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ID

44401

Description

https://www.gsk-clinicalstudyregister.com/study/102886/003?search=study&study_ids=102886#csr Study ID : 102886/003 Clinical Study ID : 102886/003 Study Title :Safety, tolerance and preliminary pharmacokinetics of single ascending intravenous doses of halofantrine [SK&F 102886] in healthy male volunteers. Clinicaltrials.gov Identifier : Sponsor : GlaxoSmithKline Collaborators :N/A Phase :N/A Study Recruitment Status :Completed Generic Name :halofantrine Trade Name :Halfan Study Indication Malaria

Link

https://www.gsk-clinicalstudyregister.com/study/102886/003?search=study&study_ids=102886#csr

Keywords

  1. 6/5/18 6/5/18 - Halim Ugurlu
  2. 9/20/21 9/20/21 -
Copyright Holder

GlaxoSmithKline (GSK)

Uploaded on

September 20, 2021

DOI

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License

Creative Commons BY-NC 3.0

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    Safety, tolerance and preliminary pharmacokinetics of single ascending intravenous doses of halofantrine [SK&F 102886] in healthy male volunteers.

    Administration, demographics, inclusion criteria, exclusion criteria, infusion details, ecg, alcohol/drug screening, baseline/advers events

    Administration
    Description

    Administration

    Alias
    UMLS CUI-1
    C1320722
    Vol. No.
    Description

    Vol. No.

    Data type

    text

    Alias
    UMLS CUI [1]
    C2348585
    Panel ID.
    Description

    Panel ID.

    Data type

    text

    Alias
    UMLS CUI [1]
    C3846158
    Study Period
    Description

    Study Period

    Data type

    text

    Alias
    UMLS CUI [1]
    C2347804
    Date and Time
    Description

    Date and Time

    Data type

    datetime

    Alias
    UMLS CUI [1]
    C1264639
    Demographic Details
    Description

    Demographic Details

    Alias
    UMLS CUI-1
    C0011298
    UMLS CUI-2
    C1522508
    Date of Birth
    Description

    Date of Birth

    Data type

    date

    Alias
    UMLS CUI [1]
    C0421451
    Race
    Description

    Race

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0034510
    Height
    Description

    Height

    Data type

    float

    Measurement units
    • metres
    Alias
    UMLS CUI [1]
    C0005890
    metres
    Weight
    Description

    Weight

    Data type

    float

    Measurement units
    • kg
    Alias
    UMLS CUI [1]
    C0005910
    kg
    Volunteer Inclusion Criteria
    Description

    Volunteer Inclusion Criteria

    Alias
    UMLS CUI-1
    C1512693
    Is the volunteer aged between 21 and 39 years?
    Description

    Age

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0001779
    Has the volunteer passed a compherensive pre-study medical examination during the week prior to the start of each study section, including: -medical history -clinical examination -electrocardiography (12 leads) -blood pressure -weight and height determination -pulmonary function test -haematological, clinical chemistry examinations, urinalysis and drug screening?
    Description

    compherensive pre-study medical examination

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0262926
    UMLS CUI [1,2]
    C0031809
    Recorder's initials
    Description

    Recorder's initials

    Data type

    text

    Alias
    UMLS CUI [1]
    C2986440
    date
    Description

    date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0011008
    Study director
    Description

    Study director

    Data type

    text

    Alias
    UMLS CUI [1]
    C0025081
    date
    Description

    date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0011008
    Volunteer Exclusion Criteria
    Description

