ID

17561

Description

Hospital Routine Documentation Form at the University Hospital Muenster. Original Form name: Pharma Aufnahme MS.

Keywords

Versions (1)
  1. 9/23/16 9/23/16 -
Uploaded on

September 23, 2016

DOI

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License

Creative Commons BY-NC 3.0
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Pharma Admission MS University Hospital Muenster (UKM)

German

Pharma Admission MS University Hospital Muenster (UKM)

1 forms  
Pharmazeutische Aufnahme
Description

Pharmazeutische Aufnahme

Alias
UMLS CUI-1
C0184666
UMLS CUI-2
C0031321
Wichtige Informationen:
Description

important information

Data type

text

Alias
UMLS CUI [1,1]
C1533716
UMLS CUI [1,2]
C3898777
Größe
Description

height

Data type

float

Measurement units
  • cm
cm
Gewicht
Description

weight

Data type

float

Measurement units
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Allergien
Description

allergies

Data type

boolean

Alias
UMLS CUI [1]
C0020517
Ja, folgende:
Description

allergies specify

Data type

text

Alias
UMLS CUI [1]
C0020517
Arzneimittel-Wechselwirkungen:
Description

drug interactions

Data type

text

Alias
UMLS CUI [1]
C0678798
Bemerkung:
Description

remark

Data type

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0184666
UMLS CUI [1,3]
C0031321
Datum
Description

date

Data type

date

Alias
UMLS CUI [1]
C0011008
Unterschritft
Description

signature

Data type

text

Alias
UMLS CUI [1]
C1519316
Rückfragen Tel:
Description

query

Data type

text

Alias
UMLS CUI [1,1]
C1522634
UMLS CUI [1,2]
C1515258
Ansprechpartner
Description

contact person

Data type

text

Alias
UMLS CUI [1]
C0337611
Medikation UKM
Description

Medikation UKM

Alias
UMLS CUI-1
C0013227
Nummer
Description

number

Data type

integer

Präparat
Description

medication

Data type

text

Alias
UMLS CUI [1]
C0013227
Wirkstoff
Description

active agent

Data type

text

Alias
UMLS CUI [1]
C1254351
Dosierung
Description

dosage

Data type

text

Alias
UMLS CUI [1]
C0178602
SB
Description

Sonderbestellung durch Apotheke, dieses Produkt ist nicht in der Hausliste des UKM und muss frühzeitig über die Apotheke bestellt werden.

Data type

boolean

Hausarztmedikation
Description

medication by family doctor

Data type

text

Alias
UMLS CUI [1,1]
C1704221
UMLS CUI [1,2]
C0013227
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Similar models

Pharma Admission MS University Hospital Muenster (UKM)

