PHA Rules

;This rule flags user to notify floor about heparin flush 10u/ml
"CHECK WT, IF<= 15kg, use heparin flush 10 u/ml. - ALERT FLOOR!"^A,
"PT is < 15kg, use heparin flush 10u/ml! - ALERT FLOOR!"^B,
IF{[f pt status]'="ADM IN" [f rx ok];
IF{[f pt oe wt kgs]^WT_.=.&([f pt adm/ser age]'>5) [f rx msg](A);
IF{[f pt oe wt kgs]'>15 [f rx msg](B);[f rx ok]}}};

[f pt sex]^SX_.=.,
[f pt oe ht cm]^HT_.=.,
[f pt oe wt kgs]^WT_.=.,
IF{SX="M" 50;45.5}^S,
IF{SX="M" 1;0.85}^F,
S+(2.3*((HT/2.54)-60)!0)^IBW_.=.,
IF{[f pt oe wt kgs]>1 IBW*1.2}^ADBW_.=.,
IF{[f pt oe wt kgs]<IBW [f pt oe wt kgs]^IBW_.=.},
IF{[f pt oe wt kgs]>ADBW ([f pt oe wt kgs]-IBW)^OW},
IF{OW'<0 (OW*0.4)^OWC_.=.},
IF{OW'<0 (OWC+IBW)^IBW_.=.},
IBW^ADBW;

IF{IF{[f rx last ver result]("CR")^SRCR_.=.;
[f pt sex]^SX_.=.;
[f pt oe ht cm]^HT_.=.;
[f pt oe wt kgs]^WT_.=.;
[f pt cur age]^AGE_.=.} " Unable to calculate Creatinine Clearance. "^X,
[f rx msg](X)," ";
IF{SX="M" 50;45.5}^S,
IF{SX="M" 1;0.85}^F,
IF{SRCR<0.8 0.8^SRCR},
S+(2.3*((HT/2.54)-60)!0)^IBW,
IF{[f pt oe wt kgs]<IBW [f pt oe wt kgs]^IBW},
140-AGE*IBW/(72*SRCR)*F}^CRCL;

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;acyclovir specific
; A>=50, B= 25-50, C=10-25, D= <10, Z= ESTIMATED CR CL
"100% usual dose (5mg/kg/dose) q8h - infused over 1 hour"^A,
"100% usual dose (5mg/kg/dose) q12h - infused over 1 hour"^B,
"100% usual dose (5mg/kg/dose) q24h - infused over 1 hour"^C,
"50% usual dose (5mg/kg/dose) q24h - infused over 1 hour"^D,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(10.4'<CRCL&(CRCL'<0)) [f rx msg](D);
(25.4'<CRCL&(CRCL'<10.5)) [f rx msg](C);
(49.4'<CRCL&(CRCL'<25.5)) [f rx msg](B);
49.5'>CRCL [f rx msg](A);[f rx ok]}}};

;THIS CALUCATES AN ESTIMATED CRCL BASED ON AN ADJUSTED BODY WEIGHT. NOTE,
; THIS HAS BEEN MODIFED FROM CRCL.ADJW (THE MESSAGE "UNABLE TO CAC.. HAS BEEN
;REMOVED. I LEFT IT IN THE RULE, BUT DID NOT REFERENCE IT. IN THE LINE UNDER
; THE MESSAGE, I REPLACED THE MESSAGE PROMPT WITH ""
IF{IF{[f rx last ver result]("CR")^SRCR_.=.;
[f pt sex]^SX_.=.;
[f pt oe ht cm]^HT_.=.;
[f pt oe wt kgs]^WT_.=.;
[f pt cur age]^AGE_.=.} " Unable to calculate Creatinine Clearance. "^X,
" "," ";
IF{SX="M" 50;45.5}^S,
IF{SX="M" 1;0.85}^F,
IF{SRCR<0.8 0.8^SRCR},
S+(2.3*((HT/2.54)-60)!0)^IBW_.=.,
IF{[f pt oe wt kgs]>1 IBW*1.2}^ADBW_.=.,
IF{[f pt oe wt kgs]<IBW [f pt oe wt kgs]^IBW_.=.},
IF{[f pt oe wt kgs]>ADBW ([f pt oe wt kgs]-IBW)^OW},
IF{OW'<0 (OW*0.4)^OWC_.=.},
IF{OW'<0 (OWC+IBW)^IBW_.=.},
140-AGE*IBW/(72*SRCR)*F}^CRCL.ADJW;

