FHIR R4
Pharmacy Work GroupMaturity Level: 3Standards Status: Trial Use
Dosage
Standards StatusThis element has a standards status of "Trial Use"
Element IdDosage
Definition 用于表示患者(应该)如何用药。
Cardinality0..*
TypeBackboneElement
Summarytrue
Dosage.sequence
Element IdDosage.sequence
Definition 需要遵循或说明的用药顺序
Cardinality0..1
Typeinteger
Requirements 当多个用法用量的用药序号相同的,则意味着应该同时使用,否则应该按序号顺序使用。
Summarytrue
Dosage.text
Element IdDosage.text
Definition

描述用法用量的自由文本说明,如:SIG.

Cardinality0..1
Typestring
Requirements 当用法用量的说明过于复杂而无法用编码来表示时,可以用自由文本来描述。此元素描述的内容仅限于用法与剂量而不应包含药物的名称或说明。 若用法用量提供了编码,则可用此元素显示友好的人读信息。
无论是哪种情况都请尽量为此元素提供说明文字。如果Dosage.timing元素也有值,则此元素(Dosage.text)提供信息应与Dosage.timing元素值的意义一致。 另外,用药或备药的相关信息也应包含在此元素中。
Summarytrue
Dosage.additionalInstruction
Element IdDosage.additionalInstruction
Definition 指导患者如何用药(如:“随餐服用”或“饭前半小时服用”)或作为用药警告使用(如:“可能导致嗜睡”或“避免皮肤阳光直射或日光灯下”)。
Cardinality0..*
Terminology Binding SNOMED CT Additional Dosage Instructions (Example)
TypeCodeableConcept
Requirements 尽量提供注意事项的编码,如果没有可用的编码,则使用文本描述。
Summarytrue
Comments 用药或备药的信息(例如“通过腹腔内端口尽快注入”或“紧跟某药物”)应在Dosage.text元素中填写。
Dosage.patientInstruction
Element IdDosage.patientInstruction
Definition 用患者或消费者能理解的方式表达的用药指导。
Cardinality0..1
Typestring
Summarytrue
Dosage.timing
Element IdDosage.timing
Definition

何时给药

Cardinality0..1
TypeTiming
Requirements 给病人用药的时间安排。此数据类型允许使用各种不同的表达方式。 例如:“每8小时”、“一天三次”、“从2019年12月23日起早餐前半小时,持续10天”、“2013年10月15日、2013年10月17日和2013年11月1日”。 当用“总容量/时间”的形式表示速率时,有时暗含了用药持续时间的信息,例如,可以用“500mL/2小时”意味着液体总药量为500毫升,持续用药2小时)。 但当时间只有单位没有数字时(例如,250毫升/小时),则需要使用Dosage.timing.repeat.duration元素来表示持续时间。
Summarytrue
Comments 由于 Dosage.timing元素是预期的尽可能提供值的元素,所以并不一定会使用此元素。 如果这两个元素都已填值,则 Dosage.text应包含 Dosage.timing的内容。
Dosage.asNeeded[x]
Element IdDosage.asNeeded[x]
Definition 用asNeededBoolean来表示是否在必要时用药; 用asNeededCodeableConcept来表示用药的先决条件。
Cardinality0..1
Terminology BindingSNOMED CT Medication As Needed Reason Codes (Example)
Typeboolean|CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
Comments 此元素要么使用asNeededBoolean表示,要么使用asNeededCodeableConcept表示,不能同时使用。 通过设置asNeededBoolean=True,可以直接表示“必要时使用(prn)”。 如果asNeededBoolean=False,则说明用药将根据计划给出,而不是“prn”或“必要时使用”。 如果设置asNeededCodeableConcept的编码来表达具体的“必要条件”,则暗示着asNeededBoolean=True。
Dosage.site
Element IdDosage.site
Definition

Body site to administer to.

Cardinality0..1
Terminology BindingSNOMED CT Anatomical Structure for Administration Site Codes (Example)
TypeCodeableConcept
Requirements 用编码形式说明药物首先进入身体的解剖部位。
Summarytrue
Comments 如果需要使用身体结构资源(BodyStructure)请使用官方标准扩展BodySite(例如,分别标识和跟踪)。 可能是摘要代码,也可能是对非常精确的位置定义的引用,或者两者都是。

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

Dosage.route
Element IdDosage.route
Definition

How drug should enter body.

