Form:DrugProjectForm01: Difference between revisions
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Gerald Chi (talk | contribs) mNo edit summary |
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__NOTOC__ | __NOTOC__ | ||
<noinclude>{{#forminput:form=DrugProjectForm01|size=50|button text=Create/Edit A Drug Page}}</noinclude><includeonly>{{{for template| | <noinclude>{{#forminput:form=DrugProjectForm01|size=50|button text=Create/Edit A Drug Page}}</noinclude><includeonly>{{{for template|DrugProjectFormSinglePage01}}} | ||
{|class="infobox" style="width: 100%; background: #DCDCDC; border-radius: 10px 10px 10px 10px;" | {|class="infobox" style="width: 100%; background: #DCDCDC; border-radius: 10px 10px 10px 10px;" | ||
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Instructions | | style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Instructions | ||
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | ||
* Is this an '''over-the-counter''' medicine? | * Is this an '''over-the-counter''' medicine? | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|OTC|input type=dropdown|values=,Yes}}} | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|OTC|input type=dropdown|values=,Yes}}} | ||
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* Please indicate the '''class''' to which the drug belongs: | * Please indicate the '''class''' to which the drug belongs: | ||
:* Search with the generic name at [http://druginfo.nlm.nih.gov/drugportal/ Drug Information Portal] | :* Search with the generic name at [http://druginfo.nlm.nih.gov/drugportal/ Drug Information Portal] | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|aOrAn|input type=dropdown|values=a,an}}}<BR>{{{field|drugClass|input type=text}}} | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|aOrAn|input type=dropdown|values=a,an}}}<BR>{{{field|drugClass|input type=text}}} | ||
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* Please describe the '''indications''' approved by the FDA: | * Please describe the '''indications''' approved by the FDA: | ||
:* Check the "Indications and Usage" section from the label | :* Check the "Indications and Usage" section from the label | ||
:* Fit the context: ''(Drug name)'' is ''(a/an)'' ''(category a, category b, and category c)'' that is FDA approved for the treatment/prophylaxis/diagnosis/procedure of ''(indication a, indication b, and indication c)''. | :* Fit the context: ''(Drug name)'' is ''(a/an)'' ''(category a, category b, and category c)'' that is FDA approved for the treatment/prophylaxis/diagnosis/procedure of ''(indication a, indication b, and indication c)''. | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|indicationType|input type=dropdown|values=treatment,prophylaxis,diagnosis,procedure}}}<BR>{{{field|indication|input type=textarea|size=40|editor|editor}}} | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|indicationType|input type=dropdown|values=treatment,prophylaxis,diagnosis,procedure}}}<BR>{{{field|indication|input type=textarea|size=40|editor|editor}}} | ||
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | ||
* Is there a '''black box warning''' associated with the drug? | * Is there a '''black box warning''' associated with the drug? | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|hasBlackBoxWarning|input type=dropdown|values=,Yes}}} | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|hasBlackBoxWarning|input type=dropdown|values=,Yes}}} | ||
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:* Collect adverse reactions from the "Highlights of Prescribing Information" section | :* Collect adverse reactions from the "Highlights of Prescribing Information" section | ||
:* Fit the context: Common adverse reactions include ''(reaction a, reaction b, and reaction c)''. | :* Fit the context: Common adverse reactions include ''(reaction a, reaction b, and reaction c)''. | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|adverseReactions|input type=textarea}}} | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|adverseReactions|input type=textarea}}} | ||
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | ||
* Please enter the '''title''' of the '''black box warning''': | * Please enter the '''title''' of the '''black box warning''': | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|blackBoxWarningTitle|input type=textarea | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|blackBoxWarningTitle|input type=textarea}}} | ||
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | ||
* Please enter the '''body''' of the '''black box warning''': | * Please enter the '''body''' of the '''black box warning''': | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|blackBoxWarningBody|input type=textarea | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|blackBoxWarningBody|input type=textarea}}} | ||
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| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Adult Indications and Dosage | | style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Adult Indications and Dosage | ||
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | ||
* Please enter information related to the '''FDA pregnancy category''': | * Please enter information related to the '''FDA pregnancy category''': | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInPregnancyFDA|input type=textarea}}} | ||
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | ||
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | ||
* Please enter information related to the '''structure''': | * Please enter information related to the '''structure''': | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|structure|input type=textarea | : <div style="font-size: 50%;"><nowiki>[[File:{{PAGENAME}}01.png|thumb|none|600px|This image is provided by the National Library of Medicine.]]</nowiki></div> | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|structure|input type=textarea}}} | |||
}}} | |||
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | ||
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* Please enter information pertaining to '''how the drug is supplied''': | * Please enter information pertaining to '''how the drug is supplied''': | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|howSupplied|input type=textarea}}} | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|howSupplied|input type=textarea}}} | ||
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| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Patient Counseling Information | | style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Patient Counseling Information | ||
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | | style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | | ||
* Please enter the '''Package and Label Display Panel''' here: | * Please enter the '''Package and Label Display Panel''' here: | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field| | : <div style="font-size: 50%;"><nowiki>[[File:XXXXX.png|thumb|none|400px|This image is provided by the National Library of Medicine.]]</nowiki></div> | ||
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|packLabel|input type=textarea}}} | |||
}}} | |||
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|}{{{end template}}} | |}{{{end template}}} |