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Pharmazeutische Aufnahme
C0184666 (UMLS CUI-1)
C0031321 (UMLS CUI-2)
important information
Item
Wichtige Informationen:
text
C1533716 (UMLS CUI [1,1])
C3898777 (UMLS CUI [1,2])
height
Item
Größe
float
weight
Item
Gewicht
float
C0005910 (UMLS CUI [1])
allergies
Item
Allergien
boolean
C0020517 (UMLS CUI [1])
allergies specify
Item
Ja, folgende:
text
C0020517 (UMLS CUI [1])
drug interactions
Item
Arzneimittel-Wechselwirkungen:
text
C0678798 (UMLS CUI [1])
remark
Item
Bemerkung:
text
C0947611 (UMLS CUI [1,1])
C0184666 (UMLS CUI [1,2])
C0031321 (UMLS CUI [1,3])
date
Item
Datum
date
C0011008 (UMLS CUI [1])
signature
Item
Unterschritft
text
C1519316 (UMLS CUI [1])
query
Item
Rückfragen Tel:
text
C1522634 (UMLS CUI [1,1])
C1515258 (UMLS CUI [1,2])
contact person
Item
Ansprechpartner
text
C0337611 (UMLS CUI [1])
Item Group
Medikation UKM
C0013227 (UMLS CUI-1)
number
Item
Nummer
integer
Item
Präparat
text
C0013227 (UMLS CUI [1])
medication
Code List
Präparat
CL Item
Allopurinol Rat 100mg Tab. (Allopurinol Rat 100mg Tab.)
CL Item
Allopurinol Rat 300mg Tab. (Allopurinol Rat 300mg Tab.)
CL Item
Amlodipin HEXAL 10mg Tab. (Amlodipin HEXAL 10mg Tab.)
CL Item
Amlodipin HEXAL 5mg Tab. (Amlodipin HEXAL 5mg Tab.)
CL Item
Antra Mups 20mg Tmr. (Antra Mups 20mg Tmr.)
CL Item
Beloc Zok 95mg Ret. (Beloc Zok 95mg Ret.)
CL Item
Beloc Zok Mite 47.5mg Ret. (Beloc Zok Mite 47.5mg Ret.)
CL Item
Benalapril 10mg Tab. (Benalapril 10mg Tab.)
CL Item
Benalapril 20mg Tab. (Benalapril 20mg Tab.)
CL Item
Benalapril 5mg Tab. (Benalapril 5mg Tab.)
CL Item
Candesartan ratio 16mg Tab. (Candesartan ratio 16mg Tab.)
CL Item
Candesartan ratio 4mg Tab. (Candesartan ratio 4mg Tab.)
CL Item
Candesartan ratio 8mg Tab. (Candesartan ratio 8mg Tab.)
CL Item
Concor 10mg Fta. (Concor 10mg Fta.)
CL Item
Delix 2.5mg Tab. (Delix 2.5mg Tab.)
CL Item
Delix 5mg Tab. (Delix 5mg Tab.)
CL Item
Herzass ratio. 100mg Tab. (Herzass ratio. 100mg Tab.)
CL Item
Lasix 40mg Tab. (Lasix 40mg Tab.)
CL Item
Marcumar Tab. (Marcumar Tab.)
CL Item
Pantoprazol Actavis 20mg Tmr. (Pantoprazol Actavis 20mg Tmr.)
CL Item
Pantoprazol Actavis 40mg Tmr. (Pantoprazol Actavis 40mg Tmr.)
CL Item
Plavix 75mg Fta. (Plavix 75mg Fta.)
CL Item
Prostacure 0.4mg Hartkap. (Prostacure 0.4mg Hartkap.)
CL Item
Simvastatin ratio 20mg Fta. (Simvastatin ratio 20mg Fta.)
CL Item
Simvastatin ratio 40mg Fta. (Simvastatin ratio 40mg Fta.)
CL Item
Torem 10mg Tab. (Torem 10mg Tab.)
CL Item
Torem Cor 5mg Tab. (Torem Cor 5mg Tab.)
CL Item
Atrovent 500ug/2ml ED Fert INH (Atrovent 500ug/2ml ED Fert INH)
CL Item
Atrovent N Inh. (Atrovent N Inh.)
CL Item
Budiair 200Ug Standard Dos. (Budiair 200Ug Standard Dos.)
