ID

40873

Beschrijving

Study ID: 101468/902 Clinical Study ID: 101468/902 Study Title:A study to evaluate the effect of repeated oral doses of ropinirole on cardiac conduction as assessed by 12-lead electrocardiogram compared to placebo and single oral doses of moxifloxacin (Bayer) as a positive control. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Sponsor: GlaxoSmithKline Phase: Phase 1 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Modutab,ZIPEREVE,ZEPREVE,REPREVE,ADARTREL,REQUIP,Zygara; Zygara,ZIPEREVE,ZEPREVE,Requip Depot,REQUIP,REPREVE,Modutab,ADARTREL Study Indication: Restless Legs Syndrome

Trefwoorden

Versies (1)
  1. 29-05-20 29-05-20 -
Houder van rechten

GlaxoSmithKline

Geüploaded op

29 mei 2020

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 4.0
Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Terug naar het model Commentaren
Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Effect of ropinirole on cardiac conduction as assessed by 12-lead electrocardiogram (101468/902)

Engels

Drug Tolerance; Dose Details

1 Formulieren  
Administrative
Beschrijving

Administrative

Alias
UMLS CUI-1
C1320722
Subject Number
Beschrijving

Subject Number

Datatype

text

Alias
UMLS CUI [1]
C2348585
Drug Tolerance
Beschrijving

Drug Tolerance

Alias
UMLS CUI-1
C0013220
Did the patient tolerate 0.125mg/0.25mg?
Beschrijving

Did the patient tolerate 0.125mg/0.25mg?

Datatype

boolean

Alias
UMLS CUI [1]
C0013220
If patient did not tolerate the dose, enter the reason why
Beschrijving

If patient did not tolerate the dose, enter the reason why

Datatype

text

Alias
UMLS CUI [1,1]
C0013220
UMLS CUI [1,2]
C0566251
In the Investigator’s opinion, is it safe for the subject to increase to the next dose level?
Beschrijving

Y - Subject will receive the next dose level. N - Select a dosing strategy from the options below and tick the relevant box:

Datatype

boolean

Alias
UMLS CUI [1,1]
C1735338
UMLS CUI [1,2]
C1113679
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:
Beschrijving

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:

Datatype

integer

Alias
UMLS CUI [1,1]
C1735338
UMLS CUI [1,2]
C1113679
UMLS CUI [2,1]
C0178602
UMLS CUI [2,2]
C0679199
Dose Details
Beschrijving

Dose Details

Alias
UMLS CUI-1
C0678766
UMLS CUI-2
C1522508
Dose to be attempted:
Beschrijving

Dose to be attempted:

Datatype

integer

Maateenheden
  • mg
Alias
UMLS CUI [1]
C3174092
mg
Dose Level Attempt:
Beschrijving

Dose Level Attempt:

Datatype

integer

Alias
UMLS CUI [1,1]
C3174092
UMLS CUI [1,2]
C0441889
Dose Details - Comments
Beschrijving

Dose Details - Comments

Datatype

text

Alias
UMLS CUI [1,1]
C0678766
UMLS CUI [1,2]
C1522508
UMLS CUI [1,3]
C0947611
Dose checked and administered by:
Beschrijving

Dose checked and administered by:

Datatype

text

Alias
UMLS CUI [1,1]
C1283174
UMLS CUI [1,2]
C0178602
UMLS CUI [1,3]
C2348343
Dose checked and witnessed by:
Beschrijving

Dose checked and witnessed by:

Datatype

text

Alias
UMLS CUI [1,1]
C1283174
UMLS CUI [1,2]
C0178602
UMLS CUI [1,3]
C0682356
UMLS CUI [1,4]
C0178602
Terug naar het begin van de pagina

Similar models

Drug Tolerance; Dose Details

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Administrative
C1320722 (UMLS CUI-1)
Subject Number
Item
Subject Number
text
C2348585 (UMLS CUI [1])
Item Group
Drug Tolerance
C0013220 (UMLS CUI-1)
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])
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:
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
LEVEL. (4)
CL Item
The investigator decides that the subject has reached their MTD. (5)
Item Group
Dose Details
C0678766 (UMLS CUI-1)
C1522508 (UMLS CUI-2)
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])
Terug naar het begin van de pagina 

Contact

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Help

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial