Form:DrugProjectForm: Difference between revisions

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<noinclude>
<noinclude>
This is the "Drug Project Form" form.
{{#forminput:form=Drug_Project_Form|size=60|button text=Create or edit a Drug Page.}}
To create a page with this form, enter the page name below;
</noinclude><includeonly>
if a page with that name already exists, you will be sent to a form to edit that page.


=Instructions=
Instructions for how to use this from will go here.


{{#forminput:form=Drug Project Form}}
=Overview Statement=
{{{for template|Label template}}}
Please enter your author tag here: {{{field|authorTag|input type=text| size=40}}}


</noinclude><includeonly>
Please enter the generic drug name here: {{{field|genericName|input type=text| size=40}}}
<div id="wikiPreview" style="display: none; padding-bottom: 25px; margin-bottom: 25px; border-bottom: 1px solid #AAAAAA;"></div>
{|
{{{for template|Label template}}}
!Please indicate the Class to which the drug belongs:
{| class="formtable"
| {{{field|drugClass|input type=dropdown|values=5-Alpha reductase inhibitor,5-Lipoxygenase inhibitor,Acetylcholine release inhibitor,Acetylcholine releasing agent,Actinomycin,Adenosine receptor agonist,Adrenal steroid synthesis inhibitor,Adrenergic receptor agonist,Adrenocorticotropic hormone,Aldehyde dehydrogenase inhibitor,Aldosterone antagonist,Alkylating drug,Allogeneic cord blood hematopoietic progenitor cell therapy,Allogeneic cultured cell scaffold,Allylamine antifungal,Alpha-adrenergic agonist,Alpha-adrenergic blocker,Alpha-glucosidase inhibitor,Aluminum complex,Amide local anesthetic,Amino acid,Amino acid hypertonic solution,Aminoglycoside antibacterial,Aminoketone,Aminosalicylate,Amphenicol-class antibacterial,Amphetamine anorectic,Amylin analog,Androgen,Androgen receptor inhibitor,Angiontensin converting enzyme inhibitor,Angiotensin 2 receptor blocker,Angiotensin converting enzyme inhibitor,Anthracycline topoisomerase inhibitor,Anti-anginal,Anti-coagulant,Anti-epileptic agent,Anti-IgE,Anti-inhibitor coagulant complex,Antiarrhythmic,Anticholinergic,Antidiarrheal,Antidote,Antidote for acetaminophen overdose,Antiemetic,Antifibrinolytic agent,Antihelminthic,Antihistamine,Antimalarial,Antimetabolite,Antimetabolite immunosuppressant,Antimycobacterial,Antiparasitic,Antiprotozoal,Antirheumatic agent,Antiseptic,Antivenin,Aromatase inhibitor,Aromatic amino acid decarboxylation inhibitor,Arteriolar vasodilator,Asparagine-specific enzyme,Atypical antipsychotic,Autologous cellular immunotherapy,Autologous cultured cell,Autonomic ganglionic blocker,Azole antifungal,B lymphocyte stimulator-specific inhibitor,Barbiturate,Benzodiazepine,Benzodiazepine antagonist,Benzothiazole,Benzylamine antifungal,Beta lactamase inhibitor,Beta-adrenergic agonist,Beta-adrenergic blocker,Beta2-adrenergic agonist,Beta3-adrenergic agonist,Biguanide,Bile acid,Bile acid sequestrant,Bismuth,Bisphosphonate,Blood coagulation factor,Blood viscosity reducer,Bovine intestinal adenosine deaminase,Bradykinin B2 receptor antagonist,Calcineurin inhibitor immunosuppressant,Calcitonin,Calcium,Calcium channel blocker,Calcium-sensing receptor agonist,Calculi dissolution agent,Cannabinoid,Carbamoyl phosphate synthetase 1 activator,Carbonic anhydrase inhibitor,Cardiac glycoside,Carnitine analog,Catechol-O-methyltransferase inhibitor,Catecholamine,Catecholamine synthesis inhibitor,Catecholamine-depleting sympatholytic,CCR5 co-receptor antagonist,CD20-directed cytolytic antibody,CD20-directed radiotherapeutic antibody,CD25-directed cytotoxin,CD3 blocker immunosuppressant,CD30-directed immunoconjugate,CD52-directed cytolytic antibody,Cell death inducer,Central alpha-2 adrenergic agonist,Central nervous system depressant,Central nervous system stimulant,Cephalosporin antibacterial,Chloride channel activator,Cholecystokinin analog,Cholinergic muscarinic agonist,Cholinergic muscarinic antagonist,Cholinergic nicotinic agonist,Cholinergic receptor agonist,Cholinesterase inhibitor,Cholinesterase reactivator,Collagen-specific enzyme,Complement inhibitor,Contrast agent for ultrasound imaging,Copper absorption inhibitor,Copper-containing intrauterine device,Corticosteroid,Cysteine depleting agent,Cystic fibrosis transmembrane conductance regulator potentiator,Cytochrome p450 2D6 inhibitor,Cytomegalovirus nucleoside analog DNA polymerase inhibitor,Cytoprotective agent,Decarboxylase inhibitor,Demulcent,Depigmenting agent,Depolarizing neuromuscular blocker,Diagnostic dye,Dietary cholesterol absorption inhibitor,Dihydrofolate reductase inhibitor antibacterial,Dihydrofolate