Form:DrugProjectForm: Difference between revisions
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! Please describe which indications the FDA has approved the use of the drug: | ! Please describe which indications the FDA has approved the use of the drug: | ||
| {{{field|indication|input type=textarea|size=35}}} | | {{{field|indication|input type=textarea|size=35|editor|editor}}} | ||
|- | |- | ||
! Is there a Black Box warning associated with the drug?: | ! Is there a Black Box warning associated with the drug?: | ||
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! Please list the most common adverse reactions associate with the drug: | ! Please list the most common adverse reactions associate with the drug: | ||
| {{{field|adverseReactions|input type=textarea|size=35}}} | | {{{field|adverseReactions|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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|- | |- | ||
!Please enter the body of the Black Box Warning | !Please enter the body of the Black Box Warning | ||
|{{{field|blackBoxWarningBody|input type=textarea|editor|size=35|default=''{{fontcolor|#FF0000|Condition Name:}}'' (Content)}}} | |{{{field|blackBoxWarningBody|input type=textarea|editor|size=35|editor|default=''{{fontcolor|#FF0000|Condition Name:}}'' (Content)}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter the FDA-Labeled Indications and Dosage Information for Adults | !Please enter the FDA-Labeled Indications and Dosage Information for Adults | ||
| {{{field|fdaLIADAdult|input type=textarea|size=35|default= <h4>Condition 1</h5> | | {{{field|fdaLIADAdult|input type=textarea|size=35|editor|default= <h4>Condition 1</h5> | ||
* Dosing Information | * Dosing Information | ||
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|- | |- | ||
!Guideline-Supported Use | !Guideline-Supported Use | ||
|{{{field|offLabelAdultGuideSupport|input type=textarea|size=35}}} | |{{{field|offLabelAdultGuideSupport|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Non-Guideline-Supported Use | !Non-Guideline-Supported Use | ||
|{{{field|offLabelAdultNoGuideSupport|input type=textarea|size=35}}} | |{{{field|offLabelAdultNoGuideSupport|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter the FDA-Labeled Indications and Dosage Information for Children | !Please enter the FDA-Labeled Indications and Dosage Information for Children | ||
| {{{field|fdaLIADPed|input type=textarea|size=35}}} | | {{{field|fdaLIADPed|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any established Off-Label Use and Dosage for Children | !Please enter any established Off-Label Use and Dosage for Children | ||
|- | |- | ||
!Guideline-Supported Use | !Guideline-Supported Use | ||
|{{{field|offLabelPedGuideSupport|input type=textarea|size=35}}} | |{{{field|offLabelPedGuideSupport|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Non-Guideline-Supported Use | !Non-Guideline-Supported Use | ||
|{{{field|offLabelPedNoGuideSupport|input type=textarea|size=35}}} | |{{{field|offLabelPedNoGuideSupport|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter the FDA reported contraindications: | !Please enter the FDA reported contraindications: | ||
| {{{field|contraindications|input type=textarea|size=35}}} | | {{{field|contraindications|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter the FDA reported warnings associated with the drug: | !Please enter the FDA reported warnings associated with the drug: | ||
| {{{field|warnings|input type=textarea|size=35}}} | | {{{field|warnings|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter the adverse reactions reported from Clinical Trial Experience | !Please enter the adverse reactions reported from Clinical Trial Experience | ||
| {{{field|clinicalTrials|input type=textarea|size=35}}} | | {{{field|clinicalTrials|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter the adverse reactions reported from Postmarketing Experience | !Please enter the adverse reactions reported from Postmarketing Experience | ||
|{{{field|postmarketing|input type=textarea|size=35}}} | |{{{field|postmarketing|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter the known drug interactions: | !Please enter the known drug interactions: | ||
| {{{field|drugInteractions|input type=textarea|size=35}}} | | {{{field|drugInteractions|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter any information related to the FDA reported pregnancy category | !Please enter any information related to the FDA reported pregnancy category | ||
| {{{field|useInPregnancyFDA|input type=textarea|size=35}}} | | {{{field|useInPregnancyFDA|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the Australian reported pregnancy category | !Please enter any information related to the Australian reported pregnancy category | ||
| {{{field|useInPregnancyAUS|input type=textarea|size=35}}} | | {{{field|useInPregnancyAUS|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the use of the drug during Labor and Delivery | !Please enter any information related to the use of the drug during Labor and Delivery | ||
|{{{field|useInLaborDelivery|input type=textarea|size=35}}} | |{{{field|useInLaborDelivery|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the use of the drug during Nursing | !Please enter any information related to the use of the drug during Nursing | ||
|{{{field|useInNursing|input type=textarea|size=35}}} | |{{{field|useInNursing|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the use of the drug in Pediatrics | !Please enter any information related to the use of the drug in Pediatrics | ||
|{{{field|useInPed|input type=textarea|size=35}}} | |{{{field|useInPed|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the use of the drug in Geriatrics | !Please enter any information related to the use of the drug in Geriatrics | ||
|{{{field|useInGeri|input type=textarea|size=35}}} | |{{{field|useInGeri|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the use of the drug and Gender | !Please enter any information related to the use of the drug and Gender | ||
|{{{field|useInGender|input type=textarea|size=35}}} | |{{{field|useInGender|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the use of the drug and Race | !Please enter any information related to the use of the drug and Race | ||
|{{{field|useInRace|input type=textarea|size=35}}} | |{{{field|useInRace|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the use of the drug in patients with Renal Impairment | !Please enter any information related to the use of the drug in patients with Renal Impairment | ||