    Volunteer Exclusion Criteria

    Alias
    UMLS CUI-1
    C0680251
    Does the volunteer have pathological findings in any of the investigations stated in the Inclusion Criteria?
    Description

    pathological findings

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0205469
    UMLS CUI [1,2]
    C0243095
    Is the volunteer currently receiving, or taken within the previous 7 days prior to dosing, any other medicine (prescribed or over-the-counter drugs) ?
    Description

    receiving medicine

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C2826257
    UMLS CUI [1,2]
    C2347852
    Has the volunteer received a research drug within the last 8 weeks (i.e, a compound which has not been granted a product licence) ?
    Description

    received a research drug

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0013230
    UMLS CUI [1,2]
    C1514756
    Is the volunteer known to practice alcohol abuse and/or have taken drugs of abuse (e.g. as shown by a positive finding in the drug screen) ?
    Description

    alcohol abuse and/or have taken drugs of abuse

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0085762
    UMLS CUI [2]
    C0038586
    Has the volunteer weight/height ratio deviations of more than 25% from the average (the average may be calculated by expressing the height above 100 m as a figure expressed in kg (Broca Formula) )
    Description

    weight/height ratio deviations

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0005890
    UMLS CUI [1,2]
    C0005910
    Does the volunteer have a known or suspected allergic status?
    Description

    allergic status

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0018759
    UMLS CUI [1,2]
    C0155877
    UMLS CUI [1,3]
    C1527304
    Does the volunteer have a history of psychiatric disorders, epilepsy or seizures?
    Description

    history of psychiatric disorders, epilepsy or seizures

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0262926
    UMLS CUI [1,2]
    C0004936
    UMLS CUI [1,3]
    C0036572
    UMLS CUI [1,4]
    C0014544
    Has the volunteer taken anti-malarial frugs within the last 12 months?
    Description

    anti-malarial frugs within the last 12 months

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0003374
    Infusion Details
    Description

    Infusion Details

    Alias
    UMLS CUI-1
    C0574032
    UMLS CUI-2
    C1522508
    Date of infusion
    Description

    Date of infusion

    Data type

    date

    Alias
    UMLS CUI [1,1]
    C0574032
    UMLS CUI [1,2]
    C0011008
    Time commenced
    Description

    Time commenced

    Data type

    time

    Alias
    UMLS CUI [1,1]
    C0011008
    UMLS CUI [1,2]
    C0451613
    Time completed
    Description

    Time completed

    Data type

    time

    Alias
    UMLS CUI [1,1]
    C0574032
    UMLS CUI [1,2]
    C0205197
    UMLS CUI [1,3]
    C1522314
    Duration of infusion
    Description

    Duration of infusion

    Data type

    integer

    Measurement units
    • mins
    Alias
    UMLS CUI [1,1]
    C0444921
    UMLS CUI [1,2]
    C0574032
    mins
    Volunteer weight on Day-1
    Description

    Volunteer weight on Day-1

    Data type

    float

    Measurement units
    • kg
    Alias
    UMLS CUI [1]
    C0005910
    kg
    Volume of infusion
    Description

    Volume of infusion

    Data type

    integer

    Measurement units
    • mls
    Alias
    UMLS CUI [1,1]
    C0574032
    UMLS CUI [1,2]
    C0449468
    mls
    Dose checked and administred by
    Description

    Dose checked and administred by

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0178602
    UMLS CUI [1,2]
    C0574032
    ECG-Arrhythmia
    Description

    ECG-Arrhythmia

    Alias
    UMLS CUI-1
    C1623258
    UMLS CUI-2
    C0003811
    Time Relative to start of infusion
    Description

    Time Relative to start of infusion

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0574032
    UMLS CUI [1,2]
    C0439659
    UMLS CUI [1,3]
    C0040223
    Actual Time
    Description

    Actual Time

    Data type

    time

    Alias
    UMLS CUI [1]
    C0040223
    Couplets (per time inverval)
    Description

    Couplets (per time inverval)

    Data type

    text

    Alias
    UMLS CUI [1]
    C0429001
    Bigeminus (per time interval)
    Description

    Bigeminus

    Data type

    text

    Alias
    UMLS CUI [1]
    C0262662
    EVPB (per time interval)
    Description

    EVPB (per time interval)

