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<li class="level1"><div class="li"><span class="li"><a href="#interactions_testing" class="toc">Interactions testing</a></span></div>
<ul class="toc">
<li class="level2"><div class="li"><span class="li"><a href="#defining_interactions" class="toc">Defining interactions</a></span></div></li>
<li class="level2"><div class="li"><span class="li"><a href="#informations_for_the_interactions" class="toc">Informations for the interactions</a></span></div></li>
<li class="level2"><div class="li"><span class="li"><a href="#drugs_databases_that_uses_the_interaction_engine" class="toc">Drugs databases that uses the interaction engine</a></span></div></li>
<li class="level2"><div class="li"><span class="li"><a href="#calculating_and_presenting_drugs_interactions" class="toc">Calculating and presenting drugs interactions</a></span></div></li>
<li class="level2"><div class="li"><span class="li"><a href="#defining_the_type_and_level_of_alert" class="toc">Defining the type and level of alert</a></span></div></li>
<li class="level2"><div class="li"><span class="li"><a href="#the_interactions_synthesis_dialog" class="toc">The interactions synthesis dialog</a></span></div></li></ul>
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<div class="plugin_include_content" id="plugin_include__en:manuals:drugswidget:interactions">
<h1><a name="interactions_testing" id="interactions_testing">Interactions testing</a></h1>
<div class="level1">
<p>
<p><div class="notedoc">This page is up-to-date.
</div></p>
</p>
</div>
<h2><a name="defining_interactions" id="defining_interactions">Defining interactions</a></h2>
<div class="level2">
<p>
The definitions of interactions are those of the AFSSAPS:
</p>
<ul>
<li class="level1"><div class="li"> <strong>The contraindications: </strong> are absolute and must not be transgressed.</div>
</li>
<li class="level1"><div class="li"> <strong>Discouraged associations: </strong> must be avoided in most cases, except after review depth of the benefit / risk and requires close monitoring of the patient.</div>
</li>
<li class="level1"><div class="li"> <strong>Precautions for use: </strong> are the most frequent case. The association is possible from there is compliance, especially in early treatment recommendations for simple avoid the occurrence of interaction (titration, strengthening clinical surveillance, biological, etc …).</div>
</li>
<li class="level1"><div class="li"> <strong>Take into account: </strong> where the potential drug interaction exists, and usually corresponds to the addition of side effects and no practical recommendation can be proposed. It is the physician to assess the appropriateness of the association.</div>
</li>
</ul>
<p>
Each interaction is represented by an icon as shown below.
</p>
<table class="inline">
<tr class="row0">
<th class="col0 leftalign"> Icon </th><th class="col1 leftalign"> Meaning </th>
</tr>
<tr class="row1">
<td class="col0"> <a href="_detail/icons/bctango/48x48/actions/help.png/en_manuals_freediams_interactions.html" class="media" title="icons:bctango:48x48:actions:help.png"><img src="icons/bctango/48x48/actions/help.png" class="media" title="Unrecognize drugs (interactions not available)" alt="Unrecognize drugs (interactions not available)" /></a> </td><td class="col1"> <strong>Unrecognize drugs (interactions not available)</strong> </td>
</tr>
<tr class="row2">
<td class="col0"> <a href="_detail/icons/bctango/48x48/actions/ok.png/en_manuals_freediams_interactions.html" class="media" title="icons:bctango:48x48:actions:ok.png"><img src="icons/bctango/48x48/actions/ok.png" class="media" title="Known drug without interaction" alt="Known drug without interaction" /></a> </td><td class="col1"> <strong>Known drug without interaction</strong> </td>
</tr>
<tr class="row3">
<td class="col0"> <a href="_detail/icons/bctango/48x48/actions/information.png/en_manuals_freediams_interactions.html" class="media" title="icons:bctango:48x48:actions:information.png"><img src="icons/bctango/48x48/actions/information.png" class="media" title="Low level interaction : INN duplication" alt="Low level interaction : INN duplication" /></a> </td><td class="col1"> <strong>Low level interaction : INN duplication</strong> </td>
</tr>
<tr class="row4">
<td class="col0"> <a href="_detail/icons/bctango/48x48/actions/messagebox_info.png/en_manuals_freediams_interactions.html" class="media" title="icons:bctango:48x48:actions:messagebox_info.png"><img src="icons/bctango/48x48/actions/messagebox_info.png" class="media" title="Low level interaction: Precaution of use" alt="Low level interaction: Precaution of use" /></a> </td><td class="col1"> <strong>Low level interaction: Precaution of use</strong> </td>
</tr>
<tr class="row5">
<td class="col0"><a href="_detail/icons/bctango/48x48/actions/messagebox_warning.png/en_manuals_freediams_interactions.html" class="media" title="icons:bctango:48x48:actions:messagebox_warning.png"><img src="icons/bctango/48x48/actions/messagebox_warning.png" class="media" title="Interaction : Take into account" alt="Interaction : Take into account" /></a> </td><td class="col1"> <strong>Interaction : Take into account</strong> </td>