reductase inhibitor antimalarial,Dihydropyridine calcium channel blocker,Dipeptidyl peptidase 4 inhibitor,Direct thrombin inhibitor,Dopamine-2 receptor antagonist,Dopaminergic agonist,Echinocandin antifungal,Endoglycosidase,Endothelin receptor antagonist,Epidermal growth factor receptor antagonist,Ergot derivative,Ergot-derived dopamine receptor agonist,Ergotamine derivative,Erythropoiesis-stimulating agent,Ester local anesthetic,Estrogen,Estrogen agonist/antagonist,Estrogen receptor antagonist,Factor VIII activator,Factor Xa inhibitor,Folate analog,Folate analog metabolic inhibitor,Gadolinium-based contrast agent,Gamma-aminobutyric acid a receptor agonist,Gamma-aminobutyric acid-ergic agonist,General anesthetic,Glinide,GLP-1 receptor agonist,Glucosylceramide synthase inhibitor,Glycopeptide antibacterial,Glycosaminoglycan,Gonadotropin,Gonadotropin releasing hormone antagonist,Gonadotropin releasing hormone receptor agonist,Growth hormone releasing factor analog,Guanylate cyclase-C agonist,Hedgehog pathway inhibitor,Helicobacter pylori diagnostic,Hematopoietic stem cell mobilizer,Heparin reversal agent,Hepatitis B virus nucleoside analog reverse transcriptase inhibitor,Hepatitis C virus NS3/4a protease inhibitor,Her2 receptor antagonist,Herpes simplex virus nucleoside analog dna polymerase inhibitor,Herpes zoster virus nucleoside analog dna polymerase inhibitor,Herpesvirus nucleoside analog dna polymerase inhibitor,Histamine-1 receptor antagonist,Histamine-1 receptor inhibitor,Histamine-2 receptor antagonist,Histone deacetylase inhibitor,HMG-CoA reductase inhibitor,Human alpha-1 proteinase inhibitor,Human antihemophilic factor,Human blood coagulation factor,Human C1 esterase inhibitor,Human immunodeficiency virus 1 fusion inhibitor,Human immunodeficiency virus 1 non-nucleoside analog reverse transcriptase inhibitor,Human immunodeficiency virus integrase strand transfer inhibitor,Human immunodeficiency virus nucleoside analog reverse transcriptase inhibitor,Human immunoglobulin,Human immunoglobulin G,Human platelet-derived growth factor,Human serum albumin,Hydrolytic lysosomal glucocerebroside-specific enzyme,Hydrolytic lysosomal glycogen-specific enzyme,Hydrolytic lysosomal glycosaminoglycan-specific enzyme,Hydrolytic lysosomal neutral glycosphingolipid-specific enzyme,Hydroxyphenyl-pyruvate dioxygenase inhibitor,Immunoglobulin G,Inactivated Salmonella typhi vaccine,Influenza A M2 protein inhibitor,Inhalation diagnostic agent,Insulin,Insulin analog,Integrin receptor antagonist,Interferon alpha,Interferon gamma,Interleukin-1 receptor antagonist,Interleukin-2 receptor blocking antibody,Intestinal lipase inhibitor,Iron chelator,Ketolide antibacterial,Kinase inhibitor,L-Thyroxine,L-Triiodothyronine,Lead chelator,Leukocyte growth factor,Leukotriene receptor antagonist,Lincosamide antibacterial,Lipid-based polyene antifungal,Lipopeptide antibacterial,Live attenuated Bacillus Calmette-Guerin immunotherapy,Live attenuated Bacillus Calmette-Guerin vaccine,Live attenuated mumps virus vaccine,Live human adenovirus type 4 vaccine,Live human adenovirus type 7 vaccine,Live rotavirus vaccine,Local anesthetic,Loop diuretic,Low molecular weight heparin,Lymphocyte growth factor,Macrolide,Macrolide antibacterial,Macrolide antimicrobial,Mast cell stabilizer,Megakaryocyte growth factor,Melanin synthesis inhibitor,Melatonin receptor agonist,Metal chelator,Methylated sulfonamide antibacterial,Methylating agent,Methylxanthine,Microtubule inhibitor,Monoamine oxidase inhibitor,Monoamine oxidase type B inhibitor,Monobactam antibacterial,Mood stabilizer,Mtor inhibitor immunosuppressant,Mucocutaneous epithelial cell growth factor,Mucolytic,Muscle relaxant,N-Methyl-D-aspartate receptor antagonist,N-Type calcium channel antagonist,Natriuretic peptide,Neuraminidase inhibitor,Nicotinic acid,Nitrate vasodilator,Nitrofuran antibacterial,Nitrogen binding agent,Nitroimidazole antimicrobial,Non-narcotic antitussive,Non-standardized animal dander allergenic extract,Non-standardized animal hair allergenic extract,Non-standardized animal skin allergenic extract,Non-standardized bacterial allergenic extract,Non-standardized chemical allergen,Non-standardized feather allergenic extract,Non-standardized food allergenic extract,Non-standardized fungal allergenic extract,Non-standardized house dust allergenic extract,Non-standardized insect allergenic extract,Non-standardized insect venom allergenic extract,Non-standardized plant allergenic extract,Non-standardized plant fiber allergenic extract,Non-standardized pollen allergenic extract,Noncompetitive ampa glutamate receptor