    Data type

    text

    Alias
    UMLS CUI [1]
    C0151636
    VPB (per time interval)
    Description

    VPB

    Data type

    text

    Alias
    UMLS CUI [1]
    C0865677
    initials
    Description

    initials

    Data type

    text

    Alias
    UMLS CUI [1]
    C2986440
    Electrocardiography
    Description

    Electrocardiography

    Alias
    UMLS CUI-1
    C1623258
    Were there any ECG recordings carried out?
    Description

    ECG recordings carried out

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C1623258
    Electrocardiography
    Description

    Electrocardiography

    Alias
    UMLS CUI-1
    C1623258
    Time relative to start of infusion
    Description

    Time relative to start of infusion

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0574032
    UMLS CUI [1,2]
    C0439659
    UMLS CUI [1,3]
    C0040223
    Date and time taken
    Description

    Date and time taken

    Data type

    datetime

    Alias
    UMLS CUI [1]
    C0011008
    Is the ECG normal
    Description

    ECG normal

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0522054
    Any changes
    Description

    Any changes

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0855329
    Comments
    Description

    Comments

    Data type

    text

    Alias
    UMLS CUI [1]
    C0947611
    Initials
    Description

    Initials

    Data type

    text

    Alias
    UMLS CUI [1]
    C2986440
    date
    Description

    date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0011008
    Alcohol Screening (Blow test)
    Description

    Alcohol Screening (Blow test)

    Alias
    UMLS CUI-1
    C0202306
    Study time relevant to dose
    Description

    Study time relevant to dose

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0439564
    Date and time sample taken
    Description

    Date and time sample taken

    Data type

    datetime

    Alias
    UMLS CUI [1,1]
    C0011008
    UMLS CUI [1,2]
    C0040223
    UMLS CUI [1,3]
    C0200345
    Was there any alcohol detected?
    Description

    any alcohol detected

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0202306
    initials
    Description

    initials

    Data type

    text

    Alias
    UMLS CUI [1]
    C2986440
    Drug Screening (Urine)
    Description

    Drug Screening (Urine)

    Alias
    UMLS CUI-1
    C0202274
    Day/hr relative to dose
    Description

    Day/hr relative to dose

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0439564
    Date and time sample taken
    Description

    Date and time sample taken

    Data type

    datetime

    Alias
    UMLS CUI [1,1]
    C0011008
    UMLS CUI [1,2]
    C0040223
    UMLS CUI [1,3]
    C0200345
    Were there any Drugs detected?
    Description

    Drugs detected

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1511790
    UMLS CUI [1,2]
    C1254351
    Type of drug/compound found
    Description

    Type of drug/compound found

    Data type

    text

    Alias
    UMLS CUI [1]
    C0457591
    Contra indicated?
    Description

    Contra indicated?

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C1301624
    Initials Lab
    Description

    Initials Lab

    Data type

    text

    Alias
    UMLS CUI [1]
    C0022877
    Initials Physician
    Description

    Initials Physician

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C2986440
    UMLS CUI [1,2]
    C2826892
    Comments
    Description

    Comments

    Data type

    text

    Alias
    UMLS CUI [1]
    C0947611
    Baseline Events
    Description

    Baseline Events

    Alias
    UMLS CUI-1
    C1442488
    UMLS CUI-2
    C0877248
    Have you felt different in any way over the last few days?
    Description

    Record baseline event observed or elicited by the following direct question to the subject:

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0559546
    Baseline Events
    Description

    Baseline Events

    Alias
    UMLS CUI-1
    C1442488
    UMLS CUI-2
    C0877248
    ADECS Code
    Description

    ADECS Code

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0805701
    UMLS CUI [1,2]
    C0600091
    Event Observed (describe)
    Description

    Event Observed (describe)

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0877248
    UMLS CUI [1,2]
    C0947611
    Onset date and time
    Description

