source: WorldVistAEHR/trunk/r/OUTPATIENT_PHARMACY-PSO-APSP-HUIP/PSOCLO1.m@ 1464

PSOCLO1 ;BHAM ISC/SAB - clozaril rx lockout routine ; 20 Apr 1999  10:50 AM

 ;;7.0;OUTPATIENT PHARMACY;**1,23,37,222**;DEC 1997;Build 12

 ;External reference YSCLTST2 supported by DBIA 4556

 ;External reference ^PS(55 supported by DBIA 2228

 ;MH package will authorize dispensing of the Clozapine drugs

 K ANQDATA,ANQX,ANQNO,PSONEW("SAND"),^TMP($J,"PSO")

 N X,Y,%,%DT,J,ANQ,ANQD,ANQJ,ANQRE,DTOUT,DUOUT,DIR,DIRUT,PSOYS

 I '$D(^PS(55,DFN,"SAND")) W !!,"*** This patient has not been registered in the clozapine program ***" G END

 I $P(^PS(55,DFN,"SAND"),"^")="" W !!,"*** This patient has no clozapine registration number ***" G END

 I $P(^PS(55,DFN,"SAND"),"^",2)="D" D  G END

 .W !!,"*** This patient has been discontinued from the clozapine treatment program ***"

 .W !,"*** and must have a new registration number assigned ***"

 S PSOYS=$$CL^YSCLTST2(DFN)

 G:+PSOYS<0 END

 S CLOZPAT=$P(PSOYS,"^",7),CLOZPAT=$S(CLOZPAT="M":2,CLOZPAT="B":1,1:0)

 G:$P(PSOYS,"^")=0 OV1

 D DSP  G:+PSOYS=1 GDOSE

 S X=$S(CLOZPAT=2:84,CLOZPAT=1:42,1:21)

 D CL1^YSCLTST2(DFN,X)

 I $D(^TMP($J,"PSO")) G CHECK

OV1 I $$OVERRIDE^YSCLTST2(DFN) S ANQRE=7 W !!,"Permission to dispense clozapine has been authorized by NCCC",! G OVRD

 D MSG4,MSG3,MH G QU

 Q

CHECK ;

 S ANQRE=$S($P(PSOYS,"^",2)<3500:3,1:5)

 S ANQD(1)=9999999-$P(PSOYS,"^",6),X1=$P(PSOYS,"^",6),X2="-6" D C^%DTC S ANQD=(9999999-$P(X,"."))

 S ANQ(1)=$P(PSOYS,"^",2)_"^"_$P(PSOYS,"^",4) D

 .F ANQJ=2:1:4 S ANQD=$O(^TMP($J,"PSO",ANQD)) Q:'ANQD  S ANQ(ANQJ)=^(ANQD),ANQD(ANQJ)=ANQD

 S ANQD=$O(ANQ(""),-1)

 I ANQD<2 W !,"*** No previous results to display ***",! G OVRD

 W !,"*** Last "_$S(ANQD=4:"Four ",ANQD=3:"Three ",1:"TWO ")_$P(PSOYS,"^",3)_" and ANC results were:"

 W !,?39,"WBC    ANC",!

 F ANQJ=ANQD:-1:1 S ANQD=9999999-ANQD(ANQJ)_"0000" W ?5,$E(ANQD,4,5)_"/"_$E(ANQD,6,7)_"/"_($E(ANQD,1,3)+1700) W:ANQD["." "@",$E(ANQD,9,10),":",$E(ANQD,11,12) W ?29,"Results: "_$P(ANQ(ANQJ),"^")_" - "_$P(ANQ(ANQJ),"^",2),!

OVRD ;

 I '$D(^XUSEC("PSOLOCKCLOZ",DUZ)) D  G EXIT

 .S ANQX=1 W !,"You Are Not Authorized to Override! See Clozapine Manager with PSOLOCKCLOZ key."

 I ANQRE W !,"Override reason being: "_$P($T(@(ANQRE_"^PSOCLO1")),";;",2),!