;This formula calculates the estimated creatinine clearance. If it is missing
;data, it flags the user to that effect "unable to calculate.."
;am not using with the atbxs because I did not want a double flag, am using
;CRCL.ADJA (ADJUSTED WT CR CL- WITHOUT THE MESSAGE. IF DATA NOT THERE, IT JUST
;shows a blank figure for cr cl.
IF{IF{[f rx last ver result]("CR")^SRCR_.=.;
[f pt sex]^SX_.=.;
[f pt oe ht cm]^HT_.=.;
[f pt oe wt kgs]^WT_.=.;
[f pt cur age]^AGE_.=.} " Unable to calculate Creatinine Clearance. "^X,
[f rx msg](X)," ";
IF{SX="M" 50;45.5}^S,
IF{SX="M" 1;0.85}^F,
IF{SRCR<0.8 0.8^SRCR},
S+(2.3*((HT/2.54)-60)!0)^IBW_.=.,
IF{[f pt oe wt kgs]>1 IBW*1.2}^ADBW_.=.,
IF{[f pt oe wt kgs]<IBW [f pt oe wt kgs]^IBW_.=.},
IF{[f pt oe wt kgs]>ADBW ([f pt oe wt kgs]-IBW)^OW},
IF{OW'<0 (OW*0.4)^OWC_.=.},
IF{OW'<0 (OWC+IBW)^IBW_.=.},
140-AGE*IBW/(72*SRCR)*F}^CRCL.ADJW;

