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Source1

{
  "resourceType": "ClinicalUseDefinition",
  "id": "renal-function-failure",
  "meta": {
    "profile": [
      "https://fhir.ee/StructureDefinition/ee-tis-renal-failure-ds"
    ]
  },
  "language": "et",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Medication",
      "id": "metformin",
      "meta": {
        "profile": [
          "https://fhir.ee/StructureDefinition/ee-tis-medication-epc"
        ]
      },
      "language": "et",
      "extension": [
        {
          "url": "https://fhir.ee/StructureDefinition/ee-tis-medicinal-product-classification",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "https://fhir.ee/CodeSystem/atc-ee",
                "code": "A10BA02",
                "display": "metformiin"
              }
            ]
          }
        }
      ],
      "identifier": [
        {
          "system": "http://ravimiregister.ee/pakendid",
          "value": "123456"
        }
      ],
      "doseForm": {
        "coding": [
          {
            "system": "https://fhir.ee/CodeSystem/ravimvormid",
            "code": "1518",
            "display": "tablett+õhukese polümeerikattega tablett"
          }
        ]
      },
      "totalVolume": {
        "value": 120
      },
      "ingredient": [
        {
          "item": {
            "concept": {
              "coding": [
                {
                  "system": "https://fhir.ee/CodeSystem/toimeained",
                  "code": "11354",
                  "display": "metformiin"
                }
              ]
            }
          },
          "isActive": true,
          "strengthRatio": {
            "numerator": {
              "value": 500,
              "system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
              "code": "MG"
            },
            "denominator": {
              "value": 1,
              "system": "https://fhir.ee/CodeSystem/retsept-mahu-ja-massiyhik",
              "code": "TABL"
            }
          }
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "https://fhir.ee/StructureDefinition/ee-tis-affected-medication-statements",
      "valueReference": {
        "reference": "MedicationStatement/MedicationStatement-metformin"
      }
    },
    {
      "url": "https://fhir.ee/StructureDefinition/ee-tis-additional-information-link",
      "valueString": "www.synbase.ee/metformin-neerufunktsioon"
    },
    {
      "url": "https://fhir.ee/StructureDefinition/ee-tis-nephrotoxic",
      "valueBoolean": false
    },
    {
      "extension": [
        {
          "url": "dosageIntervalMin",
          "valueQuantity": {
            "value": 6
          }
        },
        {
          "url": "dosageIntervalMax",
          "valueQuantity": {
            "value": 12
          }
        },
        {
          "url": "recommendation",
          "valueString": "Siin on soovitused"
        }
      ],
      "url": "https://fhir.ee/StructureDefinition/ee-tis-dosage-modification"
    },
    {
      "url": "https://fhir.ee/StructureDefinition/ee-tis-related-observation-or-condition",
      "valueReference": {
        "reference": "Observation/observation-egfr1"
      }
    }
  ],
  "type": "undesirable-effect",
  "category": [
    {
      "coding": [
        {
          "system": "https://fhir.ee/CodeSystem/drug-form-group",
          "code": "2",
          "display": "süsteemne"
        }
      ],
      "text": "Kirjeldus siia text alla, kui on veel vaja midagi lisada"
    },
    {
      "coding": [
        {
          "system": "https://fhir.ee/CodeSystem/failure-degree",
          "code": "1",
          "display": "GFR 30-59 ml/min (mõõdukas neerupuudulikkus)"
        }
      ],
      "text": "Kirjeldus siia text alla, kui on veel vaja midagi lisada"
    },
    {
      "text": "Kuna vosoritiidi ohutust ja efektiivsust neerukahjustuse korral ei ole hinnatud [(1)],[(2)], ei saa tõenduspõhiseid soovitusi anda. Siiski, tuginedes eliminatsioonimehhanismile, ei mõjuta neerupuudulikkus ilmselt vosoritiidi farmakokineetikat. Vosoritiid on modifitseeritud C-tüüpi natriureetiline peptiid. Vosoritiidi metabolism toimub eeldatavasti kataboolsete radade kaudu ja laguneb väikesteks peptiidideks ja aminohapeteks [(1)], [(2)]."
    }
  ],
  "subject": [
    {
      "reference": "#metformin"
    }
  ],
  "status": {
    "coding": [
      {
        "code": "active"
      }
    ]
  },
  "undesirableEffect": {
    "classification": {
      "coding": [
        {
          "system": "https://fhir.ee/synbase-warning-classification",
          "code": "C",
          "display": "Annust või annustamise vahemikku tuleb kohandada"
        }
      ],
      "text": "Kui on veel vaja midagi lisada"
    }
  }
}