CL Item
Cordarex (Cordarex)
CL Item
Decortin H 1mg Tab. (Decortin H 1mg Tab.)
CL Item
Decortin H 5mg Tab. (Decortin H 5mg Tab.)
CL Item
Decortin H 20mg Tab. (Decortin H 20mg Tab.)
CL Item
Decortin H 50mg Tab. (Decortin H 50mg Tab.)
CL Item
Dekristol 20000 I.E. (Dekristol 20000 I.E.)
CL Item
Delix 2,5mg Plus Tabletten (Delix 2,5mg Plus Tabletten)
CL Item
Delix 5mg Plus Tabletten (Delix 5mg Plus Tabletten)
CL Item
Delix Protect 10mg Tab. (Delix Protect 10mg Tab.)
CL Item
Diclofenac ratio 100mg REK (Diclofenac ratio 100mg REK)
CL Item
Diclofenac ratio 25mg TMR (Diclofenac ratio 25mg TMR)
CL Item
Diclofenac ratio 50mg TMR (Diclofenac ratio 50mg TMR)
CL Item
Diclofenac ratio 75mg REK (Diclofenac ratio 75mg REK)
CL Item
Diovan 80mg Fta. (Diovan 80mg Fta.)
CL Item
Foster 100/6Ug 120 Huebe Dos. (Foster 100/6Ug 120 Huebe Dos.)
CL Item
Hct HEXAL 25mg (Hct HEXAL 25mg)
CL Item
Ibu ratiopharm 200mg Akut (Ibu ratiopharm 200mg Akut)
CL Item
Ibu ratiopharm 400mg Akut (Ibu ratiopharm 400mg Akut)
CL Item
Ibuprofen STADA 600mg (Ibuprofen STADA 600mg)
CL Item
Lyrica 25mg (Lyrica 25mg)
CL Item
Lyrica 75mg (Lyrica 75mg)
CL Item
Lyrica 150mg (Lyrica 150mg)
CL Item
Macrogol ratio Balance PUL (Macrogol ratio Balance PUL)
CL Item
Magnesium Optopan KAP (Magnesium Optopan KAP)
CL Item
Magnesium Verla 300 Orange GRA (Magnesium Verla 300 Orange GRA)
CL Item
Movicol Junior Aromf PUL (Movicol Junior Aromf PUL)
CL Item
Micardis 20mg Tab. (Micardis 20mg Tab.)
CL Item
Micardis 40mg Tab. (Micardis 40mg Tab.)
CL Item
Micardis 80mg Tab. (Micardis 80mg Tab.)
CL Item
Novaminsulfon Rat 500mg/ml TEI (Novaminsulfon Rat 500mg/ml TEI)
CL Item
Novaminsulfon ratio 500mg Tab. (Novaminsulfon ratio 500mg Tab.)
CL Item
Oxis Turbohaler 6Ug 60ED (Oxis Turbohaler 6Ug 60ED)
CL Item
Oxis Turbohaler 12Ug 60ED (Oxis Turbohaler 12Ug 60ED)
CL Item
Paracetamol ratio 500mg Tab. (Paracetamol ratio 500mg Tab.)
CL Item
Serevent Fckw Frei 120 Hub DOS (Serevent Fckw Frei 120 Hub DOS)
CL Item
Siofor 500 FTA (Siofor 500 FTA)
CL Item
Siofor 850 FTA (Siofor 850 FTA)
CL Item
Sortis 10mg Fta. (Sortis 10mg Fta.)
CL Item
Sortis 20mg Fta. (Sortis 20mg Fta.)
CL Item
Sortis 40mg Fta. (Sortis 40mg Fta.)
CL Item
Spiriva Respi 2,5ug Loe INL (Spiriva Respi 2,5ug Loe INL)
CL Item
Stilnox FTA (Stilnox FTA)
CL Item
Sultanol 200hub Dos. (Sultanol 200hub Dos.)
CL Item
Symbicort Tur160/4,5Ug 120e IHP (Symbicort Tur160/4,5Ug 120e IHP)
CL Item
Symbicort Tur320/9Ug 60e IHP (Symbicort Tur320/9Ug 60e IHP)
CL Item
Tramal 50mg Hkp. (Tramal 50mg Hkp.)
CL Item
Tramal Long 100mg RET (Tramal Long 100mg RET)
CL Item
Tramal Tropfen (Tramal Tropfen)
CL Item
Vigantoletten 500IE Vit D3 (Vigantoletten 500IE Vit D3)