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;AMPICILLIN specific
; N=Normal dose: 250mg - 2 g q6h
;A>=50, B= 10-50, C=<10
"250mg - 2g/dose q6h"^A,
"250mg - 2g/dose q6-12h"^B,
"250mg - 2g/dose q12-24h"^C,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(10.4'<CRCL&(CRCL'<0)) [f rx msg](C);
(50.4'<CRCL&(CRCL'<10.5)) [f rx msg](B);
50.5'>CRCL [f rx ok];[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
; AZTREONAM specific
; N=Normal dose: 1 - 2G q8-12h
;A>=50, B= 10-30, C=<10
"Decrease dose by 50% after inital loading dose of 1 or 2 g"^B,
"Usual loading dose, followed by a maintenace dose of 1/4 loading dose"^C,
""^A,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(10.4'<CRCL&(CRCL'<0)) [f rx msg](C);
(30.4'<CRCL&(CRCL'<10.5)) [f rx msg](B);
30.5'>CRCL [f rx ok];[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;CEFAZOLIN specific
; A>=55, B= 35-54, C=11-34, D= <10, W= ESTIMATED CR CL
"Full dose"^A,
"REC. DOSE: Full dose with at least 8 hr intervals."^B,
"REC. DOSE: 1/2 usual dose with 12 hour intervals"^C,
"REC. DOSE: 1/2 usual dose q18 - 24h"^D,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(10.4'<CRCL&(CRCL'<0)) [f rx msg](D);
(34.5'<CRCL&(CRCL'<10.5)) [f rx msg](C);
(54.4'<CRCL&(CRCL'<34.5)) [f rx msg](B);
54.5'>CRCL [f rx ok];[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
; CEFOTAXIME specific
; N=Normal dose: 1 - 2G q8-12h
;C=<20
"CrCl < 20, Decrease dose by 50%"^C,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(20.4'<CRCL&(CRCL'<0)) [f rx msg](C);[f rx ok];[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;CEFTAZIDIME specific
; A=50-31, B= 30-16, C=15-6, D= <5,
"REC. DOSE: 1G Q12h for CrCl between 31-50 ml/min"^A,
"REC. DOSE: 1G q24h for CrCl between 30 - 16 ml/min"^B,
"REC. DOSE: 500 q24h mg for CrCl between 15 - 6 ml/min"^C,
"REC. DOSE: 500 mg q48h for CrCl <5 "^D,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(5.4'<CRCL&(CRCL'<0)) [f rx msg](D);
(15.4'<CRCL&(CRCL'<5.5)) [f rx msg](C);
(30.4'<CRCL&(CRCL'<15.5)) [f rx msg](B);
(50.4'<CRCL&(CRCL'<30.5)) [f rx msg](A);
50.5'>CRCL [f rx ok];[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;CEFUROXIME specific
; N=Normal dose: 1 - 2G q8-12h
;A>=20, B= 10-20, C=<10
"REC. DOSE: 750 mg q12h for CrCl between 10 -20 ml/min "^B,
"REC. DOSE: 750 MG Q24h for CrCl < 10 ml/min "^C,
""^A,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(10.4'<CRCL&(CRCL'<0)) [f rx msg](C);
(20.4'<CRCL&(CRCL'<10.5)) [f rx msg](B);
20.5'>CRCL [f rx ok];[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
; CHLORAMPHENICOL SPECIFIC
; N=Normal dose: 12.5 MG/KG Q6H
;C=<30 (30 WAS ARBITRARY NUMBER
"Normal dose: 12.5 mg/kg q6h, may be used, MNF rec. frequent serum levels"^C,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(30.4'<CRCL&(CRCL'<0)) [f rx msg](C);[f rx ok];[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
; CIPROFLOXACIN specific
; N=Normal dose: 400MG IV Q12H
;C=<29
"REC DOSE: 200 - 400 mg iv q 18 - 24 hrs for CrCl <30ml/min"^C,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(30.4'<CRCL&(CRCL'<0)) [f rx msg](C);[f rx ok];[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;COTRIMOXAZOLE specific
; N=Normal dose: 15-20 mg/kg/day (based on trimethoprim component
;A>=30, B= 15-30, C=<15
"Rec dose: 1/2 stand. regimen for pateints with CrCL between 15-30ml/min"^B,
"DRUG IS NOT RECOMMENED FOR PATIENTS WITH CrCl < 15 ml/min "^C,
"Standard dose: 15-20 mg/kg/day (based on trimethoprim component (16mg/ml)"^A,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(15.4'<CRCL&(CRCL'<0)) [f rx msg](C);
(30.4'<CRCL&(CRCL'<15.5)) [f rx msg](B)&[f rx msg](A);
30.5'>CRCL [f rx msg](A);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;doxyclycline specific
"Manufacturer doesn't recommend an change in normal dosing for Renal Failure"^B,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(10.4'<CRCL&(CRCL'<0)) [f rx msg](B);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
; ERYTHROMYCIN specific
"CrCl < 10, Bennett recommeneds 50-75% of Normal Dose"^B,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(9.4'<CRCL&(CRCL'<0)) [f rx msg](B);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;famotidine specific
"Est. CrCL <10, Recommended dose:20 mg IV Q12h"^B,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(10.4'<CRCL&(CRCL'<0)) [f rx msg](B);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
; FLUCONAZOLE specific
"After loading dose (50-400mg), 50% of normal dose"^B,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(50.4'<CRCL&(CRCL'<0)) [f rx msg](B);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;LEVOFLOXACIN specific
; A>=80, B= 50-80, C=20-49, D= <20, Z= ESTIMATED CR CL
"Full dose"^A,
"CrCl 50-80= Load 500mg, then 250 mg q24h-Unless UTI,then 250mg q24h,No Load"^B,
"CrCl 20-49= Load 500mg, then 250 mg q24h-Unless UTI,then 250mg q48h,No Load"^C,
"CrCl <20 Load 500mg, then 250 mg q24h-Unless UTI,then 250mg q24h,No Load"^D,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(19.4.4'<CRCL&(CRCL'<0)) [f rx msg](D);
(49.4'<CRCL&(CRCL'<19.5)) [f rx msg](C);
(80.4'<CRCL&(CRCL'<49.5)) [f rx msg](B);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
; METRONIDAZOLE specific
"CrCl<10, 50% of normal dose at usual intervals"^B,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(10.4'<CRCL&(CRCL'<0)) [f rx msg](B);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
; NAFCILLIN specific
"Dose reduction not necessary unless patient also has hepatic dysfunction"^B,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(25.4'<CRCL&(CRCL'<0)) [f rx msg](B);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
; PENICILLIN G specific
"CrCL 10 - 50ml/min - Recommeneded dose: 75% of (standard dose)"^B,
"CrCl < 10, Recommended dose: 20-50% of (standard dose)"^C,
""^A,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(9.4'<CRCL&(CRCL'<0)) [f rx msg](C);
(50.4'<CRCL&(CRCL'<9.5)) [f rx msg](B);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;PIPERCILLIN specific
; N=Normal dose: 250mg - 2 g q6h
"CrCl < 50, Recommended interval = Q6-8 HOURS"^A,
"CrCl = 20 - 40 ml/min, Recommended dose: 4g Q8H"^B,
"CrCl <20, Recommended dose: 4 g Q12H"^C,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(20.4'<CRCL&(CRCL'<0)) [f rx msg](C);
(40.4'<CRCL&(CRCL'<20.5)) [f rx msg](B);
(50.4'<CRCL&(CRCL'<40.5)) [f rx msg](A);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;PRIMAXIN specific
; A>=50, B= 25-50, C=10-25, D= <10, Z= ESTIMATED CR CL
"CrCl = 31-70:Dose = 500 Mg IV Q8H. 500 mg q6h for life threatening infec."^A,
"CrCl = 21-30:Dose = 500 mg IV Q12H. 500 mg q8h for life threatening infec."^B,
"CrCl = 0-20: Dose = 250mg IV Q12H, 500mg q12h for life threatening infec."^C,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(19.4'<CRCL&(CRCL'<0)) [f rx msg](C);
(30.4'<CRCL&(CRCL'<19.5)) [f rx msg](B);
(70.4'<CRCL&(CRCL'<30.5)) [f rx msg](A);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;TIMENTIN specific
"CrCl>=60, Recommended dose = 3.1g Q4H"^A,
"CrCl 30-60, Recommended dose: 2g Q4H."^B,
"CrCl 10-30, Recommended dose: 2g Q8H."^C,
"CrCl<10, 2 g Q12H, if Hepatic Dysfunction then give 2g Q24H "^D,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(9.4'<CRCL&(CRCL'<0)) [f rx msg](D);
(29.4'<CRCL&(CRCL'<9.5)) [f rx msg](C);
(59.4'<CRCL&(CRCL'<29.5)) [f rx msg](B);
59.5'>CRCL [f rx msg](A);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
; UNASYN specific
; N=Normal dose: 1.5-3G Q6-8H
;A>=30, B= 15-29, C=<14
"Est. CrCl (15-29), Recommended dose: 1.5 - 3 g q12h"^B,
"Est. CrCl (<=14, Recommended ose: 1.5 - 3g q24h"^C,
""^A,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(14.4'<CRCL&(CRCL'<0)) [f rx msg](C);
(29.4'<CRCL&(CRCL'<14.5)) [f rx msg](B);
29.5'>CRCL [f rx ok];[f rx ok]}}};