    Onset date and time

    Data type

    datetime

    Alias
    UMLS CUI [1]
    C2826806
    End date and time
    Description

    End date and time

    Data type

    datetime

    Alias
    UMLS CUI [1]
    C2826793
    Event duration
    Description

    hours and minutes

    Data type

    text

    Alias
    UMLS CUI [1]
    C0449238
    Intensity
    Description

    Intensity

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1710066
    Event Course
    Description

    Event Course

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0877248
    UMLS CUI [1,2]
    C0750729
    Outcome of Event
    Description

    Outcome of Event

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1705586
    Recorder's signature
    Description

    Recorder's signature

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C1519316
    UMLS CUI [1,2]
    C0035173
    Date
    Description

    Date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0011008
    Study Director's Signature
    Description

    Study Director's Signature

    Data type

    text

    Alias
    UMLS CUI [1]
    C2346576
    Date
    Description

    Date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0011008
    Adverse Event
    Description

    Adverse Event

    Alias
    UMLS CUI-1
    C0877248
    Do you feel different in any way since starting the new treatment or since the last visit?
    Description

    Record any adverse event observed or elicited by the following direct question to the patient:

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0559546
    UMLS CUI [1,2]
    C0877248
    Adverse Events
    Description

    Adverse Events

    Alias
    UMLS CUI-1
    C0877248
    ADECS Code
    Description

    ADECS Code

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0805701
    UMLS CUI [1,2]
    C0600091
    Event observed (describe)
    Description

    Event observed (describe)

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0877248
    UMLS CUI [1,2]
    C0947611
    Onset date and time
    Description

    Onset date and time

    Data type

    datetime

    Alias
    UMLS CUI [1]
    C2985916
    Intensity
    Description

    Intensity

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1710066
    Outcome
    Description

    Outcome

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1705586
    Event course
    Description

    Event course

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0877248
    UMLS CUI [1,2]
    C0750729
    End date and time
    Description

    End date and time

    Data type

    datetime

    Alias
    UMLS CUI [1]
    C2826793
    Event (or severity) duration
    Description

    hours and minutes

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0877248
    UMLS CUI [1,2]
    C0449238
    Relation to investigational drug
    Description

    Relation to investigational drug

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0877248
    UMLS CUI [1,2]
    C0013230
    UMLS CUI [1,3]
    C0439849
    Present before or at baseline assessment?
    Description

    Present before or at baseline assessment

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0011900
    UMLS CUI [1,2]
    C1444637
    Action taken (on study drug dosage)
    Description

    *Please inform study monitor

    Data type

    integer

    Alias
    UMLS CUI [1]
    C2826626
    Outcome of event (select more than one if necessary)
    Description

    *Please inform study monitor **Treatment given to alleviate any adverse event must be entered on Concominant Medication form.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1705586
    Recorder's initials
    Description

    Recorder's initials

    Data type

    text

    Alias
    UMLS CUI [1]
    C2986440
    Date
    Description

    Date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0011008
    Study Director
    Description

    Study Director

    Data type

    text

    Alias
    UMLS CUI [1]
    C0025081
    Date
    Description

    Date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0011008

    Similar models

    Administration, demographics, inclusion criteria, exclusion criteria, infusion details, ecg, alcohol/drug screening, baseline/advers events

