Form:DrugProjectForm01: Difference between revisions

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__NOTOC__
__NOTOC__
<noinclude>{{#forminput:form=DrugProjectForm01|size=50|button text=Create/Edit A Drug Page}}</noinclude><includeonly>{{{for template|DrugProjectFormSinglePage}}}
<noinclude>{{#forminput:form=DrugProjectForm01|size=50|button text=Create/Edit A Drug Page}}</noinclude><includeonly>{{{for template|DrugProjectFormSinglePage01}}}
{|class="infobox" style="width: 100%; background: #DCDCDC; border-radius: 10px 10px 10px 10px;"
{|class="infobox" style="width: 100%; background: #DCDCDC; border-radius: 10px 10px 10px 10px;"
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Instructions
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Instructions
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Is this an '''over-the-counter''' medicine?
* Is this an '''over-the-counter''' medicine?
:* Check the Category in the label
:* Select "Yes" from the drop-down menu if it is an over-the-counter medicine
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|OTC|input type=dropdown|values=,Yes}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|OTC|input type=dropdown|values=,Yes}}}
|-
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* Please indicate the '''class''' to which the drug belongs:
* Please indicate the '''class''' to which the drug belongs:
:* Search with the generic name at [http://druginfo.nlm.nih.gov/drugportal/ Drug Information Portal]
:* Search with the generic name at [http://druginfo.nlm.nih.gov/drugportal/ Drug Information Portal]
:* Match the collected categories with [http://dailymed.nlm.nih.gov/dailymed/browseClasses.cfm FDA Established Pharmacologic Classes]
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|aOrAn|input type=dropdown|values=a,an}}}<BR>{{{field|drugClass|input type=text}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|aOrAn|input type=dropdown|values=a,an}}}<BR>{{{field|drugClass|input type=text}}}
|-
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* Please describe the '''indications''' approved by the FDA:
* Please describe the '''indications''' approved by the FDA:
:* Check the "Indications and Usage" section from the label
:* Check the "Indications and Usage" section from the label
:* Enter the FDA approved indications
:* Fit the context: ''(Drug name)'' is ''(a/an)'' ''(category a, category b, and category c)'' that is FDA approved for the treatment/prophylaxis/diagnosis/procedure of ''(indication a, indication b, and indication c)''.
:* Fit the context: ''(Drug name)'' is ''(a/an)'' ''(category a, category b, and category c)'' that is FDA approved for the treatment/prophylaxis/diagnosis/procedure of ''(indication a, indication b, and indication c)''.
:* Create hyperlinks for indications
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|indicationType|input type=dropdown|values=treatment,prophylaxis,diagnosis,procedure}}}<BR>{{{field|indication|input type=textarea|size=40|editor|editor}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|indicationType|input type=dropdown|values=treatment,prophylaxis,diagnosis,procedure}}}<BR>{{{field|indication|input type=textarea|size=40|editor|editor}}}
|-
|-
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Is there a '''black box warning''' associated with the drug?
* Is there a '''black box warning''' associated with the drug?
:* Check the "Warnings" section from the label
:* Select "Yes" from the drop-down menu if there is a black box Warning
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|hasBlackBoxWarning|input type=dropdown|values=,Yes}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|hasBlackBoxWarning|input type=dropdown|values=,Yes}}}
|-
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:* Collect adverse reactions from the "Highlights of Prescribing Information" section
:* Collect adverse reactions from the "Highlights of Prescribing Information" section
:* Fit the context: Common adverse reactions include ''(reaction a, reaction b, and reaction c)''.
:* Fit the context: Common adverse reactions include ''(reaction a, reaction b, and reaction c)''.