;This rule caculates vanco dosing. Assumes a 15 mg/kg load for most patients
; dosing info bascially is comming off package insert
;ADBW -= adjusted body weight
;Vanco dose mg/kg/24h estimated at 0.227 * crcl +5.67
[f rx calc]("ADBW")^BW_.=.,
[f rx calc]("CRCL.ADJW")^CL_.=.,
((0.227*CL)+5.67)*BW^V,
("Rec Dose:",((((0.227*CL)+5.67)*BW)*0.33):0D," Q8H")^E,
"PATIENT IS UNDER 17, NOT A CANDIDATE FOR ONCE DAILY"^A,
"Estimated CrCl is < 10ml/min - Use with Caution"^X,
IF{[f pt cur age]'>18 [f rx ok];
IF{(9.5>CL) [f rx msg](X);
IF{(9.4<CL) ("Loading dose =",(BW*15:0D)," mg")^L,
[f rx msg](L)},
IF{(14.4'<CL&(CL'<9.5)) (".227 =",(BW*15:0D),"MG Q48H")^D,
[f rx msg](D);
(24.4'<CL&(CL'<14.5)) ("Rec Dose:",((((0.227*CL)+5.67)*BW)*0.5):0D," Q24H")^D,
[f rx msg](D),("Rec Dose:",((((0.227*CL)+5.67)*BW)):0D," Q48H")^G,
[f rx msg](G);
(34.4'<CL&(CL'<24.5)) ("Rec Dose:",((((0.227*CL)+5.67)*BW)):0D," Q24H")^D,
[f rx msg](D);
(44.4'<CL&(CL'<34.5)) ("Rec Dose:",((((0.227*CL)+5.67)*BW)*0.5):0D," Q12")^D,
[f rx msg](D),(" OR Rec Dose:",((((0.227*CL)+5.67)*BW)):0D," Q24H")^F,
[f rx msg](F);
(54.4'<CL&(CL'<45.5)) ("Rec Dose:",((((0.227*CL)+5.67)*BW)*0.5):0D," Q12H")^D,
[f rx msg](D),(" OR Rec Dose:",((((0.227*CL)+5.67)*BW)):0D," Q24H")^H,
[f rx msg](H);
(64.4'<CL&(CL'<55.5)) ("Rec Dose:",((((0.227*CL)+5.67)*BW)*0.5):0D," Q12H")^D,
[f rx msg](D);
(74.4'<CL&(CL'<65.5)) ("Rec Dose:",((((0.227*CL)+5.67)*BW)*0.5):0D," Q12H")^D,
[f rx msg](D);
(84.4'<CL&(CL'<75.5)) ("Rec Dose:",((((0.227*CL)+5.67)*BW)*0.5):0D," Q12H")^D,
[f rx msg](D);
((CL'<45.5)) ("Rec Dose:",((((0.227*CL)+5.67)*BW)*0.5):0D," Q12H")^D,
[f rx msg](D);[f rx ok]}}};