    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Administration
    C1320722 (UMLS CUI-1)
    Vol. No.
    Item
    Vol. No.
    text
    C2348585 (UMLS CUI [1])
    Panel ID.
    Item
    Panel ID.
    text
    C3846158 (UMLS CUI [1])
    Study Period
    Item
    Study Period
    text
    C2347804 (UMLS CUI [1])
    Date and Time
    Item
    Date and Time
    datetime
    C1264639 (UMLS CUI [1])
    Item Group
    Demographic Details
    C0011298 (UMLS CUI-1)
    C1522508 (UMLS CUI-2)
    Date of Birth
    Item
    Date of Birth
    date
    C0421451 (UMLS CUI [1])
    Item
    Race
    integer
    C0034510 (UMLS CUI [1])
    Code List
    Race
    CL Item
    Caucasian/European (1)
    CL Item
    Asian (2)
    CL Item
    Black (3)
    CL Item
    Oriental (4)
    CL Item
    Other, please specify (5)
    Height
    Item
    Height
    float
    C0005890 (UMLS CUI [1])
    Weight
    Item
    Weight
    float
    C0005910 (UMLS CUI [1])
    Item Group
    Volunteer Inclusion Criteria
    C1512693 (UMLS CUI-1)
    Age
    Item
    Is the volunteer aged between 21 and 39 years?
    boolean
    C0001779 (UMLS CUI [1])
    compherensive pre-study medical examination
    Item
    Has the volunteer passed a compherensive pre-study medical examination during the week prior to the start of each study section, including: -medical history -clinical examination -electrocardiography (12 leads) -blood pressure -weight and height determination -pulmonary function test -haematological, clinical chemistry examinations, urinalysis and drug screening?
    boolean
    C0262926 (UMLS CUI [1,1])
    C0031809 (UMLS CUI [1,2])
    Recorder's initials
    Item
    Recorder's initials
    text
    C2986440 (UMLS CUI [1])
    date
    Item
    date
    date
    C0011008 (UMLS CUI [1])
    Study director
    Item
    Study director
    text
    C0025081 (UMLS CUI [1])
    date
    Item
    date
    date
    C0011008 (UMLS CUI [1])
    Item Group
    Volunteer Exclusion Criteria
    C0680251 (UMLS CUI-1)
    pathological findings
    Item
    Does the volunteer have pathological findings in any of the investigations stated in the Inclusion Criteria?
    boolean
    C0205469 (UMLS CUI [1,1])
    C0243095 (UMLS CUI [1,2])
    receiving medicine
    Item
    Is the volunteer currently receiving, or taken within the previous 7 days prior to dosing, any other medicine (prescribed or over-the-counter drugs) ?
    boolean
    C2826257 (UMLS CUI [1,1])
    C2347852 (UMLS CUI [1,2])
    received a research drug
    Item
    Has the volunteer received a research drug within the last 8 weeks (i.e, a compound which has not been granted a product licence) ?
    boolean
    C0013230 (UMLS CUI [1,1])
    C1514756 (UMLS CUI [1,2])
    alcohol abuse and/or have taken drugs of abuse
    Item
    Is the volunteer known to practice alcohol abuse and/or have taken drugs of abuse (e.g. as shown by a positive finding in the drug screen) ?
    boolean
    C0085762 (UMLS CUI [1])
    C0038586 (UMLS CUI [2])
    weight/height ratio deviations
    Item
    Has the volunteer weight/height ratio deviations of more than 25% from the average (the average may be calculated by expressing the height above 100 m as a figure expressed in kg (Broca Formula) )
    boolean
    C0005890 (UMLS CUI [1,1])
    C0005910 (UMLS CUI [1,2])
    allergic status
    Item
    Does the volunteer have a known or suspected allergic status?
    boolean
    C0018759 (UMLS CUI [1,1])
    C0155877 (UMLS CUI [1,2])