 S DIR("A")="Do you want to override and issue this prescription",DIR(0)="Y",DIR("B")="N" D ^DIR K DIR I 'Y!($D(DIRUT)) S ANQX=1 G EXIT

 S DIC=200,DIC(0)="AEQM",DIC("A")="Approving member of the Clozapine team: ",DIC("S")="I $D(^XUSEC(""PSOLOCKCLOZ"",+Y)),+Y'=DUZ" D ^DIC K DIC S ANQD=+Y I Y<0 S ANQX=1 G EXIT

 S DIR(0)="52.52,5",DIR("A")="Remarks"

 D ^DIR K DIR G EXIT:$D(DIRUT)

 S ANQX=0,ANQDATA=DUZ_"^"_ANQD_"^"_ANQRE_"^"_X

 ;

GDOSE ; set variable to ask daily dose

 N PSOCD

DOSE ;

 S DIR(0)="N^12.5:3000:1",DIR("A")="CLOZAPINE dosage (mg/day) ? " D ^DIR K DIR G EXIT:$D(DIRUT)

 S PSOCD=X

 I PSOCD#25=0,PSOCD'<12.5,PSOCD<900 G EXIT

 I PSOCD#12.5 S DIR(0)="Y",DIR("B")="NO",DIR("A")=PSOCD_" is an unusual dose.  Are you sure " D ^DIR K DIR G EXIT:$D(DIRUT) I 'Y G DOSE

 I PSOCD>900 S DIR(0)="Y",DIR("A")="Recommended maximum daily dose is 900. Are you sure " D ^DIR K DIR G EXIT:$D(DIRUT) I 'Y G DOSE

EXIT ;

 K ^TMP($J,"PSO")

 S:$D(DIRUT) ANQX=1

 I $G(ANQX) W !!,"No Prescription entered!" K ANQDATA

 E  S PSONEW("SAND")=PSOCD_"^"_$P(PSOYS,"^",2)_"^"_($P($P(PSOYS,"^",6),"."))_"^"_$P(PSOYS,"^",4)

 D DIR

 Q

MSG3 ;

 W !!,"A CBC/Differential including WBC and ANC Must Be Ordered and Monitored on a",!

 W "Twice weekly basis until the WBC STABILIZES above 3500/mm3 and ANC above",!

 W "2000/mm3 with no signs of infection.",!

 Q

MSG4 ;

 W !!,"Permission to dispense clozapine has been denied. If the results of the latest"

 W !,"Lab Test drawn in the past 7 days show WBC>3000/mm3 and ANC>1500/mm3 and"

 W !,"you wish to dispense outside the FDA and VA protocol WBC/ANC limits, document"

 W !,"your request to Director of the VA National Clozapine Coordinating Center"

 W !,"(Phone: 214-857-0068 Fax: 214-857-0339) for a one-time override permission."

 Q

MSG5 ;

 W !!,"Permission to dispense clozapine has been denied. Please contact the"

 W !,"Director of the VA National Clozapine Coordinating Center"

 W !,"(Phone: 214-857-0068 Fax: 214-857-0339)."

 Q

MH       ;

 W !,"Also make sure that the LAB tests, WBC and ANC are set up correctly in the"

 W !,"Mental Health package using the CLOZAPINE MULTI TEST LINK option."

 Q

DSP ;

 W !,"*** Most recent "_$P(PSOYS,"^",3)_" and "_$P(PSOYS,"^",5)_" (ANC) results ***"

 W !,"     performed on "

 S Y=$P(PSOYS,"^",6) X ^DD("DD") W $P(Y,"@")_" are: "

 W !!,?5,$P(PSOYS,"^",3)_": "_$P(PSOYS,"^",2)

 W !,?5,"ANC: "_$P(PSOYS,"^",4),!

 Q

DIR ;

 W !! K DIR S DIR(0)="E",DIR("A")="Press Return to Continue" D ^DIR K DIR,DTOUT,DUOUT,DIRUT

 Q

END ;

 D MSG5

QU S ANQX=1 D DIR

 Q

1 ;;NO WBC IN LAST 7 DAYS

2 ;;NO VERIFIED WBC

3 ;;LAST WBC RESULT < 3500

4 ;;3 SEQ. WBC DECREASE

5 ;;LAST ANC RESULT < 2000

6 ;;3 SEQ. ANC DECREASE

7 ;;NCCC AUTHORIZED