;This rule calculates the Estimated CrCL based on an Adjusted body weight
;ZOSYN specific
;
"CrCL> 40, Recommended dose: 3.375g Q6H "^A,
"CRCL 20-40 ml/min, Rec. Dose: 2.25g Q6H"^B,
"CRCL <20, 2.25 G Q8H"^C,
IF{[f pt cur age]'>18 " ";
IF{[f rx calc]("CRCL.ADJA")^CRCL_.=.;
("EST. CRCL = ",CRCL," ml/min ")^W,
[f rx msg](W),
IF{(20.4'<CRCL&(CRCL'<0)) [f rx msg](C);
(40.4'<CRCL&(CRCL'<20.5)) [f rx msg](B);
40.5'>CRCL [f rx ok];[f rx ok]}}};

IF{IF{[f rx last ver result]("CR")^SRCR_.=.;
[f pt sex]^SX_.=.;
[f pt oe ht cm]^HT_.=.;
[f pt oe wt kgs]^WT_.=.;
[f pt cur age]^AGE_.=.} " Unable to calculate Creatinine Clearance. "^X,
[f rx msg](X)," ";
IF{SX="M" 50;45.5}^S,
IF{SX="M" 1;0.85}^F,
IF{SRCR<0.9 0.9^SRCR},
S+(2.3*((HT/2.54)-60)!0)^IBW,
IF{[f pt oe wt kgs]<IBW [f pt oe wt kgs]^IBW},
140-AGE*IBW/(72*SRCR)*F}^CRCLT;

IF{[f rx calc]("CRCL.ADJW")^CRCL_.=.;
("Creatinine Clearance = ",CRCL," ml/min ")^X,[f rx msg](X)};

;This rule calculates the mg/kg -of d70 ordered -used in rule to tell total
;volume
;THIS RULE WAS MODIFIED ON 8/26/98 (SEE REMMED PORTION) - SWITCHED ORDERING
;UNITS FROM ML TO GRAMS.
;[f rx iv add dose]^A,
;[f pt oe wt kgs]^W,
;((((A*0.7000)/W)*0.6944):1D)^MGKG;
[f rx iv add dose]^A,
[f pt oe wt kgs]^W,
(((A:4D/W)*0.6944):1D)^MGKG;

;This rule calculates MAX mg/kg d70/24 hours. Assumes tpn value -= 24 hour
; ASSUMES MAX TO BE 5 MG/KG/MIN
[f rx calc]("D70.MGKG")^MGKG_.=.,
("Current Dextrose from TPN = ",MGKG," mg/kg/min")^K,
[f rx msg](K),
[f pt oe wt kgs]^W,
((50:6D/([f pt oe wt kgs]*1.44)):1D)^D,
("Each liter of D5W/day will add ",D," mg/kg/min of Dextrose")^P,
[f rx msg](P),
(((7.2*W)):0D)^M,
("MAXIMUM D70W/DAY =",(M)," GRAMS IF NO OTHER DEXTROSE RUNNING")^B,
[f rx msg](B);

