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GW597599 and paroxetine on the pharmacokinetics of midazolam and dextromethorphan 100716 Follow-Up Concomitant Medication, Adverse Event

1 Formulär  
Concomitant Medication
Beskrivning

Concomitant Medication

Alias
UMLS CUI-1
C2347852
Are there any concomitant medication CHANGES since the start of the study?
Beskrivning

If YES, please record all medications used below. Where appropriate, medical conditions should be recorded on the Adverse Events Form, utilizing the same terminology. If a medication has had a dosage change it must be recorded with the start and stop date.

Datatyp

boolean

Alias
UMLS CUI [1,1]
C2347852
UMLS CUI [1,2]
C0443172
Drug Name (Trade Name Preferred)
Beskrivning

drug name

Datatyp

text

Alias
UMLS CUI [1]
C0013227
Single Dose Unit (e.g. 500 mg)
Beskrivning

dose unit

Datatyp

text

Alias
UMLS CUI [1]
C2826646
Frequency of this Dose (e.g. BID, PRN)
Beskrivning

dose frequency

Datatyp

text

Alias
UMLS CUI [1]
C2826654
Route
Beskrivning

route

Datatyp

text

Alias
UMLS CUI [1]
C0013153
Indication
Beskrivning

medication indication

Datatyp

text

Alias
UMLS CUI [1]
C3146298
Start Date/Time
Beskrivning

medication start

Datatyp

datetime

Alias
UMLS CUI [1]
C0451613
End Date/Time
Beskrivning

medication end

Datatyp

datetime

Alias
UMLS CUI [1,1]
C1521826
UMLS CUI [1,2]
C0806020
Continuing at end of Study?
Beskrivning

medication ongoing

Datatyp

boolean

Alias
UMLS CUI [1]
C2826666
Adverse Event
Beskrivning

Adverse Event

Alias
UMLS CUI-1
C0877248
Adverse Event
Beskrivning

adverse event

Datatyp

text

Alias
UMLS CUI [1]
C0877248
Onset Date/Time
Beskrivning

adverse event onset

Datatyp

datetime

Alias
UMLS CUI [1]
C2985916
End Date/Time
Beskrivning

(If ongoing, please leave blank)

Datatyp

datetime

Alias
UMLS CUI [1]
C2826793
Outcome
Beskrivning

adverse event outcome

Datatyp

text

Alias
UMLS CUI [1]
C1705586
Event Course
Beskrivning

adverse event course

Datatyp

text

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0750729
Number of episodes
Beskrivning

adverse event episodes

Datatyp

integer

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C4086638
Intensity (maximum)
Beskrivning

adverse event intensity

Datatyp

text

Alias
UMLS CUI [1]
C1710066
Action Taken with Respect to Investigational Drug
Beskrivning

action taken

Datatyp

text

Alias
UMLS CUI [1]
C2826626
Relationship to Investigational Drug
Beskrivning

relationship to investigational drug

Datatyp

text

Alias
UMLS CUI [1,1]
C1518404
UMLS CUI [1,2]
C0013230
UMLS CUI [1,3]
C0439849
Corrective Therapy
Beskrivning

If YES, please record on Concomitant Medication form.

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0877248
UMLS CUI [1,2]
C0087111
Was subject withdrawn due to this AE?
Beskrivning

subject withdrawn due to adverse event

Datatyp

boolean

Alias
UMLS CUI [1,1]
C2349954
UMLS CUI [1,2]
C0877248
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Similar models

GW597599 and paroxetine on the pharmacokinetics of midazolam and dextromethorphan 100716 Follow-Up Concomitant Medication, Adverse Event

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Concomitant Medication
C2347852 (UMLS CUI-1)
concomitant medication changes
Item
Are there any concomitant medication CHANGES since the start of the study?
boolean
C2347852 (UMLS CUI [1,1])
C0443172 (UMLS CUI [1,2])
drug name
Item
Drug Name (Trade Name Preferred)
text
C0013227 (UMLS CUI [1])
dose unit
Item
Single Dose Unit (e.g. 500 mg)
text
C2826646 (UMLS CUI [1])
dose frequency
Item
Frequency of this Dose (e.g. BID, PRN)
text
C2826654 (UMLS CUI [1])
route
Item
Route
text
C0013153 (UMLS CUI [1])
medication indication
Item
Indication
text
C3146298 (UMLS CUI [1])
medication start
Item
Start Date/Time
datetime
C0451613 (UMLS CUI [1])
medication end
Item
End Date/Time
datetime
C1521826 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
medication ongoing
Item
Continuing at end of Study?
boolean
C2826666 (UMLS CUI [1])
Item Group
Adverse Event
C0877248 (UMLS CUI-1)
adverse event
Item
Adverse Event
text
C0877248 (UMLS CUI [1])
adverse event onset
Item
Onset Date/Time
datetime
C2985916 (UMLS CUI [1])
adverse event end
Item
End Date/Time
datetime
C2826793 (UMLS CUI [1])
Item
Outcome
text
C1705586 (UMLS CUI [1])
adverse event outcome
Code List
Outcome
CL Item
Resolved (Resolved)
CL Item
Ongoing (Ongoing)
Item
Event Course
text
C0877248 (UMLS CUI [1,1])
C0750729 (UMLS CUI [1,2])
adverse event course
Code List
Event Course
CL Item
Intermittent (Intermittent)
CL Item
Constant (Constant)
adverse event episodes
Item
Number of episodes
integer
C0877248 (UMLS CUI [1,1])
C4086638 (UMLS CUI [1,2])
Item
Intensity (maximum)
text
C1710066 (UMLS CUI [1])
adverse event intensity
Code List
Intensity (maximum)
CL Item
Mild (Mild)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
Item
Action Taken with Respect to Investigational Drug
text
C2826626 (UMLS CUI [1])
action taken
Code List
Action Taken with Respect to Investigational Drug
CL Item
None (None)
CL Item
Dose reduced (Dose reduced)
CL Item
Dose increased (Dose increased)
CL Item
Drug interrupted/restarted (Drug interrupted/restarted)
CL Item
Drug stopped (Drug stopped)
Item
Relationship to Investigational Drug
text
C1518404 (UMLS CUI [1,1])
C0013230 (UMLS CUI [1,2])
C0439849 (UMLS CUI [1,3])
relationship to investigational drug
Code List
Relationship to Investigational Drug
CL Item
Not related (Not related)
CL Item
Unlikely (Unlikely)
CL Item
Suspected (reasonable possibility) (Suspected (reasonable possibility))
CL Item
Probable (Probable)
corrective therapy
Item
Corrective Therapy
boolean
C0877248 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
subject withdrawn due to adverse event
Item
Was subject withdrawn due to this AE?
boolean
C2349954 (UMLS CUI [1,1])
C0877248 (UMLS CUI [1,2])
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