CL Item
Vigantoletten 1000IE Vit D3 (Vigantoletten 1000IE Vit D3)
CL Item
Zopiclon-HEXAL 7,5mg FTA (Zopiclon-HEXAL 7,5mg FTA)
CL Item
Actraphane 30 Flexpen FER (Actraphane 30 Flexpen FER)
CL Item
Actrapid Flexpen (Actrapid Flexpen)
CL Item
Duodart 0,5mg/0,4mg Hkp. (Duodart 0,5mg/0,4mg Hkp.)
CL Item
Janumet 50/1000mg Filmtabl. FTA (Janumet 50/1000mg Filmtabl. FTA)
CL Item
Janumet 50/850mg Filmtabl. FTA (Janumet 50/850mg Filmtabl. FTA)
CL Item
Lisinolprol 5mg 1A Pharma TAB (Lisinolprol 5mg 1A Pharma TAB)
CL Item
Lisinolprol 10mg 1A Pharma TAB (Lisinolprol 10mg 1A Pharma TAB)
CL Item
Lisinolprol 20mg 1A Pharma TAB (Lisinolprol 20mg 1A Pharma TAB)
CL Item
Naproxen AL 250mg TAB (Naproxen AL 250mg TAB)
CL Item
Nexium Mups 20mg TMR (Nexium Mups 20mg TMR)
CL Item
Nexium Mups 40mg TMR (Nexium Mups 40mg TMR)
CL Item
Nitrolingual Akut Spr23,2% (Nitrolingual Akut Spr23,2%)
CL Item
Pravastatin ratio 10mg TAB (Pravastatin ratio 10mg TAB)
CL Item
Pravastatin ratio 20mg TAB (Pravastatin ratio 20mg TAB)
CL Item
Pravastatin ratio 40mg TAB (Pravastatin ratio 40mg TAB)
CL Item
Adalat 10 Kap. (Adalat 10 Kap.)
CL Item
Adalat Retard 20mg (Adalat Retard 20mg)
CL Item
Advagraf 0,5mg Ret. Kap. (Advagraf 0,5mg Ret. Kap.)
CL Item
Advagraf 1mg Ret. Kap. (Advagraf 1mg Ret. Kap.)
CL Item
Advagraf 3mg Ret. Kap. (Advagraf 3mg Ret. Kap.)
CL Item
Advagraf 5mg Ret. Kap. (Advagraf 5mg Ret. Kap.)
CL Item
Alendron-HEXAL 70mg Tab. (Alendron-HEXAL 70mg Tab.)
CL Item
Aprovel 75mg Fta. (Aprovel 75mg Fta.)
CL Item
Aprovel 150mg Fta. (Aprovel 150mg Fta.)
CL Item
Aprovel 300mg Fta. (Aprovel 300mg Fta.)
CL Item
Artelac Splash Edo Atr. (Artelac Splash Edo Atr.)
CL Item
Azopt Atr (Azopt Atr)
CL Item
Berodual N Dos. (Berodual N Dos.)
CL Item
Berotec N 100ug Dos. (Berotec N 100ug Dos.)
CL Item
Bicanorm Tmr. (Bicanorm Tmr.)
CL Item
Brilique 90mg Fta. (Brilique 90mg Fta.)
CL Item
Carvedilol Hexal 12,5mg Tab. (Carvedilol Hexal 12,5mg Tab.)
CL Item
Carvedilol Hexal 25mg Tab. (Carvedilol Hexal 25mg Tab.)
CL Item
Cellcept 250mg Kap. (Cellcept 250mg Kap.)
CL Item
Cellcept 500mg Fta. (Cellcept 500mg Fta.)
CL Item
Clexane 100 Fer. (Clexane 100 Fer.)
CL Item
Clexane 20 Fer. (Clexane 20 Fer.)
CL Item
Clexane 40 Fer. (Clexane 40 Fer.)
CL Item
Clexane 60 Fer. (Clexane 60 Fer.)
CL Item
Clexane 80 Fer. (Clexane 80 Fer.)
CL Item
Diovan 160mg Fta. (Diovan 160mg Fta.)
CL Item
Dreisavit Fta. (Dreisavit Fta.)
CL Item
Dytide H 50mg/25mg Tab. (Dytide H 50mg/25mg Tab.)
CL Item
Eliquis 2.5mg Fta. (Eliquis 2.5mg Fta.)
CL Item
Eliquis 5mg Fta. (Eliquis 5mg Fta.)
CL Item
Folverlan 5mg Tab. (Folverlan 5mg Tab.)
CL Item
Digimerck minor Tab. 0,07mg (Digimerck minor Tab. 0,07mg)
CL Item