antagonist,Nondepolarizing neuromuscular blocker,Nonergot dopamine agonist,Nonsteroidal anti-inflammatory drug,Norepinephrine reuptake inhibitor,"Norepinephrine, serotonin, and dopamine reuptake inhibitor anorectic",Nucleoside analog antifungal,Nucleoside analog antiviral,Nucleoside metabolic inhibitor,Omega-3 fatty acid,Opioid agonist,Opioid agonist/antagonist,Opioid antagonist,Osmotic diuretic,Osmotic laxative,Oxazolidinone antibacterial,Oxytocic,P2Y12 platelet inhibitor,Paramagnetic contrast agent,Parathyroid hormone analog,Parental iron replacement,Partial cholinergic nicotinic agonist,Partial opioid agonist,Partial opioid agonist/antagonist,Pediculicide,Penem antibacterial,Penicillin-class antibacterial,Peroxisome proliferator receptor alpha agonist,Peroxisome proliferator receptor gamma agonist,Phenothiazine,Phosphate binder,Phosphodiesterase 3 inhibitor,Phosphodiesterase 5 inhibitor,Photoactivated radical generator,Photoenhancer,Plasma volume expander,Platelet aggregation inhibitor,Platelet-reducing agent,Platinum-based drug,Pleuromutilin antibacterial,Polyene antifungal,Polyene antimicrobial,Polymyxin-class antibacterial,Porphyrin precursor,Potassium channel opener,Potassium salt,Potassium-sparing diuretic,Progesterone,Progestin,Progestin antagonist,Progestin-containing intrauterine device,Prostacycline,Prostacycline vasodilator,Prostaglandin analog,Prostaglandin E1 agonist,Prostaglandin E1 analog,Protease inhibitor,Proteasome inhibitor,Proton pump inhibitor,Provitamin D2 compound,Psoralen,Purine antimetabolite,Pyrethroid,Pyrimidine synthesis inhibitor,Pyrophosphate analog dna polymerase inhibitor,Quinolone antimicrobial,Radioactive diagnostic agent,Radioactive diagnostic agent for positron emission tomography,Radioactive therapeutic agent,Radiographic contrast agent,RANK ligand inhibitor,Recombinant antithrombin,Recombinant human deoxyribonuclease 1,Recombinant human growth hormone,Recombinant human interferon beta,Reducing and complexing thiol,Renal dehydropeptidase inhibitor,Renin inhibitor,Respiratory stimulant,Respiratory syncytial virus anti-f protein monoclonal antibody,Retinoid,Rifamycin antibacterial,Rifamycin antimycobacterial,Rna synthetase inhibitor antibacterial,Sclerosing agent,Selective T cell costimulation blocker,Selective T cell costimulation modulator,Serotonin and norepinephrine reuptake inhibitor,Serotonin reuptake inhibitor,Serotonin-1B and serotonin-1D receptor agonist,Serotonin-2C receptor agonist,Serotonin-3 receptor antagonist,Serotonin-4 receptor antagonist,Sigma-1 agonist,Skeletal muscle relaxant,Skin test antigen,Somatostatin analog,Sphingosine 1-phosphate receptor modulator,Standardized animal hair allergenic extract,Standardized animal skin allergenic extract,Standardized chemical allergen,Standardized insect allergenic extract,Standardized insect venom allergenic extract,Standardized pollen allergenic extract,Stimulant laxative,Streptogramin antibacterial,Substance P/neurokinin-1 receptor antagonist,Sucrose-specific enzyme,Sulfonamide antibacterial,Sulfonamide antimicrobial,Sulfone,Sulfonylurea,Surfactant,Sympathomimetic amine anorectic,Sympathomimetic-like agent,Tetracycline-class antibacterial,Tetracycline-class antimicrobial,Tetracycline-class drug,Thiazide diuretic,Thiazide-like diuretic,Thiazolidinedione,Thrombolytic agent,Thrombopoiesis stimulating agent,Thyroid hormone synthesis inhibitor,Thyroid stimulating hormone,Topoisomerase inhibitor,Tricyclic antidepressant,Tuberculosis skin test,Tumor necrosis factor blocker,Typical antipsychotic,Uncompetitive N-methyl-D-aspartate receptor antagonist,Unfractionated heparin,Urease inhibitor,Uric acid-specific enzyme,Vascular endothelial growth factor-directed antibody,Vasodilator,Vasopressin analog,Vasopressin antagonist,Vinca alkaloid,Vitamin A,Vitamin B complex member,Vitamin B12,Vitamin D,Vitamin D analog,Vitamin D2 analog,Vitamin D3 analog,Vitamin K,Vitamin K antagonist,Warfarin reversal agent,Xanthine oxidase inhibitor}}}
! BlackBoxWarningTitle:
| {{{field|drugClass}}}
|-
|-
! UseInRace:
! Please describe which indications the FDA has approved the use of the drug:
| {{{field|indication}}}
| {{{field|indication|input type=textarea|size=35}}}
|-
|-
! MechAction:
! Is there a Black Box warning associated with the drug?:
| {{{field|blackBoxWarning}}}
|{{{field|hasBlackBoxWarning|input type=dropdown|values=,Yes}}}
|-
|-
! NlmPatientInfo:
! Please list the most common adverse reactions associate with the drug:
| {{{field|adverseReactions}}}
| {{{field|adverseReactions|input type=textarea|size=35}}}
|}
|}
{{{end template}}}
{{{end template}}}