</tr>
<tr class="row6">
<td class="col0"><a href="_detail/icons/bctango/48x48/actions/deconseille.png/en_manuals_freediams_interactions.html" class="media" title="icons:bctango:48x48:actions:deconseille.png"><img src="icons/bctango/48x48/actions/deconseille.png" class="media" title="Interaction : Unadvised association" alt="Interaction : Unadvised association" /></a></td><td class="col1"> <strong>Interaction : Unadvised association</strong> </td>
</tr>
<tr class="row7">
<td class="col0"><a href="_detail/icons/bctango/48x48/actions/messagebox_critical.png/en_manuals_freediams_interactions.html" class="media" title="icons:bctango:48x48:actions:messagebox_critical.png"><img src="icons/bctango/48x48/actions/messagebox_critical.png" class="media" title="Interaction : contraindication" alt="Interaction : contraindication" /></a></td><td class="col1"> <strong>Interaction : contraindication</strong> </td>
</tr>
<tr class="row8">
<td class="col0"><a href="_detail/icons/bctango/48x48/actions/pencil.png/en_manuals_freediams_interactions.html" class="media" title="icons:bctango:48x48:actions:pencil.png"><img src="icons/bctango/48x48/actions/pencil.png" class="media" title="Pure textual prescription (no interaction available)" alt="Pure textual prescription (no interaction available)" /></a></td><td class="col1"> <strong>Pure textual prescription (no interaction available)</strong> </td>
</tr>
</table>
</div>
<h2><a name="informations_for_the_interactions" id="informations_for_the_interactions">Informations for the interactions</a></h2>
<div class="level2">
<p>
The interactions are detailed. Are presented:
</p>
<ul>
<li class="level1"><div class="li"> <strong>nature of risk: </strong> Contraindication, Association recommended, see above…</div>
</li>
<li class="level1"><div class="li"> <strong>risk: </strong> Major side effects or loss of efficacy and mechanism… Action summary, when available</div>
</li>
<li class="level1"><div class="li"> <strong>management</strong>: This most often comes down to one level of risk in the case of an “contraindication” or “unadvised association”. In the case of a “precaution for use”, recommendations often simple to implement is proposed to avoid the occurrence of the interaction (dose adjustment, biological controls, etc …). Level “to take into account” has no practical recommendation primarily because it signals the addition of side effects that only the use of alternative therapies may help avoid.</div>
</li>
</ul>
<p>
These informations are available in french and english.
</p>
</div>
<h2><a name="drugs_databases_that_uses_the_interaction_engine" id="drugs_databases_that_uses_the_interaction_engine">Drugs databases that uses the interaction engine</a></h2>
<div class="level2">
<p>
All databases can use the interaction engine. They just need to include mandatory datas (links between molecular content of drugs and their ATC code).
</p>
<p>
The drugs database information dialog, available from the menu <strong>About/About databases/Information on drugs database</strong>
allow you to evaluate the accurancy of the database. The percents of known molecules for the interaction engine is shown
in the category <strong>Validity/Interaction engine completion</strong>.
</p>
<p>
<a href="drugsdatabaseschema.html" class="wikilink1" title="en:manuals:freediams:drugsdatabaseschema">More informations about the drugs database schema</a>.
</p>
<p>
<a href="participate.html" class="wikilink1" title="en:manuals:freediams:participate">If you want to help this project</a>:
</p>
<ul>
<li class="level1"><div class="li"> creating new drugs database (for your country)</div>
</li>
<li class="level1"><div class="li"> helping medical doctor to link molecular content to ATC codes</div>
</li>
</ul>
</div>
<h2><a name="calculating_and_presenting_drugs_interactions" id="calculating_and_presenting_drugs_interactions">Calculating and presenting drugs interactions</a></h2>
<div class="level2">
<p>
The interactions are calculated in real time. This means that every addition of a drug
in the prescription (double click in the search / selection), interactions are
automatically recalculated. No additional action on your part is required. <br/>
The search for interactions involves analysis of INN and therapeutic classes defined by AFSSAPS.
The INN can belong to several classes. The INN and the classes are presented in the tooltip
that appears under the name of the drug when you leave the mouse over without action. <br/>
</p>
<p>
<p><div class="noteclassic"> It is also possible to add drugs just for testing purposes. These drugs
will not be notified when printing the prescription (this is useful to test intercurrent
treatment in patients already receiving chronic treatment). They will only be used
for calculating the interactions.
