documentation:vocabulary:drug
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documentation:vocabulary:drug [2016/06/13 05:22] cgreich |
documentation:vocabulary:drug [2021/10/23 08:00] adavydov |
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| The drug exposure domain concepts capture records about the utilization of a Drug when ingested or otherwise introduced into the body. A Drug is a biochemical substance formulated in such a way that when administered to a Person it will exert a certain physiological or biochemical effect. The following products are **not** considered Drugs, but Devices: | The drug exposure domain concepts capture records about the utilization of a Drug when ingested or otherwise introduced into the body. A Drug is a biochemical substance formulated in such a way that when administered to a Person it will exert a certain physiological or biochemical effect. The following products are **not** considered Drugs, but Devices: | ||
| - | * Radiopharmaceuticals | + | * Diagnostic radiopharmaceuticals. |
| - | * Contrast material for imaging | + | * Contrast material for imaging (barium sulfate, gadolinium, etc.). |
| - | * Nutritional products and supplements, including baby formula. In reality that results in the slightly arbitrary and in some cases difficult to ascertain situation that solutions of salts for parental use are Drugs (hydrating patients and maintaining ionic balance), while the addition of nutrients such as glucose or vitamins makes them devices (feeding patients). | + | * Nutritional products and supplements, including infant feeding. In reality that results in the slightly arbitrary and in some cases difficult to ascertain situation that solutions of salts are Drugs (hydrating patients and maintaining ionic balance), while the addition of nutrients such as glucose or vitamins makes them devices (feeding patients). |
| - | * Products directly derived from blood (e.g. erythocytes or plasma) | + | * Parenteral nutrition (aminoacids and/or lipid mixes). |
| + | * Solution for dialysis, catheter maintenance etc. | ||
| + | * Products directly derived from blood (erythrocytes, plasma, serum, thrombocytes), while immune globin or albumin preparations, monoclonal antibodies, coagulation factors and homeopathy derived from blood are Drugs. | ||
| + | * Transplants of any kind. | ||
| + | * Artificial saliva, artificial tears, and lubricants. | ||
| + | * Non-medicated cosmetics (creams, ointments, soaps, deodorants, shampoos), including SPF sunscreens. | ||
| + | * Glucometric strips, needles, tubes with anticoagulants, etc. | ||
| + | * Surgical materials like bone cement. | ||
| + | * Hemostatics materials (cellulose, flour, collagen, etc.). | ||
| + | * Disinfectants for inert surfaces. | ||
| + | |||
| + | **Devices that contain drug substances (e.g. bone cement with antibiotics) are considered Devices, but should obtain additional mapping to the Drug Domain concepts.** | ||
| Drug domain Concepts should be used in the drug_concept_id of the DRUG_EXPOSURE the DRUG_ERA and the DOSE_ERA (both only at the Ingredient level) tables, or in the value_as_concept_id field of the OBSERVATION or MEASUREMENT table (e.g. for Measurements like "Plasma level"). | Drug domain Concepts should be used in the drug_concept_id of the DRUG_EXPOSURE the DRUG_ERA and the DOSE_ERA (both only at the Ingredient level) tables, or in the value_as_concept_id field of the OBSERVATION or MEASUREMENT table (e.g. for Measurements like "Plasma level"). | ||
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| |ET|Dose Form Entry Term|Not implemented| | |ET|Dose Form Entry Term|Not implemented| | ||
| - | Concepts of the Concept Classses "Clinical Drug" and "Branded Drug" (SCD and SBD) of liquid formuations have drug strength provided as concentrations. These often exist in pairs -- with the total quantity provided or not. RxNorm does not represent this distinction using different Term Types, however, we defined addtional Concept Classes "Quantified Clincal Drug" and "Quantified Branded Drug" for those drugs where a quantity factor is provided. | + | Concepts of the Concept Classses "Clinical Drug" and "Branded Drug" (SCD and SBD) of liquid formulations have their drug strength provided as concentrations, with or without the total quantity provided. That means, many of them exist in pairs. RxNorm does not represent this distinction using different Term Types, however, we defined addtional Concept Classes "Quantified Clincal Drug" and "Quantified Branded Drug" for those drugs where a quantity factor is provided. |
| In addition to the RxNorm-derived Concept Classes, international coding schemes brake drugs down according to their package or box size. This is due to the fact that prescription drugs are generally sold as prepackaged products, while most prescription drugs in the US get packaged at the time of the prescription filling in the pharmacy. Note, that these boxes are different from the RxNorm packs. Packs represent the smallest unit of drug product combinations, while boxes define the total amount of units sold as a product. In addition to boxes, international coding scheme also distinguish products of different manufacturers or resellers (suppliers). To make those coding schemes work seamlessly with the RxNorm system, additional Concept Classes were defined in the RxNorm Extension vocabulary: | In addition to the RxNorm-derived Concept Classes, international coding schemes brake drugs down according to their package or box size. This is due to the fact that prescription drugs are generally sold as prepackaged products, while most prescription drugs in the US get packaged at the time of the prescription filling in the pharmacy. Note, that these boxes are different from the RxNorm packs. Packs represent the smallest unit of drug product combinations, while boxes define the total amount of units sold as a product. In addition to boxes, international coding scheme also distinguish products of different manufacturers or resellers (suppliers). To make those coding schemes work seamlessly with the RxNorm system, additional Concept Classes were defined in the RxNorm Extension vocabulary: | ||
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| ^Vocab^Name^Ingre dient^Drug strength^Dose form^Brand name^Quantity factor^Box size^Pack content ^Supplier^ | ^Vocab^Name^Ingre dient^Drug strength^Dose form^Brand name^Quantity factor^Box size^Pack content ^Supplier^ | ||
| ^RxNorm|Ingredient| x | | | | | | | | | ^RxNorm|Ingredient| x | | | | | | | | | ||
| - | ^:::|Brand Name| | | | x | | | | | | ||
| ^:::|Clinical Drug Component| x | x | | | | | | | | ^:::|Clinical Drug Component| x | x | | | | | | | | ||
| ^:::|Clinical Drug Form| x | | x | | | | | | | ^:::|Clinical Drug Form| x | | x | | | | | | | ||
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| ^:::|Branded Pack Box| x | x | x | x | | x | | | | ^:::|Branded Pack Box| x | x | x | x | | x | | | | ||
| ^:::|Marketed Product| x | x | x |optional|optional|optional|optional| x | | ^:::|Marketed Product| x | x | x |optional|optional|optional|optional| x | | ||
| + | |||
| + | This system of Concept Classes is fully normalized. I.e. that for each defined, say, Branded Drug there are the equivalent Clinical Drug, Clinical Drug Component, Branded Drug Component, Clinical Drug Form and Branded Drug Form available. For combination drugs with several Ingredients equivalent combinations are defined in the same manner. **Note** that the latter is not true for Clinical Drug Components. These only exist as single-ingredient Concepts. The reason for this is not discussed in the technical documentation by RxNorm. Ingredients are only defined as single Ingredients, RxNorm's MIN (Multiple Ingredients) are not implemented. | ||
| ==== Relationships ==== | ==== Relationships ==== | ||
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| * One-to-one mappings to all other Concept Classes | * One-to-one mappings to all other Concept Classes | ||
| - | The internal relationships between Drug Concepts are derived from RxNorm relatinships and extended to incorporate the additional Concept Classes: | + | The internal relationships between Drug Concepts are derived from RxNorm relatinships and extended to cover the additional Concept Classes of the RxNorm Extension vocabulary ("Drug" without any attribute means either "Clinical" or "Branded"): |
| ^Source^Original name^relatinship_id^Connecting Concept Classes^ | ^Source^Original name^relatinship_id^Connecting Concept Classes^ | ||
| - | |RxNorm|consists_of|Consists of|Drug and Quantified Drug and Drug Component| | + | |RxNorm|consists_of|Consists of|Drug or Quantified Drug and Drug Component| |
| |:::|constitutes|Constitutes|Drug Component and Drug or Quantified Drug| | |:::|constitutes|Constitutes|Drug Component and Drug or Quantified Drug| | ||
| |:::|contained_in|Contained in|Drug or Quantified Drug and Pack| | |:::|contained_in|Contained in|Drug or Quantified Drug and Pack| | ||
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| |:::|has_tradename|Has tradename|Clinical and Branded Concept Class equivalents| | |:::|has_tradename|Has tradename|Clinical and Branded Concept Class equivalents| | ||
| |:::|has_tradename|Has brand name|Ingredient and Brand Name| | |:::|has_tradename|Has brand name|Ingredient and Brand Name| | ||
| - | |:::|ingredient_of|RxNorm ing of|Between Ingredient and Clinical Drug Form/Component, and Brand Name and Branded Drug Form/Component. Not implemented between Branded Drug and Brand Name| | + | |:::|ingredient_of|RxNorm ing of|Ingredient and Clinical Drug Form/Component, and Brand Name and Branded Drug Form/Component. Not implemented between Branded Drug and Brand Name| |
| |:::|inverse_isa|RxNorm inverse is a|Drug Form and Drug| | |:::|inverse_isa|RxNorm inverse is a|Drug Form and Drug| | ||
| |:::|isa|RxNorm is a|Drug and Drug Form| | |:::|isa|RxNorm is a|Drug and Drug Form| | ||
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| |:::|tradename_of|Tradename of|Branded and Clinical Concept Class equivalents| | |:::|tradename_of|Tradename of|Branded and Clinical Concept Class equivalents| | ||
| |:::|tradename_of|Brand name of|Brand Name and Ingredient| | |:::|tradename_of|Brand name of|Brand Name and Ingredient| | ||
| - | |:::| - |Concept replaced by|Records in RXNATOMARCHIVE with merged_to_rxcui information| | + | |:::| - |Concept replaced by|Concepts in RXNATOMARCHIVE with merged_to_rxcui information| |
| - | |:::| - |Concept replaces|Records in RXNATOMARCHIVE with merged_to_rxcui information| | + | |:::| - |Concept replaces|Concepts in RXNATOMARCHIVE with merged_to_rxcui information| |
| |RxNorm Extension| - |Available as box|Drug and Drug Box| | |RxNorm Extension| - |Available as box|Drug and Drug Box| | ||
| |:::| - |Box of|Drug Box and Drug| | |:::| - |Box of|Drug Box and Drug| | ||
| |:::| - |Has marketed form|Drug and Marketed Product| | |:::| - |Has marketed form|Drug and Marketed Product| | ||
| |:::| - |Marketed form of|Marketed Product and Drug| | |:::| - |Marketed form of|Marketed Product and Drug| | ||
| + | |:::| - |Has supplier|Drug and Supplier| | ||
| + | |:::| - |Supplier of|Supplier and Drug| | ||
| + | For a discussion of the relationships between Drugs and Classifications and within Classifications please see the individual vocabulary sections. | ||
| + | ==== Drug Strength ==== | ||
| + | The Drug Domain has an additional DRUG_STRENGTH table defining the strength of each ingredient. This is defined for all Drug Concept Classes except Ingredient, Clinical Drug Form and Branded Drug Form, Dose Form, Brand Name and Supplier. | ||
documentation/vocabulary/drug.txt · Last modified: 2021/10/23 08:00 by adavydov
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