=Black Box Warning=
{{{for template|DrugProjectForm}}}
{{{for template|DrugProjectForm}}}
{| class="formtable"
{|
! BlackBoxWarningTitle:
! Is there a Black Box warning associated with the drug?:
| {{{field|blackBoxWarningTitle}}}
|{{{field|hasBlackBoxWarning|input type=dropdown|values=,Yes}}}
|-
|-
! UseInRace:
!Please enter the title of the Black Box Warning
| {{{field|blackBoxWarningBody}}}
| {{{field|blackBoxWarningTitle|input type=text|size=40}}}
|-
|-
! MechAction:
!Please enter the body of the Black Box Warning
| {{{field|fdaLIADAdult}}}
|{{{field|blackBoxWarningBody|input type=textarea|size=35}}}
|}
 
=Adult Indications and Dosage=
{|
!Please enter the FDA-Labeled Indications and Dosage Information for Adults
| {{{field|fdaLIADAdult|input type=textarea|size=35}}}
|-
|-
! NlmPatientInfo:
!Please enter any established Off-Label Use and Dosage for Adults
| {{{field|offLabelAdult}}}
|{{{field|offLabelAdult|input type=textarea|size=35}}}
|}
 
 
=Pediatric Indications and Dosage=
{|
!Please enter the FDA-Labeled Indications and Dosage Information for Children
| {{{field|fdaLIADPed|input type=textarea|size=35}}}
|-
|-
! DrugShortage:
!Please enter any established Off-Label Use and Dosage for Children
| {{{field|fdaLIADPed}}}
|{{{field|offLabePed|input type=textarea|size=35}}}
|}
 