</div></p>
</p>
<p>
<p><div class="notewarning">WARNING: All medications does not necessarily have recognized INN. It is therefore necessary to check the icon when prescribing
(see above: Unrecognized drugs).
</div></p>
</p>
<p>
Interactions datas are extracted from
<a href="http://www.afssaps.fr/Dossiers-thematiques/Interactions-medicamenteuses/Interactions-medicamenteuses/(offset)/0" class="urlextern" title="http://www.afssaps.fr/Dossiers-thematiques/Interactions-medicamenteuses/Interactions-medicamenteuses/(offset)/0" rel="nofollow">the french interaction thesaurus from the AFSSAPS (governemental) and translated by hand</a>.
</p>
<p>
The window dosages presents the existence or non-drug interaction for the bias
an icon in the upper left corner.
</p>
</div>
<h2><a name="defining_the_type_and_level_of_alert" id="defining_the_type_and_level_of_alert">Defining the type and level of alert</a></h2>
<div class="level2">
<p>
Interactions alerts can be:
</p>
<ul>
<li class="level1"><div class="li"> dynamics : a dialog shows when one or more interactions are found asking user to confirm ;</div>
</li>
<li class="level1"><div class="li"> passives : interactions are represented by icons, there are no dialog no user prompt.</div>
</li>
</ul>
<p>
Dynamic alerts shows :
</p>
<ul>
<li class="level1"><div class="li"> interacting drugs</div>
</li>
<li class="level1"><div class="li"> level of risk</div>
</li>
<li class="level1"><div class="li"> interacting classes and/or molecules</div>
</li>
</ul>
<p>
<a href="_detail/shots/freediams/v050/dynamic_alerts-en.png/en_manuals_freediams_interactions.html" class="media wikilink2" title="shots:freediams:v050:dynamic_alerts-en.png"><img src="shots/freediams/v050/dynamic_alerts-en.png" class="media" title="Dynamic alert" alt="Dynamic alert" /></a>
</p>
<p>
You can set the two types of alerts warning the minimum level to limit the number of requests for confirmation (<a href="en/manuals/drugswidget/preferences.html" class="wikilink1" title="en:manuals:drugswidget:preferences">refer to application preferences</a>). For example, it is possible to set alerts only for dynamic interactions to unadvised associations and contraindications.
</p>
<p>
<a href="_detail/shots/freediams/v050/dynamic_alerts_preferences-en.png/en_manuals_freediams_interactions.html" class="media" title="shots:freediams:v050:dynamic_alerts_preferences-en.png"><img src="shots/freediams/v050/dynamic_alerts_preferences-en.png" class="media" title="Dynamic alerts preferences" alt="Dynamic alerts preferences" /></a>
</p>
</div>
<h2><a name="the_interactions_synthesis_dialog" id="the_interactions_synthesis_dialog">The interactions synthesis dialog</a></h2>
<div class="level2">
<p>
The details of interactions are available by clicking on the name of the drug in the protocol window or by activating the “interactions' synthesizer” by clicking on the ad hoc (one pair of eyes).
The synthesizer shows, in a separate window, each interaction found: INN, drugs and all information interaction.
The summary can be printed with your header, footer and watermark printing with a click.<br/>
The synthesizer is an indispensable tool for pharmacies or prescription's analysis consultations.
</p>
<p>
<a href="_detail/icons/bctango/16x16/eyes.png/en_manuals_freediams_interactions.html" class="media" title="icons:bctango:16x16:eyes.png"><img src="icons/bctango/16x16/eyes.png" class="media" title="Enable the interactions' synthesizer" alt="Enable the interactions' synthesizer" /></a> : <strong>Enable the interactions' synthesizer</strong>
</p>
<p>
<a href="_detail/shots/freediams/v050/synthetic_interactions_dialog-en.png/en_manuals_freediams_interactions.html" class="media" title="shots:freediams:v050:synthetic_interactions_dialog-en.png"><img src="shots/freediams/v050/synthetic_interactions_dialog-en.png" class="media" title="The interactions' synthesizer" alt="The interactions' synthesizer" /></a>
</p>
</div>
<div class="inclmeta level1">
<abbr class="published" title="2010-09-27T13:56:49Z">2010/09/27 13:56</abbr><div class="tags"><span>
<a href="en/freediams?tag=en:freediams" class="wikilink1" title="en:freediams" rel="tag">freediams</a>,
<a href="en/usermanual?tag=en:usermanual" class="wikilink1" title="en:usermanual" rel="tag">usermanual</a>,
<a href="tag/updated?tag=tag:updated" class="wikilink1" title="tag:updated" rel="tag">updated</a>
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en/manuals/freediams/interactions.txt · Dernière modification: 2010/10/09 22:58 par Eric Maeker, MD </div>
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