rxnorm and dailymed stuart j. nelson, md, facp, facmi

RxNorm and DailyMedRxNorm and DailyMed

Stuart J. Nelson, MD, FACP, FACMIStuart J. Nelson, MD, FACP, FACMI

What is RxNorm?What is RxNorm?

Public Domain VocabularyPublic Domain VocabularyStandardized (NORMalized) names for Standardized (NORMalized) names for

Clinical DrugsClinical DrugsSupports Interoperability Supports Interoperability Part of UMLSPart of UMLS

The Clinical Drug The Clinical Drug Problem (1)Problem (1)

Missed Synonymy in UMLSMissed Synonymy in UMLSHL7 DiscussionsHL7 DiscussionsClinical Drug DefinedClinical Drug Defined

– Ingredient plus Strength or Form or BothIngredient plus Strength or Form or Both

The Clinical Drug The Clinical Drug Problem (2)Problem (2)

Ciprofloxacin 100mg/50mL IV InfusionCiprofloxacin 100mg/50mL IV InfusionCiprofloxacin 400mg/200 ml IV InfusionCiprofloxacin 400mg/200 ml IV InfusionCiprofloxacin Lactate 0.2% in Saline Ciprofloxacin Lactate 0.2% in Saline

(Base Equiv)(Base Equiv)Ciprofloxacin IV Soln 2 MG/MLCiprofloxacin IV Soln 2 MG/MLThe Same, or Different?The Same, or Different?

Why Clinical Drugs?Why Clinical Drugs?

NDC CodesNDC Codes

– Too GranularToo Granular

– Incomplete RecordsIncomplete Records

– Meaningful IdentifiersMeaningful Identifiers

– Without Hyphens - Not UniqueWithout Hyphens - Not UniqueNo Source Complete and AccurateNo Source Complete and Accurate

NDC: 46193073801NDC: 00555046506NDC: 00555046505NDC: 00555046502NDC: 00054475833NDC: 00054475831NDC: 00054475825NDC: 54441019750NDC: 54441019725NDC: 54441019715NDC: 54441019711NDC: 54441019710NDC: 00182175810NDC: 00182175801NDC: 00228232796NDC: 00228232710NDC: 00046042199NDC: 00046042198NDC: 00046042195NDC: 00603548921NDC: 53258015313NDC: 54269010901NDC: 51813007299NDC: 51813007290NDC: 51813007260NDC: 53492301303NDC: 53492301302NDC: 53492301301NDC: 00591555404NDC: 00591555401NDC: 52493063960NDC: 00839711420

NDC: 00615256113NDC: 40039006001NDC: 00025090152NDC: 00025090131NDC: 47202255103NDC: 47202255101NDC: 12027008902NDC: 12027008901NDC: 53487014510NDC: 00781134413NDC: 00781134410NDC: 00781134401NDC: 53978003410NDC: 00117134405NDC: 00117134401NDC: 51316009004NDC: 11146094210NDC: 52544030551NDC: 52544030510NDC: 00839711416NDC: 00536430910NDC: 00536430905NDC: 00536430901NDC: 35470050801NDC: 00143150225NDC: 51608042104NDC: 51608042102NDC: 10465042109NDC: 00721002301NDC: 54421011001NDC: 19458042007NDC: 19458042001

NDC: 50053310901NDC: 47679070204NDC: 47679070201NDC: 46703009410NDC: 46703009401NDC: 52584018410NDC: 00363690810NDC: 53489045101NDC: 00157052610NDC: 00157052601NDC: 00054875825NDC: 00005310931NDC: 00005310923NDC: 00071007024 NDC: 00046042191NDC: 00046042181NDC: 00046042180NDC: 00046042162NDC: 00046042161NDC: 00046042160NDC: 00814644630NDC: 54697006305NDC: 54697006304NDC: 54697006303NDC: 54697006302NDC: 49884010601NDC: 00686018201NDC: 51079027760NDC: 00349845190NDC: 00349845110NDC: 00349845101NDC: 50053310902