=Contraindications=
{|
!Please enter the FDA reported contraindications:
| {{{field|contraindications|input type=textarea|values=5-Alpha reductase inhibitor,5-Lipoxygenase inhibitor,Acetylcholine release inhibitor,Acetylcholine releasing agent,Actinomycin,Adenosine receptor agonist,Adrenal steroid synthesis inhibitor,Adrenergic receptor agonist,Adrenocorticotropic hormone,Aldehyde dehydrogenase inhibitor,Aldosterone antagonist,Alkylating drug,Allogeneic cord blood hematopoietic progenitor cell therapy,Allogeneic cultured cell scaffold,Allylamine antifungal,Alpha-adrenergic agonist,Alpha-adrenergic blocker,Alpha-glucosidase inhibitor,Aluminum complex,Amide local anesthetic,Amino acid,Amino acid hypertonic solution,Aminoglycoside antibacterial,Aminoketone,Aminosalicylate,Amphenicol-class antibacterial,Amphetamine anorectic,Amylin analog,Androgen,Androgen receptor inhibitor,Angiontensin converting enzyme inhibitor,Angiotensin 2 receptor blocker,Angiotensin converting enzyme inhibitor,Anthracycline topoisomerase inhibitor,Anti-anginal,Anti-coagulant,Anti-epileptic agent,Anti-IgE,Anti-inhibitor coagulant complex,Antiarrhythmic,Anticholinergic,Antidiarrheal,Antidote,Antidote for acetaminophen overdose,Antiemetic,Antifibrinolytic agent,Antihelminthic,Antihistamine,Antimalarial,Antimetabolite,Antimetabolite immunosuppressant,Antimycobacterial,Antiparasitic,Antiprotozoal,Antirheumatic agent,Antiseptic,Antivenin,Aromatase inhibitor,Aromatic amino acid decarboxylation inhibitor,Arteriolar vasodilator,Asparagine-specific enzyme,Atypical antipsychotic,Autologous cellular immunotherapy,Autologous cultured cell,Autonomic ganglionic blocker,Azole antifungal,B lymphocyte stimulator-specific inhibitor,Barbiturate,Benzodiazepine,Benzodiazepine antagonist,Benzothiazole,Benzylamine antifungal,Beta lactamase inhibitor,Beta-adrenergic agonist,Beta-adrenergic blocker,Beta2-adrenergic agonist,Beta3-adrenergic agonist,Biguanide,Bile acid,Bile acid sequestrant,Bismuth,Bisphosphonate,Blood coagulation factor,Blood viscosity reducer,Bovine intestinal adenosine deaminase,Bradykinin B2 receptor antagonist,Calcineurin inhibitor immunosuppressant,Calcitonin,Calcium,Calcium channel blocker,Calcium-sensing receptor agonist,Calculi dissolution agent,Cannabinoid,Carbamoyl phosphate synthetase 1 activator,Carbonic anhydrase inhibitor,Cardiac glycoside,Carnitine analog,Catechol-O-methyltransferase inhibitor,Catecholamine,Catecholamine synthesis inhibitor,Catecholamine-depleting sympatholytic,CCR5 co-receptor antagonist,CD20-directed cytolytic antibody,CD20-directed radiotherapeutic antibody,CD25-directed cytotoxin,CD3 blocker immunosuppressant,CD30-directed immunoconjugate,CD52-directed cytolytic antibody,Cell death inducer,Central alpha-2 adrenergic agonist,Central nervous system depressant,Central nervous system stimulant,Cephalosporin antibacterial,Chloride channel activator,Cholecystokinin analog,Cholinergic muscarinic agonist,Cholinergic muscarinic antagonist,Cholinergic nicotinic agonist,Cholinergic receptor agonist,Cholinesterase inhibitor,Cholinesterase reactivator,Collagen-specific enzyme,Complement inhibitor,Contrast agent for ultrasound imaging,Copper absorption inhibitor,Copper-containing intrauterine device,Corticosteroid,Cysteine depleting agent,Cystic fibrosis transmembrane conductance regulator potentiator,Cytochrome p450 2D6 inhibitor,Cytomegalovirus nucleoside analog DNA polymerase inhibitor,Cytoprotective agent,Decarboxylase inhibitor,Demulcent,Depigmenting agent,Depolarizing neuromuscular blocker,Diagnostic dye,Dietary cholesterol absorption inhibitor,Dihydrofolate reductase inhibitor antibacterial,Dihydrofolate reductase inhibitor antimalarial,Dihydropyridine calcium channel blocker,Dipeptidyl peptidase 4 inhibitor,Direct thrombin inhibitor,Dopamine-2 receptor antagonist,Dopaminergic agonist,Echinocandin antifungal,Endoglycosidase,Endothelin receptor antagonist,Epidermal growth factor receptor antagonist,Ergot derivative,Ergot-derived dopamine receptor agonist,Ergotamine derivative,Erythropoiesis-stimulating agent,Ester local anesthetic,Estrogen,Estrogen agonist/antagonist,Estrogen receptor antagonist,Factor VIII activator,Factor Xa inhibitor,Folate analog,Folate analog metabolic inhibitor,Gadolinium-based contrast agent,Gamma-aminobutyric acid a receptor agonist,Gamma-aminobutyric acid-ergic agonist,General anesthetic,Glinide,GLP-1 receptor agonist,Glucosylceramide synthase inhibitor,Glycopeptide antibacterial,Glycosaminoglycan,Gonadotropin,Gonadotropin releasing hormone antagonist,Gonadotropin releasing hormone receptor agonist,Growth hormone releasing factor analog,Guanylate cyclase-C agonist,Hedgehog pathway inhibitor,Helicobacter pylori diagnostic,Hematopoietic stem cell mobilizer,Heparin reversal agent,Hepatitis B virus nucleoside analog reverse transcriptase inhibitor,Hepatitis C virus NS3/4a protease inhibitor,Her2 receptor antagonist,Herpes simplex virus nucleoside analog dna polymerase inhibitor,Herpes zoster virus nucleoside analog dna polymerase inhibitor,Herpesvirus nucleoside analog dna polymerase inhibitor,Histamine-1 receptor antagonist,Histamine-1 receptor inhibitor,Histamine-2 receptor antagonist,Histone deacetylase inhibitor,HMG-CoA reductase inhibitor,Human alpha-1 proteinase inhibitor,Human antihemophilic factor,Human blood coagulation factor,Human C1 esterase inhibitor,Human immunodeficiency virus 1 fusion inhibitor,Human immunodeficiency virus 1 non-nucleoside analog reverse transcriptase inhibitor,Human immunodeficiency virus integrase strand transfer inhibitor,Human immunodeficiency virus nucleoside analog reverse transcriptase inhibitor,Human immunoglobulin,Human immunoglobulin G,Human platelet-derived growth factor,Human serum albumin,Hydrolytic lysosomal glucocerebroside-specific enzyme,Hydrolytic lysosomal glycogen-specific enzyme,Hydrolytic lysosomal glycosaminoglycan-specific enzyme,Hydrolytic lysosomal neutral glycosphingolipid-specific enzyme,Hydroxyphenyl-pyruvate dioxygenase inhibitor,Immunoglobulin G,Inactivated Salmonella typhi vaccine,Influenza A M2 protein inhibitor,Inhalation diagnostic