Digimerck Tab. 0,1mg (Digimerck Tab. 0,1mg)
CL Item
Gabapentin HEXAL 100mg Hkp. (Gabapentin HEXAL 100mg Hkp.)
CL Item
Gabapentin HEXAL 300mg Hkp. (Gabapentin HEXAL 300mg Hkp.)
CL Item
Gabapentin STADA 400mg Hkp. (Gabapentin STADA 400mg Hkp.)
CL Item
Gabapentin ratio 600mg Fta. (Gabapentin ratio 600mg Fta.)
CL Item
Hct HEXAL 12,5mg Tab. (Hct HEXAL 12,5mg Tab.)
CL Item
Humalog Kwikpen (Humalog Kwikpen)
CL Item
Humalog Mix 25 Kwikpen (Humalog Mix 25 Kwikpen)
CL Item
Humalog Mix 50 Kwikpen (Humalog Mix 50 Kwikpen)
CL Item
Inegy 10mg/10mg Tab. (Inegy 10mg/10mg Tab.)
CL Item
Inegy 10mg/20mg Tab. (Inegy 10mg/20mg Tab.)
CL Item
Inegy 10mg/80mg Tab. (Inegy 10mg/80mg Tab.)
CL Item
Insidon 50mg Uta. (Insidon 50mg Uta.)
CL Item
Januvia 25mg Filmtabletten Fta. (Januvia 25mg Filmtabletten Fta.)
CL Item
Januvia 50mg Filmtabletten Fta. (Januvia 50mg Filmtabletten Fta.)
CL Item
Januvia 100mg Filmtabletten Fta. (Januvia 100mg Filmtabletten Fta.)
CL Item
Lixiana 30mg Fta. (Lixiana 30mg Fta.)
CL Item
Lixiana 60mg Fta. (Lixiana 60mg Fta.)
CL Item
Loratadin ratio Tab. (Loratadin ratio Tab.)
CL Item
Losartan HCT STADA 50/12.5mg Fta. (Losartan HCT STADA 50/12.5mg Fta.)
CL Item
Losartan STADA 50mg Fta. (Losartan STADA 50mg Fta.)
CL Item
Lantus 100e/ml Solostar Fer. (Lantus 100e/ml Solostar Fer.)
CL Item
Levemir Flexpen (Levemir Flexpen)
CL Item
Levetiracetam ratio 1000mg Fta. (Levetiracetam ratio 1000mg Fta.)
CL Item
Levetiracetam ratio 500mg Fta. (Levetiracetam ratio 500mg Fta.)
CL Item
Levetiracetam ratio 250mg Fta. (Levetiracetam ratio 250mg Fta.)
CL Item
Lisinopril 2,5mg Tab. (Lisinopril 2,5mg Tab.)
CL Item
Multaq 400mg Fta. (Multaq 400mg Fta.)
CL Item
Myfortic 180mg Tmr. (Myfortic 180mg Tmr.)
CL Item
Myfortic 360mg Tmr. (Myfortic 360mg Tmr.)
CL Item
Nac ratio. Akut 600mg Bta. (Nac ratio. Akut 600mg Bta.)
CL Item
Nacom 100/25 Tab. (Nacom 100/25 Tab.)
CL Item
Nacom 100/25 retard Tab. (Nacom 100/25 retard Tab.)
CL Item
Madopar 125 T (Madopar 125 T)
CL Item
Madopar Depot Rek. (Madopar Depot Rek.)
CL Item
Nebilet Tab. (Nebilet Tab.)
CL Item
Nitrendipin ratio 10mg Tab. (Nitrendipin ratio 10mg Tab.)
CL Item
Nitrendipin ratio 20mg Tab. (Nitrendipin ratio 20mg Tab.)
CL Item
Novorapid Flexpen (Novorapid Flexpen)
CL Item
Oxygesic 5mg Ret. (Oxygesic 5mg Ret.)
CL Item
Oxygesic 10mg Ret. (Oxygesic 10mg Ret.)
CL Item
Oxygesic 20mg Ret. (Oxygesic 20mg Ret.)
CL Item
Oxygesic 40mg Ret. (Oxygesic 40mg Ret.)
CL Item
Oxygesic 80mg Ret. (Oxygesic 80mg Ret.)
CL Item
Oxygesic Akut 5mg Kps. (Oxygesic Akut 5mg Kps.)
CL Item
Oxygesic Akut 10mg Kps. (Oxygesic Akut 10mg Kps.)
CL Item
Oxygesic Akut 20mg Kps. (Oxygesic Akut 20mg Kps.)
CL Item
Prograf 0.5mg Kap. (Prograf 0.5mg Kap.)
