Approximate decision support rule | Inpatient/ Outpatient DB | Laboratory DB | Supportive Knowledge | Information/ Recommendation/ Warning |
---|---|---|---|---|
IF the patient has ASM AND the patient has a tumor with a D816V c-Kit mutation THEN recommended dose of Gleevec is 400 mg/day | Medication – Imatinib mesylate (Gleevec®) Disease status – ASM, DFSP, or GIST | Tumor/Pathogen genotype – gastrointestinal stromal tumor c-Kit expression | N/A | Recommendation |
IF the patient has a CYP2C9 variant AND the variant causes poor metabolism THEN the dose of Celecoxib should be reduced by 50% | Medication – Celecoxib | CYP2C9 variant status | CYP2C9 variants causing poor metabolism | Recommendation |
IF the patient has a CYP2C19 variant AND the variant causes poor metabolism THEN the dose adjustment for Clopidogrel is unknown for the patient | Medication – Clopidogrel (Plavix®) | CYP2C19 variant status | CYP2C19 variants causing poor metabolism | Information |
IF the patient has hepatic impairment OR the patient is taking a medication that is a strong CYP2D6 inhibitor OR the patient is a CYP2D6 poor metabolizer THEN the dose of Atomoxetine should be adjusted | Disease status – hepatic impairment Medication – Atomoxetine Medication list | CYP2D6 variant status | Medications that are CYP2D6 inhibitors CYP2D6 variants causing poor metabolism | Information |
IF the patient will be taking Fluoxetine AND the patient is taking other drugs that are metabolized by CYP2D6, THEN coadministration should be approached with caution | Medication – Fluoxetine HCL (Prozac®) Medication list | N/A | Medications metabolized by CYP2D6 | Warning |