;THIS RULE REQUIRES- DIAL TO BE CHARGE TYPE
"FOR DIALYSIS PATIENTS, CHARGE TYPE SHOULD BE DIAL"^E,
IF{[f pt location]'="NP-KDU" [f rx ok];
IF{[f rx chg type]'="DIAL" [f rx err msg](E);[f rx ok]}};

;THIS RULE REQUIRES- DIAL-IV TO BE CHARGE TYPE
"FOR DIALYSIS PATIENTS, CHARGE TYPE SHOULD BE DIAL-IV"^E,
IF{[f pt location]'="NP-KDU" [f rx ok];
IF{[f rx chg type]'="DIAL-IV" [f rx err msg](E);[f rx ok]}};

;THIS RULE REQUIRES- DIAL-IV or DIAL to BE CHARGE TYPE
"FOR DIALYSIS PATIENTS, CHARGE TYPE SHOULD BE DIAL-IV OR DIAL"^E,
IF{[f pt location]'="NP-KDU" [f rx ok];
IF{[f rx chg type]="DIAL-IV"!([f rx chg type]="DIAL") 1,
[f rx ok];[f rx err msg](E)}};

;this rule calculates amount of dipyridamole IV which should be given
;based on 0.57 mg/kg and total volume 35 ml
"LINE FEED THE ADDITIVE MED, PRESS SPECIAL FUNCTION KEY & UPDATE WT"^A,
"Pt is > 104.5kg, therefore, 60 mg dipyridamole, 23 ml NaCl 0.9%"^M,
IF{[f pt oe wt kgs]^WT_.=. [f rx err msg](A);
IF{[f pt oe wt kgs]>104.5 [f rx msg](M);(([f pt oe wt kgs]*0.57):1D)^Z,
("CALCULATED DIPYRIDAMOLE DOSE ",Z," MG")^D,
("NaCl needed = ",(35-(Z/5))," mls")^N,
[f rx msg](D) [f rx msg](N)}};

; THIS RULE WILL display a warning for meds which should not be sold to DRUG
;stores
"Do NOT sell this med to other pharmacies. Check with Dorothy or Jim first!"^W,
IF{[f pt location]="DS" [f rx msg](W);[f rx ok]};

; THIS RULE WILL STOP A USER FROM SELLING A MED TO A DRUG STORE
"Do NOT sell this med to other pharmacies. Check with Dorothy or Jim first!"^W,
IF{[f pt location]="DS" [f rx err msg](W);[f rx ok]};

;This rule displays the appropriate charge type for a employee rx,
;based on guaranter occupation. "RN or EMP"
"Contract status = NON-CONTRACT, charge type = RN"^NC,
"Contract status = MNA, charge type = RN"^R,
"Contract status = AFSCME, charge type = EMP"^E,
"PLEASE EDIT PATIENT'S GUARANTOR'S OCCUPATION IN THE PATIENT CENSUS ROUTINE"^U,
IF{[f pt facility]="." [f rx ok];
IF{[f pt guar occ]="MNA" [f rx msg](R);
IF{[f pt guar occ]="AFSCME" [f rx msg](E);
IF{[f pt guar occ]="NC" [f rx msg](NC);
IF{[f pt guar occ]="DS" [f rx ok];
IF{[f pt guar occ]="HOS" [f rx ok];
[f rx msg](U)}}}}}};

; THIS RULE WILL PREVENT PEOPLE FROM ORDERING OTHER MEDS THAN EPO 4,000 ON
;DIALYSIS PATIENTS
IF{[f pt location]="NP-KDU" "USE DRUG MNEMONIC ERYT-4000"}^X,
IF{[f pt location]="NP-KDU" [f rx err msg](X);[f rx ok]};

;THIS RULE
;WILL NOT ALLOW SOMEONE TO ENTER A INCORECT # TODISP/DOSE
IF{[f pt location]="NP-KDU",
"PLEASE CHECK EPO DOSE VERSUS VIALS (QUANTITY TO DISPENSE !!)"^E,
[f rx dose]^D,
[f rx charge]}^DS,
(DS:4D/(D:2D/1000))^P,
IF{[f pt location]'="NP-KDU" [f rx ok];
IF{(9.20<P&(P<9.24)) [f rx ok];[f rx err msg](E)}};

IF{[f rx iv add dose]<10 [f rx iv add dose]^GENT.DOSE};