:* Create hyperlinks for adverse reactions
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|adverseReactions|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|adverseReactions|input type=textarea}}}
|-
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter the '''title''' of the '''black box warning''':
* Please enter the '''title''' of the '''black box warning''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|blackBoxWarningTitle|input type=textarea|editor|default='''{{fontcolor|#FF0000|TITLE}}'''}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|blackBoxWarningTitle|input type=textarea}}}
|-
|-
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter the '''body''' of the '''black box warning''':
* Please enter the '''body''' of the '''black box warning''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|blackBoxWarningBody|input type=textarea|editor|default=''{{fontcolor|#FF0000|Condition Name:}}''}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|blackBoxWarningBody|input type=textarea}}}
|-
|-
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Adult Indications and Dosage
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Adult Indications and Dosage
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter the '''adverse reactions''' provided in the "Clinical Trials Experience" section:
* Please enter the '''adverse reactions''' provided in the "Clinical Trials Experience" section:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|clinicalTrials|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|clinicalTrials|input type=textarea|default=There is limited information regarding ''Clinical Trials Experience'' of {{PAGENAME}} in the drug label.}}}
|-
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter the '''adverse reactions''' provided in the "Postmarketing Experience" section:
* Please enter the '''adverse reactions''' provided in the "Postmarketing Experience" section:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|postmarketing|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|postmarketing|input type=textarea|default=There is limited information regarding ''Postmarketing Experience'' of {{PAGENAME}} in the drug label.}}}
|-
|-
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Drug Interactions
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Drug Interactions
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the '''FDA pregnancy category''':
* Please enter information related to the '''FDA pregnancy category''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|FDAPregCat|input type=dropdown|values=A,B,C,D,X,N}}}<BR>{{{field|useInPregnancyFDA|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInPregnancyFDA|input type=textarea}}}
|-
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the use of the drug '''during labor and delivery''':
* Please enter information related to the use of the drug '''during labor and delivery''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInLaborDelivery|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInLaborDelivery|input type=textarea|default=There is no FDA guidance on the use of {{PAGENAME}} during labor and delivery.}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the use of the drug '''during nursing''':
* Please enter information related to the use of the drug '''during nursing''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInNursing|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInNursing|input type=textarea|default=There is no FDA guidance on the use of {{PAGENAME}} with respect to nursing mothers.}}}
|-
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the use of the drug in '''pediatrics''':
* Please enter information related to the use of the drug in '''pediatrics''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInPed|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInPed|input type=textarea|default=There is no FDA guidance on the use of {{PAGENAME}} with respect to pediatric patients.}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the use of the drug in '''geriatrics''':
* Please enter information related to the use of the drug in '''geriatrics''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInGeri|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInGeri|input type=textarea|default=There is no FDA guidance on the use of {{PAGENAME}} with respect to geriatric patients.}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the use of the drug and '''gender''':
* Please enter information related to the use of the drug and '''gender''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInGender|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInGender|input type=textarea|default=There is no FDA guidance on the use of {{PAGENAME}} with respect to specific gender populations.}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the use of the drug and '''race''':
* Please enter information related to the use of the drug and '''race''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInRace|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInRace|input type=textarea|default=There is no FDA guidance on the use of {{PAGENAME}} with respect to specific racial populations.}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the use of the drug in patients with '''renal impairment''':
* Please enter information related to the use of the drug in patients with '''renal impairment''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInRenalImpair|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInRenalImpair|input type=textarea|default=There is no FDA guidance on the use of {{PAGENAME}} in patients with renal impairment.}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the use of the drug in patients with '''hepatic impairment''':
* Please enter information related to the use of the drug in patients with '''hepatic impairment''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInHepaticImpair|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInHepaticImpair|input type=textarea|default=There is no FDA guidance on the use of {{PAGENAME}} in patients with hepatic impairment.}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the use of the drug in '''females of reproductive potential and males''':
* Please enter information related to the use of the drug in '''females of reproductive potential and males''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInReproPotential|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInReproPotential|input type=textarea|default=There is no FDA guidance on the use of {{PAGENAME}} in women of reproductive potentials and males.}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the use of the drug in '''immunocompromised patients''':
