Form:DrugProjectForm: Difference between revisions

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{|
{|
| style="width: 50%;" valign=top | Please enter the '''generic name''' here: {{{field|genericName|input type=text| size=40}}}
| style="width: 50%;" valign=top | Please enter the '''generic name''' here:
| style="width: 50%;" valign=top | {{{field|genericName|input type=text| size=40}}}
|-
|-
| style="width: 50%;" valign=top | Please indicate the '''class''' to which the drug belongs {{{field|aOrAn|input type=dropdown|values=a,an}}}:<BR><SMALL>
| style="width: 50%;" valign=top | Please indicate the '''class''' to which the drug belongs {{{field|aOrAn|input type=dropdown|values=a,an}}}:<BR><SMALL>
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{|
{|
| style="width: 50%;" valign=top | Please enter the '''title''' of the Black Box Warning
| style="width: 50%;" valign=top | Please enter the '''title''' of the Black Box warning:
| style="width: 50%;" valign=top | {{{field|blackBoxWarningTitle|input type=textarea|editor|size=40|default='''{{fontcolor|#FF0000|TITLE}}'''}}}
| style="width: 50%;" valign=top | {{{field|blackBoxWarningTitle|input type=textarea|editor|size=40|default='''{{fontcolor|#FF0000|TITLE}}'''}}}
|-
|-
| style="width: 50%;" valign=top | Please enter the '''body''' of the Black Box Warning
| style="width: 50%;" valign=top | Please enter the '''body''' of the Black Box warning:
| style="width: 50%;" valign=top | {{{field|blackBoxWarningBody|input type=textarea|editor|size=35|default=''{{fontcolor|#FF0000|Condition Name:}}'' (Content)}}}
| style="width: 50%;" valign=top | {{{field|blackBoxWarningBody|input type=textarea|editor|size=35|default=''{{fontcolor|#FF0000|Condition Name:}}'' (Content)}}}
|}
|}
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{|
{|
| style="width: 50%;" valign=top | Please enter '''FDA-labeled indications and dosing information''' for '''adults'''<BR><SMALL>
| style="width: 50%;" valign=top | Please enter '''FDA-labeled indications and dosing information''' for '''adults''':<BR><SMALL>
* '''Step 1: Check the "Dosage And Administration" section from the FDA label'''<BR>
* '''Step 1: Check the "Dosage And Administration" section from the FDA label'''<BR>
* '''Step 2: Insert the dosing information for each indication'''</SMALL>
* '''Step 2: Insert the dosing information for each indication'''</SMALL>
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:: (Dosage)}}}
:: (Dosage)}}}
|-
|-
| style="width: 50%;" valign=top | Please enter established '''off-label use and dosage''' for '''adults'''
| style="width: 50%;" valign=top | Please enter established '''off-label use and dosage''' for '''adults''':
|-
|-
| style="width: 50%;" valign=top | Enter '''guideline-supported off-label use''' in this field
| style="width: 50%;" valign=top | Please enter '''guideline-supported off-label use''' in this field:
| style="width: 50%;" valign=top | {{{field|offLabelAdultGuideSupport|input type=textarea|size=35|editor|default=
| style="width: 50%;" valign=top | {{{field|offLabelAdultGuideSupport|input type=textarea|size=35|editor|default=
'''Condition 1'''
'''Condition 1'''
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:* (Dosage)}}}
:* (Dosage)}}}
|-
|-
| style="width: 50%;" valign=top | Enter '''non–guideline-supported off-label use''' in this field
| style="width: 50%;" valign=top | Please enter '''non–guideline-supported off-label use''' in this field:
| style="width: 50%;" valign=top | {{{field|offLabelAdultNoGuideSupport|input type=textarea|size=35|editor|default=
| style="width: 50%;" valign=top | {{{field|offLabelAdultNoGuideSupport|input type=textarea|size=35|editor|default=
'''Condition 1'''
'''Condition 1'''
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{|
{|
| style="width: 50%;" valign=top | Please enter '''FDA-Labeled Indications and Dosage Information''' for '''Children'''<BR><SMALL>
| style="width: 50%;" valign=top | Please enter '''FDA-labeled indications and dosage information''' for '''children''':<BR><SMALL>
* '''Step 1: Check the "Dosage And Administration" section from the FDA label'''<BR>
* '''Step 1: Check the "Dosage And Administration" section from the FDA label'''<BR>
* '''Step 2: Insert the dosing information for each indication'''</SMALL>
* '''Step 2: Insert the dosing information for each indication'''</SMALL>
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:: (Dosage)}}}
:: (Dosage)}}}
|-
|-
| style="width: 50%;" valign=top | Please enter established '''off-label use and dosage''' for '''children'''
| style="width: 50%;" valign=top | Please enter established '''off-label use and dosage''' for '''children''':
|-
|-
| style="width: 50%;" valign=top | Enter '''Guideline-Supported Off-Label Use''' in this field
| style="width: 50%;" valign=top | Please enter '''guideline-supported off-label use''' in this field:
