--- type: "resource-definitions" title: "Medication Definitions" resource: "Medication" --- # Medication Definitions ## Medication Definition of a Medication **Definition:** This resource is primarily used for the identification and definition of a medication, including ingredients, for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use. **Cardinality:** 0..* **Mappings:** script10.6=NewRx/MedicationPrescribed -or- RxFill/MedicationDispensed -or- RxHistoryResponse/MedicationDispensed -or- RxHistoryResponse/MedicationPrescribed; rim=ManufacturedProduct[classCode=ADMM]; w5=clinical.medication ## Medication.identifier Business identifier for this medication **Definition:** Business identifier for this medication. **Comments:** The serial number could be included as an identifier. **Cardinality:** 0..* **Type:** [Identifier](/Identifier) **Summary:** true **Mappings:** w5=FiveWs.identifier; rim=.id ## Medication.code Codes that identify this medication **Definition:** A code (or set of codes) that specify this medication, or a textual description. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems. The name of the medication can be conveyed in the code.text even if it is different from any of the coding displayName values. **Comments:** Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one). **Cardinality:** 0..1 **Type:** [CodeableConcept](/CodeableConcept) **Binding:** example:[medication-codes](/valueset-medication-codes) **Summary:** true **Mappings:** script10.6=coding.code = //element(*,MedicationType)/DrugCoded/ProductCode coding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier coding.display = //element(*,MedicationType)/DrugDescription; w5=FiveWs.class; v2=RXO-1.1 Requested Give Code.code / RXE-2.1 Give Code.code / RXD-2.1 Dispense/Give Code.code / RXG-4.1 Give Code.code /RXA-5.1 Administered Code.code / RXC-2.1 Component Code; rim=.code ## Medication.status active | inactive | entered-in-error **Definition:** A code to indicate if the medication is in active use. **Comments:** This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status. **Cardinality:** 0..1 **Type:** [code](/code) **Binding:** required:[medication-status](/valueset-medication-status) **Summary:** true **Is Modifier:** true (Reason: This element changes the interpretation of all descriptive attributes.) **Mappings:** rim=.statusCode ## Medication.marketingAuthorizationHolder Organization that has authorization to market medication **Definition:** The company or other legal entity that has authorization, from the appropriate drug regulatory authority, to market a medicine in one or more jurisdictions. Typically abbreviated MAH.Note: The MAH may manufacture the product and may also contract the manufacturing of the product to one or more companies (organizations). **Cardinality:** 0..1 **Type:** Reference([Organization](/Organization)) **Summary:** true **Mappings:** rim=.player.scopingRole[typeCode=MANU].scoper ## Medication.doseForm powder | tablets | capsule + **Definition:** Describes the form of the item. Powder; tablets; capsule. **Comments:** When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form. **Cardinality:** 0..1 **Type:** [CodeableConcept](/CodeableConcept) **Binding:** example:[medication-form-codes](/valueset-medication-form-codes) **Mappings:** script10.6=coding.code = //element(*,DrugCodedType)/FormCode coding.system = //element(*,DrugCodedType)/FormSourceCode; v2=RXO-5 Requested Dosage Form / RXE-6 Give Dosage Form / RXD-6 Actual Dosage Form / RXG-8 Give Dosage Form / RXA-8 Administered Dosage Form; rim=.formCode ## Medication.packageSize When the code does not specify the package size, this backbone element can be used to specify the overall amount of medication in the package **Definition:** When the code does not specify the package size, this backbone element can be used to specify the overall amount of medication in the package. **Comments:** To represent a medication that has 5 vials with 10ml in each vial and the medication code just represents a vial, then the number of Items would be '5 vial' and the amountPerItem would be '10ml/vial'. To represent a medication where there are 300 tablets and the code is for 100mg tablets, the number of items would be '300 tablets' **Cardinality:** 0..1 **Type:** [BackboneElement](/BackboneElement) **Summary:** true **Constraints:** med-1 | error | Either numberOfItems or amountPerItem must exist | numberOfItems.exists() or amountPerItem.exists() **Mappings:** rim=.quantity ## Medication.packageSize.numberOfItems The number of items in the package that are represented by the code **Definition:** The number of items in the package that are represented by the code, e.g. 5 vials or 100 tablets. **Cardinality:** 0..1 **Type:** [SimpleQuantity](/SimpleQuantity) ## Medication.packageSize.amountPerItem The amount per each item **Definition:** The amount per each item, e.g. 10 ml / vial. **Cardinality:** 0..1 **Type:** [Ratio](/Ratio) ## Medication.ingredient Components of a medication. These can be ingredient substances or other medications, in the case of combination packaged medications **Definition:** Identifies a particular constituent of interest in the product. **Comments:** The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients. If Medication.code represents a fully specified product (the product + the strength + the dosage form) then including ingredients is duplicative. However, there may be implementation considerations which dictate including ingredients when Medication.code is a fully specified product. For compounded products, active and inactive ingredients should be included. However, even with all ingredients specified, a Medication resource should not be considered a "recipe" as the sequence and techniques for preparing the final product cannot be included. **Cardinality:** 0..