Cardinality0..1
Terminology BindingSNOMED CT Route Codes (Example)
TypeCodeableConcept
Requirements 一种代码,指明将治疗剂注入或注入病人体内的路径或生理路径。

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Summarytrue
Dosage.method
Element IdDosage.method
Definition

Technique for administering medication.

Cardinality0..1
Terminology BindingSNOMED CT Administration Method Codes (Example)
TypeCodeableConcept
Requirements 一种编码值,指示药物进入或进入身体的方法。最常用于注射。例如,慢推;深静脉注射。

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Summarytrue
Comments 术语通常用于预先协调这一术语的路线和或管理形式。

Terminologies used often pre-coordinate this term with the route and or form of administration.

Dosage.doseAndRate
Element IdDosage.doseAndRate
Definition 给药的量。

The amount of medication administered.

Cardinality0..*
Summarytrue
Dosage.doseAndRate.type
Element IdDosage.doseAndRate.type
Definition 指定的剂量或速率的种类,例如,有序的或计算的。

The kind of dose or rate specified, for example, ordered or calculated.

Cardinality0..1
Terminology BindingDoseAndRateType (Example)
TypeCodeableConcept
Requirements 如果类型未填充,则假定为“ordered”。

If the type is not populated, assume to be "ordered".

Summarytrue
Dosage.doseAndRate.dose[x]
Element IdDosage.doseAndRate.dose[x]
Definition 每次剂量的药物用量。

Amount of medication per dose.

Cardinality0..1
TypeRange|SimpleQuantity
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements 在一次给药事件中给予的治疗性或其他物质的量。

The amount of therapeutic or other substance given at one administration event.

Summarytrue
Comments 请注意,这指定了指定药物的数量,而不是每个活性成分的数量。每种成分的含量都可以在药物资源中进行交流。例如,如果要告知片剂为375 mg,其中剂量为一片,则可以使用药物资源来记录该片剂由375 mg药物XYZ组成。或者,如果剂量是375毫克,那么您可能只需要使用药物资源来表明这是一个片剂。如果这个例子是静脉注射,比如多巴胺,你想说明400毫克的多巴胺混合在500毫升的静脉注射溶液中,那么这一切都会在药物资源中进行交流。如果给药不是瞬时的(存在速率或定时有持续时间),则可指定此值来表示在附表所示的时间段内要给药的总量,例如500毫升的剂量,定时用于表示应在4小时内给药。

Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

Dosage.doseAndRate.rate[x]
Element IdDosage.doseAndRate.rate[x]
Definition 单位时间内的药物用量。

Amount of medication per unit of time.

Cardinality0..1
TypeRatio|Range|SimpleQuantity
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements 确定药物被或将被引入患者体内的速度。通常为每小时100毫升或每小时100毫升的输液速率。也可以表示为每单位时间的速率,例如每2小时500毫升。其他示例:200 mcg/min或200 mcg/1分钟;1升/8小时。有时,速率可以表示总体积/持续时间(例如,500mL/2小时表示2小时的持续时间)。然而,当速率并不意味着持续时间(例如,250毫升/小时)时,则需要计时。重复。持续时间以在一段时间内传递灌注。

Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Summarytrue
Comments 有可能提供一个比率和剂量相等,以提供有关如何给药和供应药物的全部细节。如果要根据本地规则/法规随时间更改费率,则应将每个更改捕获为具有更新费率的新版本的MedicationRequest,或捕获为具有新费率的新MedicationRequest。

It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

可以使用速率比和速率量指定随时间变化的速率(例如,100毫升/小时)。rateQuantity方法要求系统能够解析包含ml/小时的UCUM grammer,而不是将时间指定为分母的特定比率。如果规定了500ml/2小时的速率,则使用速率比可能比使用250 mg/h的速率量更准确。

It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

Dosage.maxDosePerPeriod
Element IdDosage.maxDosePerPeriod
Definition

Upper limit on medication per unit of time.

Cardinality0..1
TypeRatio
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Summarytrue
Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

Dosage.maxDosePerAdministration
Element IdDosage.maxDosePerAdministration
Definition

Upper limit on medication per administration.

Cardinality0..1
TypeSimpleQuantity
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Summarytrue
Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

Dosage.maxDosePerLifetime
Element IdDosage.maxDosePerLifetime
Definition

Upper limit on medication per lifetime of the patient.

Cardinality0..1
TypeSimpleQuantity
Requirements

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

Summarytrue