    C1527304 (UMLS CUI [1,3])
    history of psychiatric disorders, epilepsy or seizures
    Item
    Does the volunteer have a history of psychiatric disorders, epilepsy or seizures?
    boolean
    C0262926 (UMLS CUI [1,1])
    C0004936 (UMLS CUI [1,2])
    C0036572 (UMLS CUI [1,3])
    C0014544 (UMLS CUI [1,4])
    anti-malarial frugs within the last 12 months
    Item
    Has the volunteer taken anti-malarial frugs within the last 12 months?
    boolean
    C0003374 (UMLS CUI [1])
    Item Group
    Infusion Details
    C0574032 (UMLS CUI-1)
    C1522508 (UMLS CUI-2)
    Date of infusion
    Item
    Date of infusion
    date
    C0574032 (UMLS CUI [1,1])
    C0011008 (UMLS CUI [1,2])
    Time commenced
    Item
    Time commenced
    time
    C0011008 (UMLS CUI [1,1])
    C0451613 (UMLS CUI [1,2])
    Time completed
    Item
    Time completed
    time
    C0574032 (UMLS CUI [1,1])
    C0205197 (UMLS CUI [1,2])
    C1522314 (UMLS CUI [1,3])
    Duration of infusion
    Item
    Duration of infusion
    integer
    C0444921 (UMLS CUI [1,1])
    C0574032 (UMLS CUI [1,2])
    Volunteer weight on Day-1
    Item
    Volunteer weight on Day-1
    float
    C0005910 (UMLS CUI [1])
    Volume of infusion
    Item
    Volume of infusion
    integer
    C0574032 (UMLS CUI [1,1])
    C0449468 (UMLS CUI [1,2])
    Dose checked and administred by
    Item
    Dose checked and administred by
    text
    C0178602 (UMLS CUI [1,1])
    C0574032 (UMLS CUI [1,2])
    Item Group
    ECG-Arrhythmia
    C1623258 (UMLS CUI-1)
    C0003811 (UMLS CUI-2)
    Item
    Time Relative to start of infusion
    integer
    C0574032 (UMLS CUI [1,1])
    C0439659 (UMLS CUI [1,2])
    C0040223 (UMLS CUI [1,3])
    Code List
    Time Relative to start of infusion
    CL Item
    -0.5 to 0 hours (1)
    CL Item
    0 to +0.5 hours (2)
    CL Item
    +0.5 to +1.5 hours (3)
    CL Item
    +1.5 to 2.5 hours (4)
    CL Item
    +2.5 to +3.5 hours (5)
    CL Item
    +3.5 to +4.5 hours (6)
    CL Item
    +4.5 to +5.5 hours (7)
    CL Item
    +5.5 to +6.5 hours (8)
    CL Item
    +6.5 to +7.5 hours (9)
    CL Item
    +7.5 to +8.5 hours (10)
    Actual Time
    Item
    Actual Time
    time
    C0040223 (UMLS CUI [1])
    Couplets (per time inverval)
    Item
    Couplets (per time inverval)
    text
    C0429001 (UMLS CUI [1])
    Bigeminus
    Item
    Bigeminus (per time interval)
    text
    C0262662 (UMLS CUI [1])
    EVPB (per time interval)
    Item
    EVPB (per time interval)
    text
    C0151636 (UMLS CUI [1])
    VPB
    Item
    VPB (per time interval)
    text
    C0865677 (UMLS CUI [1])
    initials
    Item
    initials
    text
    C2986440 (UMLS CUI [1])
    Item Group
    Electrocardiography
    C1623258 (UMLS CUI-1)
    ECG recordings carried out
    Item
    Were there any ECG recordings carried out?
    boolean
    C1623258 (UMLS CUI [1])
    Item Group
    Electrocardiography
    C1623258 (UMLS CUI-1)
    Item
    Time relative to start of infusion
    integer
    C0574032 (UMLS CUI [1,1])
    C0439659 (UMLS CUI [1,2])
    C0040223 (UMLS CUI [1,3])
    Code List
    Time relative to start of infusion
    CL Item
    -15 mins (1)
    CL Item
    +35 mins (2)
    CL Item
    +0.5 to +1.5 hours (3)
    CL Item
    +1 hour (4)
    CL Item
    +2.5 hours (5)
    CL Item
    +4.5 hours (6)
    CL Item
    +7.5 hours (7)
    CL Item
    +10.5 hours (8)
    CL Item
    +25.5 hours (9)
    CL Item
    +49.25 hours (10)
    Date and time taken
    Item