;THIS RULE
;WILL NOT ALLOW SOMEONE TO PICK HEPATITIS B VACCINE 10 U ON DIALYSIS PATS
"USE THE MNEMONIC> HEPA-B-VAC"^E,
IF{[f pt location]'="NP-KDU" [f rx ok];[f rx err msg](E)};

;THIS RULE
;WILL NOT ALLOW SOMEONE TO FILE HEPATITIS B VACCINE WITH CHARGES ON DIALYSIS
;PATIENTS- THEY ARE CHARGED SEPERATELY
"CHARGE TYPE MUST BE NOCALC & CHARGE MUST BE $0.00"^E,
IF{[f pt location]'="NP-KDU" [f rx ok];
IF{[f rx chg type]="NOCALC"&([f rx charge]=0.00) [f rx ok];[f rx err msg](E)}};

IF{[f rx last ver result]("INR")^INR_.=.;
("LAST INR = ",INR,"")^I,
[f rx msg](I)};

IF{[f rx last ver result]("K")^K_.=.,
IF{[f rx last ver result]("MG")^MG_.=.,
("MG = ",MG," mg/dL, protocol= 2 g (16.24 mEq in 50 ml D5W over 1 hour")^E,
("MG = ",MG," mg/dL, protocol= 4 g (32.48 mEq in 100 ml D5W over 2 hours")^F,
("MG = ",MG," mg/dL, Since > 1.7, MG OK, does NOT need replacement")^G,
IF{(1.75'<MG&(MG'<1.39)) [f rx msg](E);
(MG<1.39) [f rx msg](F);[f rx msg](G),
("Last K+ level = ",K," Protocol is KCL 10 mEq x 2 doses")^A,
("Last K+ level = ",K," Protocol is KCL 10 mEq x 3 doses")^B,
("Last K+ level = ",K," Protocol is KCL 10 mEq x 4 doses")^C,
("Last K+ level = ",K," Protocol is KCL 10 mEq x 5 doses")^D,
IF{(3.85'<K&(K'<3.5)) [f rx msg](A);
(3.45'<K&(K'<2.95)) [f rx msg](B);
(2.94'<K&(K'<2.45)) [f rx msg](C);
(K<2.44) [f rx msg](D);[f rx ok]}}}};

; THIS RULE WILL NOT ALLOW STOCK MED CHARGES TO DIALYSIS PATIENTS
"Do NOT use stock med for dialysis pateints (no DX entered) "^X,
IF{[f pt location]'="NP-KDU" [f rx ok];
IF{[f rx sig]'=".STK-MED" [f rx ok];[f rx err msg](X)}};

; THIS RULE WILL ONLY ALLOW DI OR DM FOR DIALYSIS PATIENTS
"Use order type DI or DM for dialysis patients"^X,
IF{[f pt location]'="NP-KDU" [f rx ok];
IF{[f rx ord type]="DI"!([f rx ord type]="DM") [f rx ok];[f rx err msg](X)}};

;THIS RULE WARNS USER TO CHANGE CHARGE CODE ON ER MEDS
"CHARGE TYPE FOR PILLS GIVEN IN ER OR OPS SHOULD BE NOCALC"^B,
IF{[f pt status]'="REG ER"&([f pt status]'="REG SDC") [f rx ok];
IF{[f rx route]="PO"&(([f rx chg type]'="ER")&([f rx chg type]'="NOCALC")) 1,
[f rx msg](B);[f rx ok]}};

;THIS RULE WILL NOT ALLOW USER FILE CHARGES FOR PILLS IN ER
"CHARGE TYPE FOR ORALS PILLS GIVEN IN ER OR OPS SHOULD BE NOCALC"^B,
IF{[f pt status]'="REG ER"&([f pt status]'="REG SDC") [f rx ok];
IF{[f rx chg type]="PO" [f rx msg](B);[f rx ok]}};

;THIS RULE WILL NOT ALLOW USER FILE CHARGES FOR PILLS IN ER
"CHARGE TYPE FOR ORALS PILLS GIVEN IN ER OR OPS SHOULD BE NOCALC"^B,
"IF THIS RX IS A TAKE HOME RX, EDIT RX SO CHARGE CODE = ER-NS, ELSE NOCALC"^C,
IF{[f pt status]'="REG ER"&([f pt status]'="REG SDC") [f rx ok];
IF{[f rx route]'="PO" [f rx ok];
IF{[f rx chg type]="NOCALC" [f rx ok];
IF{[f rx chg type]="ER" [f rx ok];
IF{[f rx chg type]="ER-NS" [f rx ok];
[f rx err msg](B),[f rx err msg](C)}}}}};