* Please enter information related to the use of the drug in '''immunocompromised patients''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInImmunocomp|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|useInImmunocomp|input type=textarea|default=There is no FDA guidance on the use of {{PAGENAME}} in patients who are immunocompromised.}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information pertaining to the '''monitoring''' here:
* Please enter information pertaining to the '''monitoring''' here:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|monitoring|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|monitoring|input type=textarea|default=There is limited information regarding ''Monitoring'' of {{PAGENAME}} in the drug label.}}}
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| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Overdose
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Overdose
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the '''structure''':
* Please enter information related to the '''structure''':
: <div style="font-size: 50%;"><nowiki>[[File:{{PAGENAME}}01.png|thumb|none|600px|This image is provided by the National Library of Medicine.]]</nowiki></div>
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|structure|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|structure|input type=textarea}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the '''pharmacodynamics''':
* Please enter information related to the '''pharmacodynamics''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|PD|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|PD|input type=textarea|default=There is limited information regarding ''Pharmacodynamics'' of {{PAGENAME}} in the drug label.}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the '''pharmacokinetics''':
* Please enter information related to the '''pharmacokinetics''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|PK|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|PK|input type=textarea|default=There is limited information regarding ''Pharmacokinetics'' of {{PAGENAME}} in the drug label.}}}
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| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information related to the '''nonclinical toxicology''':
* Please enter information related to the '''nonclinical toxicology''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|nonClinToxic|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|nonClinToxic|input type=textarea|default=There is limited information regarding ''Nonclinical Toxicology'' of {{PAGENAME}} in the drug label.}}}
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| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Clinical Studies
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Clinical Studies
Line 214: Line 207:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information pertaining to the '''clinical studies''' of the drug:
* Please enter information pertaining to the '''clinical studies''' of the drug:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|clinicalStudies|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|clinicalStudies|input type=textarea|default=There is limited information regarding ''Clinical Studies'' of {{PAGENAME}} in the drug label.}}}
|-
|-
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | How Supplied
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | How Supplied
|-
|-
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information pertaining to '''how the drug is supplied''':
* Please enter information pertaining to '''how the drug is supplied''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|howSupplied|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|howSupplied|input type=textarea}}}
|-
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter information pertaining to '''how the drug should be stored''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|storage|input type=textarea}}}
|-
|-
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Patient Counseling Information
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Patient Counseling Information
Line 231: Line 219:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter the '''Patient Counseling Information''' here:
* Please enter the '''Patient Counseling Information''' here:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|fdaPatientInfo|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|fdaPatientInfo|input type=textarea|default=There is limited information regarding ''Patient Counseling Information'' of {{PAGENAME}} in the drug label.}}}
|-
|-
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Precautions with Alcohol
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Precautions with Alcohol
Line 243: Line 231:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter the '''brand names''' here:
* Please enter the '''brand names''' here:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|brandNames|input type=textarea}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|brandNames|input type=textarea|default=®}}}
|-
|-
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Look-Alike Drug Names
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Look-Alike Drug Names
Line 249: Line 237:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter '''look-alike names''' that could be confused with the drug:
* Please enter '''look-alike names''' that could be confused with the drug:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|lookAlike|input type=textarea}}}{{{end template}}}
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|lookAlike|input type=textarea|default=A® — B®}}}
|}
|-
| style="font-weight: bold; font-size: 150%; padding: 5px 15px; background: #545454; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); color: #F8F8FF;" colspan=2 | Package and Label Display Panel
|-
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
* Please enter the '''Package and Label Display Panel''' here:
: <div style="font-size: 50%;"><nowiki>[[File:XXXXX.png|thumb|none|400px|This image is provided by the National Library of Medicine.]]</nowiki></div>
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|packLabel|input type=textarea}}}
|-
|}{{{end template}}}
----
----
{{{standard input|save}}} {{{standard input|preview}}} {{{standard input|changes}}} {{{standard input|cancel}}}
{{{standard input|save}}} {{{standard input|preview}}} {{{standard input|changes}}} {{{standard input|cancel}}}
</includeonly>
</includeonly>

Latest revision as of 17:27, 25 February 2015

Retrieved from "https://www.wikidoc.org/index.php?title=Form:DrugProjectForm01&oldid=1073410"