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Logs and Repeats: Concomitant Medications

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Concomitant Medications
Description

Concomitant Medications

Sequence Number
Description

Sequence Number

Data type

integer

Drug name
Description

Trade name preferred

Data type

text

Modified reported term
Description

Modified reported term

Data type

text

Unit dose
Description

Unit dose

Data type

float

Units
Description

Units

Data type

text

Frequency
Description

Frequency

Data type

integer

Route
Description

Route

Data type

text

Reason for medication
Description

Reason for medication

Data type

text

Start Date
Description

Start Date

Data type

date

Start Time
Description

Start Time

Data type

time

Taken prior to study?
Description

Taken prior to study?

Data type

boolean

Ongoing?
Description

Ongoing?

Data type

boolean

If NO, record End Date
Description

If NO, record End Date

Data type

date

If NO, record End Time
Description

If NO, record End Time

Data type

time

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Similar models

Logs and Repeats: Concomitant Medications

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Concomitant Medications
Sequence Number
Item
Sequence Number
integer
Drug name
Item
Drug name
text
Modified reported term
Item
Modified reported term
text
Unit dose
Item
Unit dose
float
Item
Units
text
Units
Code List
Units
CL Item
Actuation (1)
CL Item
Ampoule (2)
CL Item
Application (3)
CL Item
Bottle (4)
CL Item
Capsule (5)
CL Item
Cubic centimeter (6)
CL Item
Drops (7)
CL Item
Gram (8)
CL Item
International units (9)
CL Item
International units per kilogram (10)
CL Item
International units per millilitre (11)
CL Item
Litre (12)
CL Item
Litre per minute (13)
CL Item
Lozenge (14)
CL Item
Megaunits (million units) (15)
CL Item
Microgram (MCG) (16)
CL Item
Microgram (UG) (17)
CL Item
Microgram /kilogram (18)
CL Item
Microgram /kilogram/minute (19)
CL Item
Micrograms /minutes (20)
CL Item
Microlitre (21)
CL Item
Milliequivalent (22)
CL Item
Milliequivalent/24 hours (23)
CL Item
Milligram (24)
CL Item
Milligrams percent (25)
CL Item
Milligram/hour (26)
CL Item
Milligram/kilogram (27)
CL Item
Milligram/metre squared (28)
CL Item
Milligram/millilitre (29)
CL Item
Millilitre (30)
CL Item
Millilitre/hour (31)
CL Item
Millilitre/minute (32)
CL Item
Millimole (33)
CL Item
Million international units (34)
CL Item
Minimum alveolar concentration (35)
CL Item
Nebule (36)
CL Item
Patch (37)
CL Item
Percent (38)
CL Item
Puff (39)
CL Item
Sachet (40)
CL Item
Spray (41)
CL Item
Suppository (42)
CL Item
Tablespoon (43)
CL Item
Tablet (44)
CL Item
Teaspoon (45)
CL Item
Units (46)
CL Item
Unknown (47)
CL Item
Vial (48)
Item
Frequency
integer
Frequency
Code List
Frequency
CL Item
2 times per week (1)
CL Item
3 times per week (2)
CL Item
4 times per week (3)
CL Item
5 times per day (4)
CL Item
5 times per week (5)
CL Item
AC (6)
CL Item
BID (7)
CL Item
Continuous infusion (8)
CL Item
Every 2 weeks (9)
CL Item
Every 3 weeks (10)
CL Item
Every 3 month (11)
CL Item
Every other day (12)
CL Item
HS (13)
CL Item
Once a month (14)
CL Item
Once a week (15)
CL Item
Once daily (16)
CL Item
Once only (17)
CL Item
PC (18)
CL Item
PRN (19)
CL Item
Q2H (20)
CL Item
Q3D (21)
CL Item
Q4D (22)
CL Item
Q4H (23)
CL Item
Q6H (24)
CL Item
Q8H (25)
CL Item
Q12H (26)
CL Item
QAM (27)
CL Item
QH (28)
CL Item
QID (29)
CL Item
QPM (30)
CL Item
TID (31)
CL Item
Unknown (32)
Item
Route
text
Route
Code List
Route
CL Item
Both eyes (1)
CL Item
Epidural (2)
CL Item
Gastrostomy Tube (3)
CL Item
Inhalation (4)
CL Item
Injection (5)
CL Item
Intra-arterial (6)
CL Item
Intra-bursa (7)
CL Item
Intramuscular (8)
CL Item
Intranasal (9)
CL Item
Intraocular (10)
CL Item
Intraosteal (11)
CL Item
Intrathesal (12)
CL Item
Intrauterine (13)
CL Item
Intravenous (14)
CL Item
Nasal (15)
CL Item
Oral (16)
CL Item
Rectal (17)
CL Item
SUbcutaneous (18)
CL Item
Subkingual (19)
CL Item
Topical (20)
CL Item
Transdermal (21)
CL Item
Unknown (22)
CL Item
Vaginal (23)
Reason for medication
Item
Reason for medication
text
Start Date
Item
Start Date
date
Start Time
Item
Start Time
time
Taken prior to study?
Item
Taken prior to study?
boolean
Ongoing?
Item
Ongoing?
boolean
If NO, record End Date
Item
If NO, record End Date
date
If NO, record End Time
Item
If NO, record End Time
time
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