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Decision Support for Drug Forms in Chronic Disease Management Guidelines

Develop a computer system that can answer drug-related questions for chronic disease management guidelines. The system should classify drugs by indication, chemical structure, route of administration, and form. Proposed forms include spray, dermal spray, and various inhalant forms. Classification includes physical form, administration action, and device taxonomy.

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Decision Support for Drug Forms in Chronic Disease Management Guidelines

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  1. Drug Forms Peter Johnson SCHIN, Newcastle, UK Work done in Prodigy 3 project By Chris Wroe, Medical Informatics Group, Manchester University, UK

  2. Motivation • Decision support • Chronic disease management guidelines • Computer needs to be able to answer questions such as :- • “Is this patient on an inhaled steroid for asthma?” • “on a sustained release tablet for angina?” • Implies machine has explicit categorisation of drugs by Indication, Chemical structure, Route of admin, Form, etc.

  3. Patient on • Becodisks • Dry powder for inhalation, disks containing 8 blisters of beclometasone dipropionate • 100 micrograms/blister

  4. Forms proposed Spray.  Dermal Spray.  Inhalant.  .  Inhalant Powder.  .  .  Inhalant Powder Capsule.  .  Nasal Inhalant.  .  Oral Inhalant.  Nasal Spray.  Spray with Adaptor.  Powder Spray.  .  Inhalant Powder.  .  .  Inhalant Powder Capsule

  5. Inhaledsteroid for asthma Route – implies some forms Aerosol, Dry powder Drug class Indication

  6. Route of administration Physical Form + Administration Action + Administration Device Inhaled Powder Form for chewing Delivered by applicator ‘Form’ in reality

  7. Route taxonomy . topical to conjunctiva . topical to ear . topical to nose . topical to skin . topical to scalp . topical to oral mucosa . . buccal . sublingual . topical to teeth . oral (passing through oral cavity) . rectal . vaginal . intravenous . intrathecal . intraperitoneal . inhaled to lung . . inhaled to lung via nose . . inhaled to lung via mouth

  8. Drug form taxonomy . aerosol . bar . cake . disk . foam . gel . . jelly . gum . liniment . liquidEmulsion . lotion . ointment . particulate . . bead . . crystal . . flake . . granule . . pellet . . powder . . suppository . paste . patch . pillShaped . . caplet . . capsule . . tablet . . . lozenge . . . pastille . . troche . semiSolidEmulsion . . cream . solution . . aqueous . . . elixir . . . syrup . . oil . stick . suspension . wafer

  9. Device taxonomy . spray device . drug applicator . drug dropper device

  10. Process/Action taxonomy .Douching . Rinsing . Irrigating . Spraying . Liquid installing . . Infusing . . Irrigating . Chewing . Inhaling . Ingesting

  11. By Route . 'inhaled to lung form' . . 'Inhalation Solution' . . 'Nasal Inhalant' . . 'Oral Inhalant' . . 'Inhalant Powder' . . . 'Inhalant Powder Capsule‘ By Action By Physical Form . 'Solid' . . 'Powder' . . . 'Powder Spray' . . . . 'Inhalant Powder' . . . . . 'Inhalant Powder Capsule' . . . 'Powder for Reconstitution‘ By Device 4 hierarchies of ‘form’

  12. 'Sustained Release Buccal Tablet' Intermediate Representation : MAIN tabletHAS_PHARMACOKINETICS sustained releaseHAS_ROUTE buccal 

  13. Form classification: 'Solid‘ . 'Pill‘ . . 'Tablet‘ . . . 'Sustained Release Buccal Tablet' From form taxonomy: pillShaped  .  . caplet  .  . capsule  .  . tablet  .  .  . lozenge  .  .  . pastille  .  . troche   'Sustained Release Buccal Tablet'First parent :Form classification

  14. Route classification . 'oral mucosa form'. . 'buccal form'. . .'Sustained Release Buccal Tablet' From route taxonomy Route. topical to conjunctiva. topical to ear. topical to nose. topical to skin. topical to scalp. topical to oral mucosa. . buccal 'Sustained Release Buccal Tablet’ second parent : Route classification n.b. Pharmacokinetics – sustained release is another classification concept

  15. Preliminary work Quick classification of the leaf terms supplied Intermediate nodes from Prodigy work Chris Wroe [wroec@cs.man.ac.uk] http://www.cs.man.ac.uk/mig/people/wroec/index.html Where now?

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