| style="width: 50%;" valign=top | {{{field|offLabelPedGuideSupport|input type=textarea|size=35|editor|default=
| style="width: 50%;" valign=top | {{{field|offLabelPedGuideSupport|input type=textarea|size=35|editor|default=
'''Condition 1'''
'''Condition 1'''
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:* (Dosage)}}}
:* (Dosage)}}}
|-
|-
| style="width: 50%;" valign=top | Enter '''non–guideline-supported off-label use''' in this field
| style="width: 50%;" valign=top | Please enter '''non–guideline-supported off-label use''' in this field:
| style="width: 50%;" valign=top | {{{field|offLabelPedNoGuideSupport|input type=textarea|size=35|editor|default=
| style="width: 50%;" valign=top | {{{field|offLabelPedNoGuideSupport|input type=textarea|size=35|editor|default=
'''Condition 1'''
'''Condition 1'''
Line 360: Line 361:
}}}
}}}
|-
|-
| style="width: 50%;" valign=top | Please enter the '''adverse reactions''' reported from '''postmarketing experience'''<BR><SMALL>
| style="width: 50%;" valign=top | Please enter the '''adverse reactions''' reported from '''postmarketing experience''':<BR><SMALL>
* '''Step 1: Check the "Adverse Reactions" section from the FDA label'''<BR>
* '''Step 1: Check the "Adverse Reactions" section from the FDA label'''<BR>
* '''Step 2: Arrange the contents based on organ systems'''</SMALL>
* '''Step 2: Arrange the contents based on organ systems'''</SMALL>
Line 418: Line 419:
| style="width: 50%;" valign=top | FDA Pregnancy Category: {{{field|FDAPregCat|input type=dropdown|values=A,B,C,D,X,N}}}
| style="width: 50%;" valign=top | FDA Pregnancy Category: {{{field|FDAPregCat|input type=dropdown|values=A,B,C,D,X,N}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the FDA reported pregnancy category
| style="width: 50%;" valign=top | Please enter information related to the FDA reported pregnancy category:
| {{{field|useInPregnancyFDA|input type=textarea|size=35|editor}}}
| {{{field|useInPregnancyFDA|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Australian Pregnancy Category: {{{field|AUSPregCat|input type=dropdown|values=A,B1,B2,B3,C,D,X}}}
| style="width: 50%;" valign=top | Australian Pregnancy Category: {{{field|AUSPregCat|input type=dropdown|values=A,B1,B2,B3,C,D,X}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the Australian reported pregnancy category
| style="width: 50%;" valign=top | Please enter information related to the Australian reported pregnancy category:
| {{{field|useInPregnancyAUS|input type=textarea|size=35|editor}}}
| {{{field|useInPregnancyAUS|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the use of the drug during labor and delivery
| style="width: 50%;" valign=top | Please enter information related to the use of the drug during labor and delivery:
| style="width: 50%;" valign=top | {{{field|useInLaborDelivery|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|useInLaborDelivery|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the use of the drug during nursing
| style="width: 50%;" valign=top | Please enter information related to the use of the drug during nursing:
| style="width: 50%;" valign=top | {{{field|useInNursing|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|useInNursing|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in pediatrics
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in pediatrics:
| style="width: 50%;" valign=top | {{{field|useInPed|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|useInPed|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in geriatrics
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in geriatrics:
| style="width: 50%;" valign=top | {{{field|useInGeri|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|useInGeri|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the use of the drug and gender
| style="width: 50%;" valign=top | Please enter information related to the use of the drug and gender:
| style="width: 50%;" valign=top | {{{field|useInGender|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|useInGender|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the use of the drug and race
| style="width: 50%;" valign=top | Please enter information related to the use of the drug and race:
| style="width: 50%;" valign=top | {{{field|useInRace|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|useInRace|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in patients with renal impairment
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in patients with renal impairment:
| style="width: 50%;" valign=top | {{{field|useInRenalImpair|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|useInRenalImpair|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in patients with hepatic impairment
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in patients with hepatic impairment:
| style="width: 50%;" valign=top | {{{field|useInHepaticImpair|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|useInHepaticImpair|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in females of reproductive potential and males
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in females of reproductive potential and males:
| style="width: 50%;" valign=top | {{{field|useInReproPotential|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|useInReproPotential|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in immunocompromised patients
| style="width: 50%;" valign=top | Please enter information related to the use of the drug in immunocompromised patients:
| style="width: 50%;" valign=top | {{{field|useInImmunocomp|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|useInImmunocomp|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Others
| style="width: 50%;" valign=top | 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|editor}}}
Body: {{{field|useInOthers|input type=textarea|size=35|editor}}}
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{|
{|
| style="width: 50%;" valign=top | Please enter information pertaining to drug administration here
| style="width: 50%;" valign=top | Please enter information pertaining to drug administration here:
| {{{field|administration|input type=textarea|size=35|editor}}}
| {{{field|administration|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information pertaining to the drug monitoring here
| style="width: 50%;" valign=top | Please enter information pertaining to the drug monitoring here:
| style="width: 50%;" valign=top | {{{field|monitoring|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|monitoring|input type=textarea|size=35|editor}}}
|}
|}
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{|
{|
| style="width: 50%;" valign=top | Please enter information pertaining to the IV compatibility here
| style="width: 50%;" valign=top | Please enter information pertaining to the IV compatibility here:
| style="width: 50%;" valign=top | {{{field|IVCompat|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|IVCompat|input type=textarea|size=35|editor}}}
|}
|}
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{|
{|
| style="width: 50%;" valign=top | Please enter information pertaining to the drug overdose here
| style="width: 50%;" valign=top | Please enter information pertaining to the drug overdose here:
| style="width: 50%;" valign=top | {{{field|overdose|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|overdose|input type=textarea|size=35|editor}}}
|}
|}
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| {{{field|drugBox|input type=textarea|size=35|editor}}}
| {{{field|drugBox|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the mechanism of action
| style="width: 50%;" valign=top | Please enter information related to the mechanism of action:
| {{{field|mechAction|input type=textarea|size=35|editor}}}
| {{{field|mechAction|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the structure
| style="width: 50%;" valign=top | Please enter information related to the structure:
| {{{field|structure|input type=textarea|size=35|editor}}}
| {{{field|structure|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the pharmacodynamics
| style="width: 50%;" valign=top | Please enter information related to the pharmacodynamics:
| style="width: 50%;" valign=top | {{{field|PD|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|PD|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the pharmacokinetics
| style="width: 50%;" valign=top | Please enter information related to the pharmacokinetics:
| style="width: 50%;" valign=top | {{{field|PK|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|PK|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information related to the nonclinical toxicology
| style="width: 50%;" valign=top | Please enter information related to the nonclinical toxicology:
| style="width: 50%;" valign=top | {{{field|nonClinToxic|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|nonClinToxic|input type=textarea|size=35|editor}}}
|}
|}
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{|
{|
| style="width: 50%;" valign=top | Please enter information pertaining to the clinical studies of the drug
| style="width: 50%;" valign=top | Please enter information pertaining to the clinical studies of the drug:
| style="width: 50%;" valign=top | {{{field|clinicalStudies|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|clinicalStudies|input type=textarea|size=35|editor}}}
|}
|}
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{|
{|
| style="width: 50%;" valign=top | Please enter information pertaining to how the drug is supplied
| style="width: 50%;" valign=top | Please enter information pertaining to how the drug is supplied:
| style="width: 50%;" valign=top | {{{field|howSupplied|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|howSupplied|input type=textarea|size=35|editor}}}
|-
|-
Line 544: Line 545:


{|
{|
| style="width: 50%;" valign=top | Please enter information pertaining to the drug images here
| style="width: 50%;" valign=top | Please enter information pertaining to the drug images here:
| style="width: 50%;" valign=top | {{{field|drugImages|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|drugImages|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter information pertaining to the FDA package label here
| style="width: 50%;" valign=top | Please enter information pertaining to the FDA package label here:
| style="width: 50%;" valign=top | {{{field|packLabel|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|packLabel|input type=textarea|size=35|editor}}}
|}
|}
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{|
{|
| style="width: 50%;" valign=top | Please enter the FDA provided patient information here
| style="width: 50%;" valign=top | Please enter the FDA provided patient information here:
| style="width: 50%;" valign=top | {{{field|fdaPatientInfo|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|fdaPatientInfo|input type=textarea|size=35|editor}}}
|-
|-
| style="width: 50%;" valign=top | Please enter the NLM provided patient information Here
| style="width: 50%;" valign=top | Please enter the NLM provided patient information here:
| style="width: 50%;" valign=top | {{{field|nlmPatientInfo|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|nlmPatientInfo|input type=textarea|size=35|editor}}}
|}
|}
Line 567: Line 568:
=Precautions with Alcohol=
=Precautions with Alcohol=


'''{|'''
{|
| style="width: 50%;" valign=top | Please describe any guideline on the concurrent use of the drug with alcohol:
c Please describe any guideline on the concurrent use of the drug with alcohol:
| style="width: 50%;" valign=top | {{{field|alcohol|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|alcohol|input type=textarea|size=35|editor}}}
<font color="#777777">|}</font>
|}
 
 


=Look-Alike Drug Names=
=Look-Alike Drug Names=
Please enter drug names that could be confused for the drug whose page is currently being created.
 
{{{field|lookAlike|input type=textarea|size=35|editor}}}
{|
| style="width: 50%;" valign=top | Please enter look-alike names that could be confused with the drug:
| style="width: 50%;" valign=top | {{{field|lookAlike|input type=textarea|size=35|editor}}}
|}
 
 


=Price=
=Price=
{|
{|
| style="width: 50%;" valign=top | Please enter the drugs a patient may want to compare for Price
| style="width: 50%;" valign=top | Please enter the drugs a patient may want to compare for price:
| style="width: 50%;" valign=top | {{{field|price|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|price|input type=textarea|size=35|editor}}}
|}
|}


=Drug Shortages=
=Drug Shortages=
{|
{|
| style="width: 50%;" valign=top | Please enter information relevant to Drug Shortages
| style="width: 50%;" valign=top | Please enter information relevant to drug shortages:
| style="width: 50%;" valign=top | {{{field|drugShortage|input type=textarea|size=35|editor}}}
| style="width: 50%;" valign=top | {{{field|drugShortage|input type=textarea|size=35|editor}}}
|}
|}


{{{end template}}}
{{{end template}}}

Revision as of 23:18, 1 May 2014