agent,Insulin,Insulin analog,Integrin receptor antagonist,Interferon alpha,Interferon gamma,Interleukin-1 receptor antagonist,Interleukin-2 receptor blocking antibody,Intestinal lipase inhibitor,Iron chelator,Ketolide antibacterial,Kinase inhibitor,L-Thyroxine,L-Triiodothyronine,Lead chelator,Leukocyte growth factor,Leukotriene receptor antagonist,Lincosamide antibacterial,Lipid-based polyene antifungal,Lipopeptide antibacterial,Live attenuated Bacillus Calmette-Guerin immunotherapy,Live attenuated Bacillus Calmette-Guerin vaccine,Live attenuated mumps virus vaccine,Live human adenovirus type 4 vaccine,Live human adenovirus type 7 vaccine,Live rotavirus vaccine,Local anesthetic,Loop diuretic,Low molecular weight heparin,Lymphocyte growth factor,Macrolide,Macrolide antibacterial,Macrolide antimicrobial,Mast cell stabilizer,Megakaryocyte growth factor,Melanin synthesis inhibitor,Melatonin receptor agonist,Metal chelator,Methylated sulfonamide antibacterial,Methylating agent,Methylxanthine,Microtubule inhibitor,Monoamine oxidase inhibitor,Monoamine oxidase type B inhibitor,Monobactam antibacterial,Mood stabilizer,Mtor inhibitor immunosuppressant,Mucocutaneous epithelial cell growth factor,Mucolytic,Muscle relaxant,N-Methyl-D-aspartate receptor antagonist,N-Type calcium channel antagonist,Natriuretic peptide,Neuraminidase inhibitor,Nicotinic acid,Nitrate vasodilator,Nitrofuran antibacterial,Nitrogen binding agent,Nitroimidazole antimicrobial,Non-narcotic antitussive,Non-standardized animal dander allergenic extract,Non-standardized animal hair allergenic extract,Non-standardized animal skin allergenic extract,Non-standardized bacterial allergenic extract,Non-standardized chemical allergen,Non-standardized feather allergenic extract,Non-standardized food allergenic extract,Non-standardized fungal allergenic extract,Non-standardized house dust allergenic extract,Non-standardized insect allergenic extract,Non-standardized insect venom allergenic extract,Non-standardized plant allergenic extract,Non-standardized plant fiber allergenic extract,Non-standardized pollen allergenic extract,Noncompetitive ampa glutamate receptor antagonist,Nondepolarizing neuromuscular blocker,Nonergot dopamine agonist,Nonsteroidal anti-inflammatory drug,Norepinephrine reuptake inhibitor,"Norepinephrine, serotonin, and dopamine reuptake inhibitor anorectic",Nucleoside analog antifungal,Nucleoside analog antiviral,Nucleoside metabolic inhibitor,Omega-3 fatty acid,Opioid agonist,Opioid agonist/antagonist,Opioid antagonist,Osmotic diuretic,Osmotic laxative,Oxazolidinone antibacterial,Oxytocic,P2Y12 platelet inhibitor,Paramagnetic contrast agent,Parathyroid hormone analog,Parental iron replacement,Partial cholinergic nicotinic agonist,Partial opioid agonist,Partial opioid agonist/antagonist,Pediculicide,Penem antibacterial,Penicillin-class antibacterial,Peroxisome proliferator receptor alpha agonist,Peroxisome proliferator receptor gamma agonist,Phenothiazine,Phosphate binder,Phosphodiesterase 3 inhibitor,Phosphodiesterase 5 inhibitor,Photoactivated radical generator,Photoenhancer,Plasma volume expander,Platelet aggregation inhibitor,Platelet-reducing agent,Platinum-based drug,Pleuromutilin antibacterial,Polyene antifungal,Polyene antimicrobial,Polymyxin-class antibacterial,Porphyrin precursor,Potassium channel opener,Potassium salt,Potassium-sparing diuretic,Progesterone,Progestin,Progestin antagonist,Progestin-containing intrauterine device,Prostacycline,Prostacycline vasodilator,Prostaglandin analog,Prostaglandin E1 agonist,Prostaglandin E1 analog,Protease inhibitor,Proteasome inhibitor,Proton pump inhibitor,Provitamin D2 compound,Psoralen,Purine antimetabolite,Pyrethroid,Pyrimidine synthesis inhibitor,Pyrophosphate analog dna polymerase inhibitor,Quinolone antimicrobial,Radioactive diagnostic agent,Radioactive diagnostic agent for positron emission tomography,Radioactive therapeutic agent,Radiographic contrast agent,RANK ligand inhibitor,Recombinant antithrombin,Recombinant human deoxyribonuclease 1,Recombinant human growth hormone,Recombinant human interferon beta,Reducing and complexing thiol,Renal dehydropeptidase inhibitor,Renin inhibitor,Respiratory stimulant,Respiratory syncytial virus anti-f protein monoclonal antibody,Retinoid,Rifamycin antibacterial,Rifamycin antimycobacterial,Rna synthetase inhibitor antibacterial,Sclerosing agent,Selective T cell costimulation blocker,Selective T cell costimulation modulator,Serotonin and norepinephrine reuptake inhibitor,Serotonin reuptake inhibitor,Serotonin-1B and serotonin-1D receptor agonist,Serotonin-2C receptor agonist,Serotonin-3 receptor antagonist,Serotonin-4 receptor antagonist,Sigma-1 agonist,Skeletal muscle relaxant,Skin test antigen,Somatostatin analog,Sphingosine 1-phosphate receptor modulator,Standardized animal hair allergenic extract,Standardized animal skin allergenic extract,Standardized chemical allergen,Standardized insect allergenic extract,Standardized insect venom allergenic extract,Standardized pollen allergenic extract,Stimulant laxative,Streptogramin antibacterial,Substance P/neurokinin-1 receptor antagonist,Sucrose-specific enzyme,Sulfonamide antibacterial,Sulfonamide antimicrobial,Sulfone,Sulfonylurea,Surfactant,Sympathomimetic amine anorectic,Sympathomimetic-like agent,Tetracycline-class antibacterial,Tetracycline-class antimicrobial,Tetracycline-class drug,Thiazide diuretic,Thiazide-like diuretic,Thiazolidinedione,Thrombolytic agent,Thrombopoiesis stimulating agent,Thyroid hormone synthesis inhibitor,Thyroid stimulating hormone,Topoisomerase inhibitor,Tricyclic antidepressant,Tuberculosis skin test,Tumor necrosis factor blocker,Typical antipsychotic,Uncompetitive N-methyl-D-aspartate receptor antagonist,Unfractionated heparin,Urease inhibitor,Uric acid-specific enzyme,Vascular endothelial growth factor-directed antibody,Vasodilator,Vasopressin analog,Vasopressin antagonist,Vinca alkaloid,Vitamin A,Vitamin B complex member,Vitamin B12,Vitamin D,Vitamin D analog,Vitamin D2 analog,Vitamin D3 analog,Vitamin K,Vitamin K antagonist,Warfarin reversal agent,Xanthine oxidase inhibitor
}}}
|}
 
