Using rxNorm with FHIR
Contents
Introduction
On this page, all the rules & semantics for using RxNorm with FHIR are defined.
All of these are defined in terms of the default mysql RxNorm database created (after fixes!) by the scripts provided with RxNorm. This does not imply that implementations are required to use it, only that this is a useful place from which to start
Basics
- Namespace is http://www.nlm.nih.gov/research/umls/rxnorm
- codes = CUIs, though AUIs may be used in the property filters
- The display name is
select Str from rxnconso where RXCUI = :code and SAB = 'RXNORM'
Filter properties
to make the SQL filters work, the base SQL is
Select RXCUI from rxnconso where SAB = 'RXNORM'
Description | Property Name | Property Operators | Value | Comments | SQL clause for '=' operator |
---|---|---|---|---|---|
Semantic Type | STY | in/= | [column:]Value | if not column is specified, the default column is TUI | and RXCUI in (select RXCUI from rxnsty where :column = :value) |
Source | SAB | in/= | Value | value comes from (select RSAB from rxnsab) | and RXCUI in (select RXCUI from rxnconso where SAB = :value) |
Term Type | TTY | in/= | Value | value of TTY column in rxnconso | and TTY = :value |
Relationship (A) | [REL] | in/= | Value | REL (:rel) is one of SY, SIB, RN, PAR, CHD, RB or RO, and Value is either a RXCUI or RXAUI (the relationship test traverses both AUI and CUI links | and (RXCUI in (select RXCUI from rxnconso where RXAUI in (select RXAUI1 from rxnrel where REL = :rel and RXAUI2 = :value)) or RXCUI in (select RXCUI1 from rxnrel where REL = :rel and RXCUI2 = :value)) |
Relationship (B) | [RELA] | in/= | Value | RELA (:rela) is one of the relationship types immediately below, and Value is either a RXCUI or RXAUI (the relationship test traverses both AUI and CUI links | and (RXCUI in (select RXCUI from rxnconso where RXAUI in (select RXAUI1 from rxnrel where RELA = :rela and RXAUI2 = :value)) or RXCUI in (select RXCUI1 from rxnrel where RELA = :rela and RXCUI2 = :value)) |
Relationship Types
- active_ingredient_of
- active_metabolites_of
- chemical_structure_of
- consists_of
- constitutes
- contained_in
- contains
- contraindicated_with_disease
- contraindicating_class_of
- contraindicating_mechanism_of_action_of
- contraindicating_physiologic_effect_of
- doseformgroup_of
- dose_form_of
- effect_may_be_inhibited_by
- entry_version_of
- form_of
- has_active_ingredient
- has_active_metabolites
- has_chemical_structure
- has_contraindicated_drug
- has_contraindicating_class
- has_contraindicating_mechanism_of_action
- has_contraindicating_physiologic_effect
- has_doseformgroup
- has_dose_form
- has_entry_version
- has_form
- has_ingredient
- has_ingredients
- has_mechanism_of_action
- has_member
- has_part
- has_participant
- has_permuted_term
- has_pharmacokinetics
- has_physiologic_effect
- has_precise_ingredient
- has_print_name
- has_product_component
- has_quantified_form
- has_sort_version
- has_therapeutic_class
- has_tradename
- included_in
- includes
- induced_by
- induces
- ingredients_of
- ingredient_of
- inverse_isa
- isa
- mapped_from
- mapped_to
- may_be_diagnosed_by
- may_be_prevented_by
- may_be_treated_by
- may_diagnose
- may_inhibit_effect_of
- may_prevent
- may_treat
- mechanism_of_action_of
- member_of
- metabolic_site_of
- participates_in
- part_of
- permuted_term_of
- pharmacokinetics_of
- physiologic_effect_of
- precise_ingredient_of
- print_name_of
- product_component_of
- quantified_form_of
- reformulated_to
- reformulation_of
- site_of_metabolism
- sort_version_of
- therapeutic_class_of
- tradename_of
RxNorm Term Types
RxNorm includes the following term types (TTY)
TTY | Name | Description | Example |
---|---|---|---|
IN | Ingredient | A compound or moiety that gives the drug its distinctive clinical properties. Ingredients generally use the United States Adopted Name (USAN). | Fluoxetine |
PIN | Precise Ingredient | A specified form of the ingredient that may or may not be clinically active. Most precise ingredients are salt or isomer forms. | Fluoxetine Hydrochloride |
