors)
    Antihyperlipidemics (Statins, Fibrates, Bile acid sequestrants)

    Skin (D)
    Emollients • Cicatrizants • Antipruritics • Antipsoriatics • Medicated dressings

    Genitourinary system (G)
    Hormonal contraception • Fertility agents • SERMs • Sex hormones

    Endocrine system (H)
    Hypothalamic-pituitary hormones • Corticosteroids (Glucocorticoids, Mineralocorticoids) • Sex hormones • Thyroid hormones/Antithyroid agents

    Infections and infestations (J, P, QI)
    Antimicrobials: Antibacterials (Antimycobacterials) • Antifungals • Antivirals • Antiparasitics (Antiprotozoals, Anthelmintics, Ectoparasiticides) • IVIG • Vaccines

    Malignant disease (L01-L02)
    Anticancer agents (Antimetabolites, Alkylating, Spindle poisons, Antineoplastic, Topoisomerase inhibitors)

    Immune disease (L03-L04)
    Immunomodulators (Immunostimulants, Immunosuppressants)

    Muscles, bones, and joints (M)
    Anabolic steroids • Anti-inflammatories (NSAIDs) • Antirheumatics • Corticosteroids • Muscle relaxants • Bisphosphonates

    Brain and nervous system (N)
    Analgesics • Anesthetics (General, Local) • Anorectics • Anti-ADHD Agents • Antiaddictives • Anticonvulsants • Antidementia Agents • Antidepressants • Antimigraine Agents • Antiparkinson's Agents • Antipsychotics • Anxiolytics • Depressants • Entactogens • Entheogens • Euphoriants • Hallucinogens (Psychedelics, Dissociatives, Deliriants) • Hypnotics/Sedatives • Mood Stabilizers • Neuroprotectives • Nootropics • Neurotoxins • Orexigenics • Serenics • Stimulants • Wakefulness-Promoting Agents

    Respiratory system (R)
    Decongestants • Bronchodilators • Cough medicines • H1 antagonists

    Sensory organs (S)
    Ophthalmologicals • Otologicals

    Other ATC (V)
    Antidotes • Contrast media • Radiopharmaceuticals • Dressings
  12. Graham

    Graham Developer Staff Member

    Part of the work I did for drug interactions was to map RxCUI to ATC.

    Eventually that work will find its way across.
  13. Jerry

    Jerry Administrator Staff Member

    Graham, so would it be hard to filter a user's RXCUIs by ATC?
  14. Graham

    Graham Developer Staff Member

    It would have to be a web service I think ...

    In the meantime I have sped up the adding of medications by using F2 to save drug choices ...
  15. Graham

    Graham Developer Staff Member

  16. Graham

    Graham Developer Staff Member

    Now I have the Ajax working on all three phases .. so now to work on getting the CSS right.
  17. Jason

    Jason Developer / Handyman Staff Member

    Tried to see your progress but the Guest Guest Login for the portal doesn't seem to work.
  18. Graham

    Graham Developer Staff Member

    That's what the movies are for! :p

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