CL Item
Prograf 1mg Kap. (Prograf 1mg Kap.)
CL Item
Prograf 5mg Kap. (Prograf 5mg Kap.)
CL Item
Amaryl 1mg Tab. (Amaryl 1mg Tab.)
CL Item
Amaryl 2mg Tab. (Amaryl 2mg Tab.)
CL Item
Amaryl 3mg Tab. (Amaryl 3mg Tab.)
CL Item
Amineurin 10mg Fta. (Amineurin 10mg Fta.)
CL Item
Spiriva Respi 2,5ug Loe Inh. (Spiriva Respi 2,5ug Loe Inh.)
CL Item
Spironolacton HEXAL 50mg Tab. (Spironolacton HEXAL 50mg Tab.)
CL Item
Spironolacton HEXAL 100mg Tab. (Spironolacton HEXAL 100mg Tab.)
CL Item
Siofor 1000 Fta. (Siofor 1000 Fta.)
CL Item
Simvastatin ratio 10mg Fta. (Simvastatin ratio 10mg Fta.)
CL Item
Torem 200 Tab. (Torem 200 Tab.)
CL Item
Tegretal 200mg Ret. (Tegretal 200mg Ret.)
CL Item
Tegretal 400mg Ret. (Tegretal 400mg Ret.)
CL Item
Telmisartan 20mg Tab. (Telmisartan 20mg Tab.)
CL Item
Telmisartan 40mg Tab. (Telmisartan 40mg Tab.)
CL Item
Telmisartan 80mg Tab. (Telmisartan 80mg Tab.)
CL Item
Tilidin comp 100/8mg Ret. (Tilidin comp 100/8mg Ret.)
CL Item
Tilidin comp 50/4mg Ret. (Tilidin comp 50/4mg Ret.)
CL Item
Tilidin comp 150/12mg Tab. (Tilidin comp 150/12mg Tab.)
CL Item
Tilidin plus 50/4m 20ml Tro. (Tilidin plus 50/4m 20ml Tro.)
CL Item
Trevilor 75mg retard Kap. (Trevilor 75mg retard Kap.)
CL Item
Venlafaxin 150mg retard Tab. (Venlafaxin 150mg retard Tab.)
CL Item
Venlafaxin 37,5mg Tab. (Venlafaxin 37,5mg Tab.)
CL Item
Vesikur 5mg Fta. (Vesikur 5mg Fta.)
CL Item
Vesikur 10mg Fta. (Vesikur 10mg Fta.)
CL Item
Votum 10mg Fta. (Votum 10mg Fta.)
CL Item
Votum 20mg Fta. (Votum 20mg Fta.)
CL Item
Votum 40mg Fta. (Votum 40mg Fta.)
CL Item
Xarelto 10mg Tab. (Xarelto 10mg Tab.)
CL Item
Xarelto 15mg Tab. (Xarelto 15mg Tab.)
CL Item
Xarelto 20mg Tab. (Xarelto 20mg Tab.)
CL Item
Zopiclon 3,75mg Fta. (Zopiclon 3,75mg Fta.)
CL Item
L Thyroxin 150µg Henning Tab. (L Thyroxin 150µg Henning Tab.)
CL Item
L Thyroxin 75µg Henning Tab. (L Thyroxin 75µg Henning Tab.)
CL Item
L.-Thyroxin µg Tab. (L.-Thyroxin µg Tab.)
CL Item
L Thyroxin 125µg Henning Tab. (L Thyroxin 125µg Henning Tab.)
CL Item
L Thyroxin 50µg Henning Tab. (L Thyroxin 50µg Henning Tab.)
CL Item
L Thyroxin 25µg Henning Tab. (L Thyroxin 25µg Henning Tab.)
CL Item
Thyronajod 50µg Tab. (Thyronajod 50µg Tab.)
CL Item
Thyronajod 75µg Tab. (Thyronajod 75µg Tab.)
CL Item
Thyronajod 100µg Tab. (Thyronajod 100µg Tab.)
CL Item
Ultibro Breezhaler 85/43µg Ika. (Ultibro Breezhaler 85/43µg Ika.)
active agent
Item
Wirkstoff
text
C1254351 (UMLS CUI [1])
dosage
Item
Dosierung
text
C0178602 (UMLS CUI [1])
SB
Item
SB
boolean
medication by family doctor
Item
Hausarztmedikation
text
C1704221 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
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