    Date and time taken
    datetime
    C0011008 (UMLS CUI [1])
    ECG normal
    Item
    Is the ECG normal
    boolean
    C0522054 (UMLS CUI [1])
    Any changes
    Item
    Any changes
    boolean
    C0855329 (UMLS CUI [1])
    Comments
    Item
    Comments
    text
    C0947611 (UMLS CUI [1])
    Initials
    Item
    Initials
    text
    C2986440 (UMLS CUI [1])
    date
    Item
    date
    date
    C0011008 (UMLS CUI [1])
    Item Group
    Alcohol Screening (Blow test)
    C0202306 (UMLS CUI-1)
    Item
    Study time relevant to dose
    integer
    C0439564 (UMLS CUI [1])
    Code List
    Study time relevant to dose
    CL Item
    Day -1 (1)
    CL Item
    Day 1 (2)
    CL Item
    Day +1 (3)
    CL Item
    Day +2 (4)
    CL Item
    Day +3 (5)
    CL Item
    Day +6 (6)
    CL Item
    Day +9 (7)
    CL Item
    Day +14 (8)
    Date and time sample taken
    Item
    datetime
    C0011008 (UMLS CUI [1,1])
    C0040223 (UMLS CUI [1,2])
    C0200345 (UMLS CUI [1,3])
    any alcohol detected
    Item
    Was there any alcohol detected?
    boolean
    C0202306 (UMLS CUI [1])
    initials
    Item
    initials
    text
    C2986440 (UMLS CUI [1])
    Item Group
    Drug Screening (Urine)
    C0202274 (UMLS CUI-1)
    Item
    Day/hr relative to dose
    integer
    C0439564 (UMLS CUI [1])
    Code List
    Day/hr relative to dose
    CL Item
    Day -1 (1)
    CL Item
    Day 1 (2)
    Date and time sample taken
    Item
    Date and time sample taken
    datetime
    C0011008 (UMLS CUI [1,1])
    C0040223 (UMLS CUI [1,2])
    C0200345 (UMLS CUI [1,3])
    Drugs detected
    Item
    Were there any Drugs detected?
    boolean
    C1511790 (UMLS CUI [1,1])
    C1254351 (UMLS CUI [1,2])
    Type of drug/compound found
    Item
    Type of drug/compound found
    text
    C0457591 (UMLS CUI [1])
    Contra indicated?
    Item
    Contra indicated?
    boolean
    C1301624 (UMLS CUI [1])
    Initials Lab
    Item
    Initials Lab
    text
    C0022877 (UMLS CUI [1])
    Initials Physician
    Item
    Initials Physician
    text
    C2986440 (UMLS CUI [1,1])
    C2826892 (UMLS CUI [1,2])
    Comments
    Item
    Comments
    text
    C0947611 (UMLS CUI [1])
    Item Group
    Baseline Events
    C1442488 (UMLS CUI-1)
    C0877248 (UMLS CUI-2)
    Felt different in any way over tha last few days
    Item
    Have you felt different in any way over the last few days?
    boolean
    C0559546 (UMLS CUI [1])
    Item Group
    Baseline Events
    C1442488 (UMLS CUI-1)
    C0877248 (UMLS CUI-2)
    ADECS Code
    Item
    ADECS Code
    text
    C0805701 (UMLS CUI [1,1])
    C0600091 (UMLS CUI [1,2])
    Event Observed (describe)
    Item
    Event Observed (describe)
    text
    C0877248 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Onset date and time
    Item
    Onset date and time
    datetime
    C2826806 (UMLS CUI [1])
    End date and time
    Item
    End date and time
    datetime
    C2826793 (UMLS CUI [1])
    Event duration
    Item
    Event duration
    text
    C0449238 (UMLS CUI [1])
    Item
    Intensity
    integer
    C1710066 (UMLS CUI [1])
    Code List
    Intensity
    CL Item
    Mild (1)
    CL Item
    Moderate (2)
    CL Item
    Severe (3)
    Item
    Event Course
    integer
    C0877248 (UMLS CUI [1,1])
    C0750729 (UMLS CUI [1,2])
    Code List
    Event Course
    CL Item
    Once (1)
    CL Item
    Consant (2)
    CL Item
    Intermittent (3)
    Item
    Outcome of Event
    integer