=Warnings=
{|
!Please enter the FDA reported warnings associated with the drug:
| {{{field|warnings|input type=textarea|size=35}}}
|}
 
=Adverse Reactions=
{|
!Are there any data on adverse reactions?
|{{{field|hasAdverseReactions|input type=dropdown|values=Yes,}}}
 
|-
|-
! OffLabelPed:
!Please enter the adverse reactions reported from Clinical Trial Experience
| {{{field|offLabelPed}}}
| {{{field|clinicalTrials|input type=textarea|size=35}}}
|-
|-
! Contraindications:
!Please enter the adverse reactions reported from Postmarketing Experience
| {{{field|contraindications}}}
|{{{field|postmarketing|input type=textarea|size=35}}}
|}
 
=Drug Interactions=
{|
!Please enter the known drug interactions:
| {{{field|drugInteractions|input type=textarea|size=35}}}
|}
 
=Use in Specific Populations=
{|
! Does the US FDA provide any information related to the usage of the drug in women who are pregnant?
|{{{field|hasUseInPregnancyFDA|input type=dropdown|values=,Yes}}}
|-
|-
! Warnings:
!Please enter any information related to the FDA reported pregnancy category
| {{{field|warnings}}}
| {{{field|useInPregnancyFDA|input type=textarea|size=35}}}
|-
|-
! AdverseReactions:
! Does the Australian Drug Evaluation Committee (ADEC) provide any information related to the usage of the drug in women who are pregnant?
| {{{field|adverseReactions}}}
|{{{field|hasUseInPregnancyAUS|input type=dropdown|values=,Yes}}}
|-
|-
! ClinicalTrials:
!Please enter any information related to the Australian reported pregnancy category
| {{{field|clinicalTrials}}}
| {{{field|useInPregnancyAUS|input type=textarea|size=35}}}
|-
|-
! Postmarketing:
! Does the US FDA provide any information related to the usage of the drug during labor and delivery?
| {{{field|postmarketing}}}
|{{{field|hasUseInLaborDelivery|input type=dropdown|values=,Yes}}}
|-
|-
! DrugInteractions:
!Please enter any information related to the use of the drug during Labor and Delivery
| {{{field|drugInteractions}}}
|{{{field|useInLaborDelivery|input type=textarea|size=35}}}
|-
|-
! UseInPregnancyFDA:
! Does the US FDA provide any information related to the usage of the drug in women who are nursing?
| {{{field|useInPregnancyFDA}}}
|{{{field|hasUseInNursing|input type=dropdown|values=,Yes}}}
|-
|-
! UseInPregnancyAUS:
!Please enter any information related to the use of the drug during Nursing
| {{{field|useInPregnancyAUS}}}
|{{{field|useInNursing|input type=textarea|size=35}}}
|-
|-
! UseInLaborDelivery:
! Does the US FDA provide any information related to the usage of the drug in pediatric settings?
| {{{field|useInLaborDelivery}}}
|{{{field|hasUseInPed|input type=dropdown|values=,Yes}}}
|-
|-
! UseInNursing:
!Please enter any information related to the use of the drug in Pediatrics
| {{{field|useInNursing}}}
|{{{field|useInPed|input type=textarea|size=35}}}
|-
|-
! UseInPed:
! Does the US FDA provide any information related to the usage of the drug in geriatric settings?
| {{{field|useInPed}}}
|{{{field|hasUseInGeri|input type=dropdown|values=,Yes}}}
|-
|-
! UseInGeri:
!Please enter any information related to the use of the drug in Geriatrics
| {{{field|useInGeri}}}
|{{{field|useInGeri|input type=textarea|size=35}}}
|-
|-
! UseInGender:
! Does the US FDA provide any information related to the usage of the drug in specific gender populations?
| {{{field|useInGender}}}
|{{{field|hasUseInGender|input type=dropdown|values=,Yes}}}
|-
|-
! UseInRace:
!Please enter any information related to the use of the drug and Gender
| {{{field|useInRace}}}
|{{{field|useInGender|input type=textarea|size=35}}}
|-
|-
! UseInRenalImpair:
! Does the US FDA provide any information related to the usage of the drug in specific racial populations?
| {{{field|useInRenalImpair}}}
|{{{field|hasUseInRace|input type=dropdown|values=,Yes}}}
|-
|-
! UseInHepaticImpair:
!Please enter any information related to the use of the drug and Race
| {{{field|useInHepaticImpair}}}
|{{{field|useInRace|input type=textarea|size=35}}}
|-
|-
! UseInReproPotential:
! Does the US FDA provide any information related to the usage of the drug in patients with renal impairment?
| {{{field|useInReproPotential}}}
|{{{field|hasUseInRenalImpair|input type=dropdown|values=,Yes}}}
|-
|-
! UseInImmunocomp:
!Please enter any information related to the use of the drug in patients with Renal Impairment
| {{{field|useInImmunocomp}}}
|{{{field|useInRenalImpair|input type=textarea|size=35}}}
|-
|-
! Routes:
! Does the US FDA provide any information related to the usage of the drug in patients with hepatic impairment?
| {{{field|routes}}}
|{{{field|hasUseInHepaticImpair|input type=dropdown|values=,Yes}}}
|-
|-
! Preparations:
!Please enter any information related to the use of the drug in patients with Hepatic Impairment
| {{{field|preparations}}}
|{{{field|useInHepaticImpair|input type=textarea|size=35}}}
|-
|-
! IVCompat:
! Does the US FDA provide any information related to the usage of the drug in females of reproductive potential and males?
| {{{field|IVCompat}}}
|{{{field|hasUseInReproPotential|input type=dropdown|values=,Yes}}}
|-
|-
! Overdose:
!Please enter any information related to the use of the drug in Females of Reproductive Potential and Males
| {{{field|overdose}}}
|{{{field|useInReproPotential|input type=textarea|size=35}}}
|-
|-
! Mechanism of Action:
! Does the US FDA provide any information related to the usage of the drug in patients who are immunocompromised?
| {{{field|Mechanism of Action}}}
|{{{field|hasUseInImmunocomp|input type=dropdown|values=,Yes}}}
|-
|-
! MechAction:
!Please enter any information related to the use of the drug in Immunocompromised Patients
| {{{field|mechAction}}}
|{{{field|useInImmunocomp|input type=textarea|size=35}}}
|-
|-
! Structure:
! When you have finished copying the content generated for the above sections into the appropriate Microchapters, please change this value from "In Progress" to blank.
| {{{field|structure}}}
|{{{field|hasUsageInfo|default=In Progress|input type=dropdown|values=In Progress,}}}
|}
 