[f rx calc]("ADBW")^BW_.=.,
[f rx calc]("CRCL.ADJW")^CL_.=.,
"PATIENT IS NOT A CANDIDATE FOR ONCE DAILY DOSING"^E,
"PATIENT IS UNDER 17, NOT A CANDIDATE FOR ONCE DAILY"^A,
IF{[f pt cur age]<17 [f rx msg](A);
IF{(40.4'<CL&(CL'<29.5)) ("ONCE DAILY DOSE =",(BW*2.5:0D),"MG Q 24 HRS")^D,
[f rx msg](D);
(60.4'<CL&(CL'<40.5)) ("ONCE DAILY DOSE =",(BW*3.5:0D),"MG Q 24 HRS")^D,
[f rx msg](D);
(80.4'<CL&(CL'<60.5)) ("ONCE DAILY DOSE =",(BW*4:0D),"MG Q 24 HRS")^D,
[f rx msg](D);
(99.4'<CL&(CL'<80.5)) ("ONCE DAILY DOSE =",(BW*5:0D),"MG Q 24 HRS")^D,
[f rx msg](D);
(120.4'<CL&(CL'<99.5)) ("ONCE DAILY DOSE =",(BW*6:0D),"MG Q 24 HRS")^D,
[f rx msg](D);
(120.5'>CL!(CL'>29.4)) [f rx msg](E)};[f rx msg](A)};

;THIS RULE WILL NOT ALLOW USER TO USE QD FOR SIG - PYXIS WILL DO CHARGING
"DO NOT USE QD SIG ON INPATIENTS - WILL AUTO CHARGE!!, USE D INSTEAD"^A,
IF{[f pt status]'="ADM IN" [f rx ok];
IF{[f rx sig]="QD" [f rx err msg](A);[f rx ok]}};

;This rule does not allow amino acids to be used unless order type "T"
"IV order type for TPNs should be T (NOT I)"^E,
IF{[f rx med]="AA10-WO-AD"&([f rx ord type]="T") [f rx ok];[f rx err msg](E)};

;This rule does not allow amino acids to be used unless order type "T"
"IV order type for TPNs should be T (NOT I)"^E,
IF{[f rx med]="TPN"&([f rx ord type]="T") [f rx ok];[f rx err msg](E)};

; This rule warns the user if ALT is higher than normal limits
; when troglitazone is ordered
IF{[f rx last ver result]("ALT")^ALT_.=.;
("ALT is ",ALT,", which is 1.5 - 2 times upper normal limit, watch usage")^A,
("ALT IS ",ALT,", which is > 2 times upper normal limit, watch usage, ?DC")^B,
("ALT IS ",ALT,", Which is >3 times upper normal-REZULIN should be DCed!!")^C,
("ALT IS ",ALT,", Which is less than 1.5 times normal upper limit = OK")^D,
IF{(54.4'<ALT&(ALT'<41.4)) [f rx msg](A);
(79.8'<ALT&(ALT'<54.5)) [f rx msg](B);
(ALT>79.9) [f rx msg](C);[f rx msg](D)}};

;DETERMINES VOLUME - PUTS INTO VOL
[f rx iv tot vol]^VOL;

;WILL NO ALLOW CHARGES FOR WORKMANS COMP
"CHARGE FOR WORKMANS COMP SHOULD BE $0.00"^B,
"Edit Charge field to 0.00 and Type rx CHARGE (actual cost) into Rx Comments"^C,
"To insert Workmans Comp Billing code, press the F4 key, and type WC"^D,
IF{[f rx chg type]="WCOMP"&([f rx charge]'="0.00") 1,
[f rx err msg](B),[f rx err msg](C),[f rx err msg](D);[f rx ok]};

;THIS RULE SPECIFIES 100 ML SHOULD BE USED FOR ZOSYN - USES CALC RULE TO
;DETERMINE VOLUME
"THIS IS A"^A,
[f rx calc]("VOL.TOT")^VOL_.=.,
VOL^V,
("ZOSYN SHOULD GENERALLY BE IN 100 ML NS. Current volume = ",(V),"")^W,
IF{(99'<VOL) [f rx msg](W);[f rx ok]};