MIN | Multiple Ingredients | Two or more ingredients appearing together in a single drug preparation, created from SCDF. In rare cases when IN/PIN or PIN/PIN combinations of the same base ingredient exist, created from SCD. | Fluoxetine / Olanzapine |
DF | Dose Form | Oral Solution | |
DFG | Dose Form Group | Oral Liquid | |
SCDC | Semantic Clinical Drug Component | Ingredient + Strength | Fluoxetine 4 MG/ML |
SCDF | Semantic Clinical Drug Form | Ingredient + Dose Form | Fluoxetine Oral Solution |
SCDG | Semantic Clinical Dose Form Group | Ingredient + Dose Form Group | Fluoxetine Oral Product |
SCD | Semantic Clinical Drug | Ingredient + Strength + Dose Form | Fluoxetine 4 MG/ML Oral Solution |
BN | Brand Name | A proprietary name for a family of products containing a specific active ingredient. | Prozac |
SBDC | Semantic Branded Drug Component | Ingredient + Strength + Brand Name | Fluoxetine 4 MG/ML [Prozac] |
SBDF | Semantic Branded Drug Form | Ingredient + Dose Form + Brand Name | Fluoxetine Oral Solution [Prozac] |
SBDG | Semantic Branded Dose Form Group | Brand Name + Dose Form Group | Prozac Pill |
SBD | Semantic Branded Drug | Ingredient + Strength + Dose Form + Brand Name | Fluoxetine 4 MG/ML Oral Solution [Prozac] |
PSN | Prescribable Name | Synonym of another TTY, given for clarity and for display purposes in electronic prescribing applications. Only one PSN per concept. | Leena 28 Day Pack |
SY | Synonym | Synonym of another TTY, given for clarity. | Prozac 4 MG/ML Oral Solution |
TMSY | Tall Man Lettering Synonym | Tall Man Lettering synonym of another TTY, given to distinguish between commonly confused drugs. | FLUoxetine 10 MG Oral Capsule [PROzac] |
BPCK | Brand Name Pack | {# (Ingredient Strength Dose Form) / # (Ingredient Strength Dose Form)} Pack [Brand Name] | {12 (Ethinyl Estradiol 0.035 MG / Norethindrone 0.5 MG Oral Tablet) / 9 (Ethinyl Estradiol 0.035 MG / Norethindrone 1 MG Oral Tablet) / 7 (Inert Ingredients 1 MG Oral Tablet) } Pack [Leena 28 Day] |
GPCK | Generic Pack | {# (Ingredient + Strength + Dose Form) / # (Ingredient + Strength + Dose Form)} Pack | {11 (varenicline 0.5 MG Oral Tablet) / 42 (varenicline 1 MG Oral Tablet) } Pack |
RxNorm Relationships
This graph represents relationships between term types (TTY), in terms of a small set of relationships (RELA). The green arcs represent connection from the first (leftmost) TTY to the relationship, and the yellow arcs represent the connection from the relationship to the rightmost TTY. Thus, for example, the relationship of {PIN, precise_ingredient_of, BN} (precise ingredient name (PIN) is a precise_ingredient_of a brand name (BN)), there is a green arc from PIN to precise_ingredient_of, and a yellow arc from precise_ingredient_of to BN.
The complete set of RxNorm relationships includes the following:
Name | From | To |
---|---|---|
consists_of | SBD, SCD | SBDC, SCDC |
constitutes | SBDC, SCDC | SBD, SCD |
contained_in | SBD, SCD | BPCK, GPCK |
contains | BPCK, GPCK | SBD, SCD |
dose_form_of | DF | BPCK, GPCK, SBD, SBDF, SCD, SCDF |
has_dose_form | BPCK, GPCK, SBD, SBDF, SCD, SCDF | DF |
doseformgroup_of | DFG | SBDG, SCDG |
has_doseformgroup | SBDG, SCDG | DFG |
form_of | PIN | IN |
has_form | IN | PIN |
ingredient_of | BN, IN | SBD, SBDC, SBDF, SBDG, SCDC, SCDF, SCDG |
ingredients_of | MIN | SCD |
has_ingredient | SBD, SBDC, SBDF, SBDG, SCDC, SCDF, SCDG, SCD | BN, IN, MIN |
part_of | IN, PIN | MIN |
has_part | MIN | IN, PIN |
precise_ingredient_of | PIN | BN, SCDC |
has_precise_ingredient | BN, SCDC | PIN |
quantified_form_of | SBD, SCD | SBD, SCD |
has_quantified_form | SBD, SCD | SBD, SCD |
tradename_of | BN, BPCK, SBD, SBDC, SBDF, SBDG | IN, GPCK, SCD, SCDC, SCDF, SCDG |
has_tradename | GPCK, IN, SCD, SCDC, SCDF, SCDG | BPCK, BN, SBD, SBDC, SBDF, SBDG |
isa | DF, SBD, SBDF, SCD, SCDF | DFG, SBDF, SBDG, SCDF, SCDG |
inverse_isa | DFG, SBDF, SBDG, SCDF, SCDG | DF, SBD, SBDF, SCD, SCDF |
reformulated_to | BN | BN |
reformulation_of | BN | BN |
or, put differently, the following ten and their inverses:
- consists of
- contains
- dose form group of
- dose form of
- form of
- ingredient(s) of
- is a
- part of
- precise ingredient of
- quantified form of
- tradename of