|{{{field|useInRenalImpair|input type=textarea|size=35}}} | |{{{field|useInRenalImpair|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the use of the drug in patients with Hepatic Impairment | !Please enter any information related to the use of the drug in patients with Hepatic Impairment | ||
|{{{field|useInHepaticImpair|input type=textarea|size=35}}} | |{{{field|useInHepaticImpair|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the use of the drug in Females of Reproductive Potential and Males | !Please enter any information related to the use of the drug in Females of Reproductive Potential and Males | ||
|{{{field|useInReproPotential|input type=textarea|size=35}}} | |{{{field|useInReproPotential|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the use of the drug in Immunocompromised Patients | !Please enter any information related to the use of the drug in Immunocompromised Patients | ||
|{{{field|useInImmunocomp|input type=textarea|size=35}}} | |{{{field|useInImmunocomp|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Others | !Others | ||
|Title of Section: {{{field|othersTitle|input type=text|size=40}}} | |Title of Section: {{{field|othersTitle|input type=text|size=40}}} | ||
Body: {{{field|useInOthers|input type=textarea|size=35}}} | Body: {{{field|useInOthers|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter information pertaining to drug administration here | !Please enter information pertaining to drug administration here | ||
| {{{field|administration|input type=textarea|size=35}}} | | {{{field|administration|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter information pertaining to the drug monitoring here | !Please enter information pertaining to the drug monitoring here | ||
|{{{field|monitoring|input type=textarea|size=35}}} | |{{{field|monitoring|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter information pertaining to the IV Compatibility here | !Please enter information pertaining to the IV Compatibility here | ||
|{{{field|IVCompat|input type=textarea|size=35}}} | |{{{field|IVCompat|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter information pertaining to the drug Overdose here | !Please enter information pertaining to the drug Overdose here | ||
|{{{field|overdose|input type=textarea|size=35}}} | |{{{field|overdose|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter the DrugBox template in its entirety here: | !Please enter the DrugBox template in its entirety here: | ||
|{{{field|drugBox|input type=textarea|size=35}}} | |{{{field|drugBox|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the Mechanism of Action | !Please enter any information related to the Mechanism of Action | ||
| {{{field|mechAction|input type=textarea|size=35}}} | | {{{field|mechAction|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the Structure | !Please enter any information related to the Structure | ||
| {{{field|structure|input type=textarea|size=35}}} | | {{{field|structure|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the Pharmacodynamics | !Please enter any information related to the Pharmacodynamics | ||
|{{{field|PD|input type=textarea|size=35}}} | |{{{field|PD|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the Pharmacokinetics | !Please enter any information related to the Pharmacokinetics | ||
|{{{field|PK|input type=textarea|size=35}}} | |{{{field|PK|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter any information related to the Nonclinical Toxicology | !Please enter any information related to the Nonclinical Toxicology | ||
|{{{field|nonClinToxic|input type=textarea|size=35}}} | |{{{field|nonClinToxic|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter information pertaining to the Clinical Studies of the drug | !Please enter information pertaining to the Clinical Studies of the drug | ||
|{{{field|clinicalStudies|input type=textarea|size=35}}} | |{{{field|clinicalStudies|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter information pertaining to the How the Drug is Supplied | !Please enter information pertaining to the How the Drug is Supplied | ||
|{{{field|howSupplied|input type=textarea|size=35}}} | |{{{field|howSupplied|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!National Drug Code (NDC): | !National Drug Code (NDC): | ||
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{| | {| | ||
!Please enter information pertaining to the Drug Images here | !Please enter information pertaining to the Drug Images here | ||
|{{{field|drugImages|input type=textarea|size=35}}} | |{{{field|drugImages|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter information pertaining to the FDA Package Label here | !Please enter information pertaining to the FDA Package Label here | ||
|{{{field|packLabel|input type=textarea|size=35}}} | |{{{field|packLabel|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter the FDA Provided Patient Information here | !Please enter the FDA Provided Patient Information here | ||
|{{{field|fdaPatientInfo|input type=textarea|size=35}}} | |{{{field|fdaPatientInfo|input type=textarea|size=35|editor}}} | ||
|- | |- | ||
!Please enter the NLM Provided Patient Information Here | !Please enter the NLM Provided Patient Information Here | ||
|{{{field|nlmPatientInfo|input type=textarea|size=35}}} | |{{{field|nlmPatientInfo|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
=Precautions with Alcohol= | =Precautions with Alcohol= | ||
Please describe any guidelines on the concurrent use of the drug with the consumption of alcohol: | Please describe any guidelines on the concurrent use of the drug with the consumption of alcohol: | ||
{{{field|alcohol|input type=textarea|size=35}}} | {{{field|alcohol|input type=textarea|size=35|editor}}} | ||
=Look-Alike Drug Names= | =Look-Alike Drug Names= | ||
Please enter any drug names that could be confused for the drug whose page is currently being created. | Please enter any drug names that could be confused for the drug whose page is currently being created. | ||
{{{field|lookAlike|input type=textarea|size=35}}} | {{{field|lookAlike|input type=textarea|size=35|editor}}} | ||
=Price= | =Price= | ||
{| | {| | ||
!Please enter the drugs a patient may want to compare for Price | !Please enter the drugs a patient may want to compare for Price | ||
|{{{field|price|input type=textarea|size=35}}} | |{{{field|price|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
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{| | {| | ||
!Please enter information relevant to Drug Shortages | !Please enter information relevant to Drug Shortages | ||
|{{{field|drugShortage|input type=textarea|size=35}}} | |{{{field|drugShortage|input type=textarea|size=35|editor}}} | ||
|} | |} | ||
Revision as of 20:51, 2 April 2014