* **Type:** [BackboneElement](/BackboneElement) **Mappings:** rim=.scopesRole[typeCode=INGR] ## Medication.ingredient.item The specific substance or medication that is the ingredient **Definition:** The ingredient (substance or medication) that the ingredient.strength relates to. This is represented as a concept from a code system or described in another resource (Substance or Medication). **Comments:** The ingredient may reference a medication substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base). A referenced medication may be fully specified (amoxicillin 250 mg capsule), partially specified (amoxicillin 250mg), or may refer to an abstract ingredient (e.g., amoxicillin). **Cardinality:** 1..1 **Type:** [CodeableReference](/CodeableReference) **Binding:** example:[medication-codes](/valueset-medication-codes) **Mappings:** script10.6=coding.code = //element(*,MedicationType)/DrugCoded/ProductCode coding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier coding.display = //element(*,MedicationType)/DrugDescription; v2=RXC-2 Component Code if medication: RXO-1 Requested Give Code / RXE-2 Give Code / RXD-2-Dispense Give Code / RXG-4 Give Code / RXA-5 Administered Code; rim=.player ## Medication.ingredient.isActive Active ingredient indicator **Definition:** Indication of whether this ingredient affects the therapeutic action of the drug. **Requirements:** True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive). **Cardinality:** 0..1 **Type:** [boolean](/boolean) **Mappings:** rim=NA ## Medication.ingredient.role A code that defines the type of ingredient, active, base, etc. **Definition:** Indication of whether this ingredient affects the therapeutic action of the drug. **Requirements:** This can be used in combination with the isActive element to provide further information about the type of ingredient. **Cardinality:** 0..1 **Type:** [CodeableConcept](/CodeableConcept) **Binding:** example:[v3-RoleClassIngredientEntity](/valueset-v3-RoleClassIngredientEntity) **Mappings:** rim=NA ## Medication.ingredient.strength[x] Quantity of ingredient present **Definition:** Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet but can also be expressed a quantity when the denominator is assumed to be 1 tablet. **Comments:** Medication.ingredient.strength.denominator can cause some confusion. For example, the concentration of a pediatric acetaminophen suspension can be '32 mg / 1 ml' or '160 mg / 5 ml'. Both strengths are the same (32 mg * 5 = 160 mg). In clinical systems (drug databases) strengths are usually to unit volumes (32 mg / 1 ml). While on a consumer product it's preferred to say how much per 'typical' dose (160 mg / 5 ml, with 5 ml (1 tsp) being the typical dose). Both representations are valid. Best practice is to select the denominator most relevant to the situation and use that same denominator for all ingredients. Ingredient.strength is problematic for multi-ingredient ingredients. For example, antacid products often contain multiple ingredients, such as 'aluminum & magnesium hydroxide with simethicone 400-400-40 mg/5ml'. Expressing a 'final concentration' in these cases is intractable and the best option is to not include ingredient.strength. **Cardinality:** 0..1 **Type:** [Ratio](/Ratio), [CodeableConcept](/CodeableConcept), [Quantity](/Quantity) **Binding:** preferred:[medication-ingredientstrength](/valueset-medication-ingredientstrength) **Mappings:** script10.6=//element(*,DrugCodedType)/Strength; v2=RXC-3 Component Amount & RXC-4 Component Units if medication: RXO-2 Requested Give Amount - Minimum & RXO-4 Requested Give Units / RXO-3 Requested Give Amount - Maximum & RXO-4 Requested Give Units / RXO-11 Requested Dispense Amount & RXO-12 Requested Dispense Units / RXE-3 Give Amount - Minimum & RXE-5 Give Units / RXE-4 Give Amount - Maximum & RXE-5 Give Units / RXE-10 Dispense Amount & RXE-10 Dispense Units; rim=.quantity ## Medication.instance Details about packaged medications **Definition:** Information that only applies to packages (not products). **Cardinality:** 0..1 **Type:** [BackboneElement](/BackboneElement) **Mappings:** script10.6=no mapping; rim=.player[classCode=CONT] ## Medication.instance.identifier Identifier for the physical instance, typically a serial number **Definition:** Identifier for the physical instance, typically a serial number. **Cardinality:** 0..* **Type:** [Identifier](/Identifier) **Mappings:** rim=.id ## Medication.instance.lotNumber Identifier assigned to batch **Definition:** The assigned lot number of a batch of the specified product. **Cardinality:** 0..1 **Type:** [string](/string) **Mappings:** script10.6=no mapping; v2=RXA-15 Substance Lot Number / RXG-19 Substance Lot Number; rim=.id ## Medication.instance.expirationDate When instance will expire **Definition:** When this specific instance of product will expire. **Cardinality:** 0..1 **Type:** [dateTime](/dateTime) **Mappings:** script10.6=no mapping; v2=RXA-16 Substance Expiration Date / RXG-20 Substance Expiration Date; rim=participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime ## Medication.definition Formal definition of the medication **Definition:** A reference to a definitional resource that provides more information about this medication. **Cardinality:** 0..1 **Type:** Reference([MedicinalProductDefinition](/MedicinalProductDefinition), [AdministrableProductDefinition](/AdministrableProductDefinition), [PackagedProductDefinition](/PackagedProductDefinition), [ManufacturedItemDefinition](/ManufacturedItemDefinition))