NDC: 51285032190NDC: 51285032160NDC: 52985003606NDC: 52985003601NDC: 51285032112NDC: 51285032109NDC: 51285032105NDC: 51285032102NDC: 00555036505NDC: 00555036502NDC: 00308627099NDC: 00308627060NDC: 00308627030NDC: 54697006301NDC: 00302573210NDC: 11146091299NDC: 00719179413NDC: 00719179410NDC: 00904041180NDC: 00904041160NDC: 00894633104NDC: 00894633103NDC: 00894633102NDC: 00894633101NDC: 10647042101NDC: 50111046707NDC: 50111046703NDC: 50111046701NDC: 52555001010NDC: 52555001001NDC: 00093060010NDC: 00093060001

Propranolol10 Mg Oral

Tablet

NDC: 00686027720NDC: 48695117305NDC: 00047007032NDC: 0007007024NDC: 00223255002NDC: 00223255001NDC: 00364075690NDC: 00364075602NDC: 00364075601NDC: 52953000304NDC: 00378018210NDC: 00378018201NDC: 51432097106NDC: 00677104110NDC: 00677104105NDC: 00677104101NDC: 54569055650NDC: 00102333502NDC: 46193073810NDC: 46193073805NDC: 52544030505NDC: 52544030501NDC: 53633032116NDC: 53633032110NDC: 12071044010NDC: 54441004350NDC: 54441004325NDC: 54441004310NDC: 54441004305NDC: 54441004301NDC: 49884010610NDC: 49884010605

The RxNorm ModelThe RxNorm Model

Sources of Clinical Sources of Clinical Drug VocabulariesDrug Vocabularies

First DatabankFirst DatabankMultumMultumMicromedexMicromedexMediSpanMediSpanGold StandardGold StandardSNOMED-CTSNOMED-CTVA NDFVA NDFFDA - NDC Registry, DailyMedFDA - NDC Registry, DailyMed

Present StatusPresent Status

CoverageCoverage– Prescription Drugs (US)Prescription Drugs (US)

– 99% Complete99% CompleteBrowser (RxNav)Browser (RxNav)www.nlm.nih.gov/research/umls/rxnormwww.nlm.nih.gov/research/umls/rxnorm

Differences From UMLS Differences From UMLS

Normalized Names Establish SynonymyNormalized Names Establish SynonymyFrequent ReleasesFrequent ReleasesLimited ScopeLimited Scope

DailyMed BasisDailyMed Basis

Structured Product LabelsStructured Product LabelsFDA Approved InformationFDA Approved Information

What is a Product Label? What is a Product Label?

Content Approved by FDAContent Approved by FDAInformation for Prescribers/ DispensersInformation for Prescribers/ DispensersRarely Information for PatientsRarely Information for Patients

Product Label Distribution Product Label Distribution Old Method Old Method

Printed on Odd Shaped PaperPrinted on Odd Shaped PaperTiny PrintTiny PrintFolded to Postage Stamp SizeFolded to Postage Stamp SizeStuck Inside BoxStuck Inside BoxSome Printed in PDRSome Printed in PDRUpdates Erratic Updates Erratic

Product Label Distribution Product Label Distribution New Method New Method

Submitted and Processed ElectronicallySubmitted and Processed ElectronicallySent to NLMSent to NLMAvailable Online (Section 508 Available Online (Section 508

Compliant)Compliant)Downloadable for ReuseDownloadable for ReuseFirst Label November 1, 2005First Label November 1, 2005Easily UpdatedEasily Updated

Other Features of DailyMedOther Features of DailyMed

LinksLinks– PubMedPubMed

– MEDLINEplusMEDLINEplus

– ClinicalTrialsClinicalTrials

– Presence in Breast MilkPresence in Breast Milk

– Reporting Adverse EventsReporting Adverse EventsRxNorm Names and CodesRxNorm Names and Codes

DailyMed FunctionsDailyMed Functions

Download Product LabelsDownload Product LabelsPrint Product LabelsPrint Product LabelsForward LabelForward LabelSearch Archive for Old LabelsSearch Archive for Old LabelsNotify of Changes (RSS)Notify of Changes (RSS)

DailyMedDailyMed