Did the patient tolerate 0.125mg/0.25mg?
Item
Did the patient tolerate 0.125mg/0.25mg?
boolean
C0013220 (UMLS CUI [1])
If patient did not tolerate the dose, enter the reason why
Item
If patient did not tolerate the dose, enter the reason why
text
C0013220 (UMLS CUI [1,1])
C0566251 (UMLS CUI [1,2])
In the Investigator’s opinion, is it safe for the subject to increase to the next dose level?
Item
In the Investigator’s opinion, is it safe for the subject to increase to the next dose level?
boolean
C1735338 (UMLS CUI [1,1])
C1113679 (UMLS CUI [1,2])
Item
If it is not safe for the subject to increase to the next dose level, select a dosing strategy from the options below and tick the relevant box:
integer
C1735338 (UMLS CUI [1,1])
C1113679 (UMLS CUI [1,2])
C0178602 (UMLS CUI [2,1])
C0679199 (UMLS CUI [2,2])
Code List
If it is not safe for the subject to increase to the next dose level, select a dosing strategy from the options below and tick the relevant box:
CL Item
Dose reduce to the dose level below (return to the previous dose level) for a further 1-4 days of dosing at the (1)
CL Item
lower dose level. (2)
CL Item
Administer domperidone to reduce adverse events. ONLY IF THIS IS A SECOND ATTEMPT AT THIS DOSE (3)
CL Item
The investigator decides that the subject has reached their MTD. (5)
Dose to be attempted:
Item
Dose to be attempted:
integer
C3174092 (UMLS CUI [1])
Dose Level Attempt:
Item
Dose Level Attempt:
integer
C3174092 (UMLS CUI [1,1])
C0441889 (UMLS CUI [1,2])
Dose Details - Comments
Item
Dose Details - Comments
text
C0678766 (UMLS CUI [1,1])
C1522508 (UMLS CUI [1,2])
C0947611 (UMLS CUI [1,3])
Dose checked and administered by:
Item
Dose checked and administered by:
text
C1283174 (UMLS CUI [1,1])
C0178602 (UMLS CUI [1,2])
C2348343 (UMLS CUI [1,3])
Dose checked and witnessed by:
Item
Dose checked and witnessed by:
text
C1283174 (UMLS CUI [1,1])
C0178602 (UMLS CUI [1,2])
C0682356 (UMLS CUI [1,3])
C0178602 (UMLS CUI [1,4])