=Routes and Preparations=
{|
!Please enter information pertaining to the administration Routes here
| {{{field|routes|input type=textarea|size=35}}}
|-
|-
! PD:
!Please enter information pertaining to the drug Preparations here
| {{{field|PD}}}
|{{{field|preparations|input type=textarea|size=35}}}
|}
 
=IV Compatibility=
{|
!Please enter information pertaining to the IV Compatibility here
|{{{field|IVCompat|input type=textarea|size=35}}}
|}
 
=Overdose=
{|
!Please enter information pertaining to the drug Overdose here
|{{{field|overdose|input type=textarea|size=35}}}
|}
 
 
=Pharmacology=
{|
!Please enter any information related to the Mechanism of Action
| {{{field|mechAction|input type=textarea|size=35}}}
|-
|-
! PK:
!Please enter any information related to the Structure
| {{{field|PK}}}
| {{{field|structure|input type=textarea|size=35}}}
|-
|-
! NonClinToxic:
!Please enter any information related to the Pharmacodynamics
| {{{field|nonClinToxic}}}
|{{{field|PD|input type=textarea|size=35}}}
|-
|-
! ClinicalStudies:
!Please enter any information related to the Pharmacokinetics
| {{{field|clinicalStudies}}}
|{{{field|PK|input type=textarea|size=35}}}
|-
|-
! HowSupplied:
!Please enter any information related to the Nonclinical Toxicology
| {{{field|howSupplied}}}
|{{{field|nonClinToxic|input type=textarea|size=35}}}
|}
 
=Clinical Studies=
{|
!Please enter information pertaining to the Clinical Studies of the drug
|{{{field|clinicalStudies|input type=textarea|size=35}}}
|}
 
=How Supplied=
{|
!Please enter information pertaining to the How the Drug is Supplied
|{{{field|howSupplied|input type=textarea|size=35}}}
|}
 
=Images=
{|
!Please enter information pertaining to the Drug Images here
|{{{field|drugImages|input type=textarea|size=35}}}
|-
|-
! DrugImages:
!Please enter information pertaining to the FDA Package Label here
| {{{field|drugImages}}}
|{{{field|packLabel|input type=textarea|size=35}}}
|-
|}
! PackLabel:
 
| {{{field|packLabel}}}
=Patient Information=
|-
{|
! FdaPatientInfo:
!Please enter the FDA Provided Patient Information here
| {{{field|fdaPatientInfo}}}
|{{{field|fdaPatientInfo|input type=textarea|size=35}}}
|-
|-
! NlmPatientInfo:
!Please enter the NLM Provided Patient Information Here
| {{{field|nlmPatientInfo}}}
|{{{field|nlmPatientInfo|input type=textarea|size=35}}}
|-
! Price:
| {{{field|price}}}
|-
! DrugShortage:
| {{{field|drugShortage}}}
|}
|}
{{{end template}}}


'''Free text:'''


{{{standard input|free text|rows=10}}}
=Price=
{|
!Please enter the drugs a patient may want to compare for Price
|{{{field|price|input type=textarea|size=35}}}
|}


=Drug Shortages=
{|
!Please enter information relevant to Drug Shortages
|{{{field|drugShortage|input type=textarea|size=35}}}
|}


{{{standard input|summary}}}
<headertabs/>
 
{{{standard input|minor edit}}} {{{standard input|watch}}}
 
{{{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>

Revision as of 15:59, 21 March 2014


Retrieved from "https://www.wikidoc.org/index.php?title=Form:DrugProjectForm&oldid=958763"