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 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}}}
|-
|-
| 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 related to the '''structure''':
* Please enter information related to the '''structure''':
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|structure|input type=textarea|default=File:{{PAGENAME}}01.png|thumb|none|600px|This image is provided by the National Library of Medicine.}}}
: <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 |
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top |
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* 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
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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 '''Package and Label Display Panel''' here:
* Please enter the '''Package and Label Display Panel''' here:
| style="width: 1000px; padding: 5px 5px; border: 2px solid #999; border-radius: 5px 5px 5px 5px;" valign=top | {{{field|brandNames|input type=textarea|default=File:{{PAGENAME}}11.png|thumb|none|600px|This image is provided by the National Library of Medicine.}}}
: <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}}}
|}{{{end template}}}

Latest revision as of 17:27, 25 February 2015

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