    C1705586 (UMLS CUI [1])
    Code List
    Outcome of Event
    CL Item
    Event continuing (1)
    CL Item
    Event resolved (2)
    Recorder's signature
    Item
    Recorder's signature
    text
    C1519316 (UMLS CUI [1,1])
    C0035173 (UMLS CUI [1,2])
    Date
    Item
    Date
    date
    C0011008 (UMLS CUI [1])
    Study Director's Signature
    Item
    Study Director's Signature
    text
    C2346576 (UMLS CUI [1])
    Date
    Item
    Date
    date
    C0011008 (UMLS CUI [1])
    Item Group
    Adverse Event
    C0877248 (UMLS CUI-1)
    adverse event observed or elicited
    Item
    Do you feel different in any way since starting the new treatment or since the last visit?
    boolean
    C0559546 (UMLS CUI [1,1])
    C0877248 (UMLS CUI [1,2])
    Item Group
    Adverse Events
    C0877248 (UMLS CUI-1)
    ADECS Code
    Item
    ADECS Code
    text
    C0805701 (UMLS CUI [1,1])
    C0600091 (UMLS CUI [1,2])
    Event observed (describe)
    Item
    Event observed (describe)
    text
    C0877248 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Onset date and time
    Item
    Onset date and time
    datetime
    C2985916 (UMLS CUI [1])
    Item
    Intensity
    integer
    C1710066 (UMLS CUI [1])
    Code List
    Intensity
    CL Item
    Mild (1)
    CL Item
    Moderate (2)
    CL Item
    Severe (3)
    Item
    Outcome
    integer
    C1705586 (UMLS CUI [1])
    Code List
    Outcome
    CL Item
    Event continuing (1)
    CL Item
    event resolved (2)
    Item
    Event course
    integer
    C0877248 (UMLS CUI [1,1])
    C0750729 (UMLS CUI [1,2])
    Code List
    Event course
    CL Item
    Once (1)
    CL Item
    Constant (2)
    CL Item
    Intermittent (3)
    End date and time
    Item
    End date and time
    datetime
    C2826793 (UMLS CUI [1])
    Event (or severity) duration
    Item
    Event (or severity) duration
    text
    C0877248 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    Item
    Relation to investigational drug
    integer
    C0877248 (UMLS CUI [1,1])
    C0013230 (UMLS CUI [1,2])
    C0439849 (UMLS CUI [1,3])
    Code List
    Relation to investigational drug
    CL Item
    Unrelated (1)
    CL Item
    Possibly related (2)
    CL Item
    Related (3)
    Item
    Present before or at baseline assessment?
    integer
    C0011900 (UMLS CUI [1,1])
    C1444637 (UMLS CUI [1,2])
    Code List
    Present before or at baseline assessment?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Action taken (on study drug dosage)
    integer
    C2826626 (UMLS CUI [1])
    Code List
    Action taken (on study drug dosage)
    CL Item
    None (1)
    CL Item
    Dose interrupted (2)
    CL Item
    Dose changed (3)
    CL Item
    Drug withdrawn* (4)
    Item
    Outcome of event (select more than one if necessary)
    integer
    C1705586 (UMLS CUI [1])
    Code List
    Outcome of event (select more than one if necessary)
    CL Item
    Corrective therapy given** (1)
    CL Item
    Life threatening* (2)
    CL Item
    Significantly disabling* (3)
    CL Item
    Pat. hosp./Hosp. prolonged* (4)
    CL Item
    Patient died* (5)
    Recorder's initials
    Item
    Recorder's initials
    text
    C2986440 (UMLS CUI [1])
    Date
    Item
    Date
    date
    C0011008 (UMLS CUI [1])
    Study Director
    Item
    Study Director
    text
    C0025081 (UMLS CUI [1])
    Date
    Item
    Date
    date
    C0011008 (UMLS CUI [1])

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