Difference between revisions of "Form:CalcBenzo"
From Psychiatrienet
(+clonazepam) |
(input type=dropdown| was default, moet nu expliciet gegeven worden) |
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{{{for template|CalculateBenzo}}} | {{{for template|CalculateBenzo}}} | ||
{| class="formtable" | {| class="formtable" | ||
| − | | colspan="4" | <center>Choose one or more benzodiazepines and dosage expressed as mg/day</center> | + | | colspan="4" | <center>''Choose one or more benzodiazepines and dosage expressed as mg/day''</center> |
|- | |- | ||
| − | ! | + | ! colspan="2" | <center>Drug</center> |
| − | ! | + | ! colspan="2" | <center>Dosage</center> |
| − | |||
! | ! | ||
|- | |- | ||
| Benzodiazepine 1 | | Benzodiazepine 1 | ||
| − | | {{{field|benzo1|mandatory|values from category=Benzodiazepine}}} | + | | {{{field|benzo1|mandatory|input type=dropdown|values from category=Benzodiazepine}}} |
| − | | {{{field|dose1|mandatory|input type=Number}}} | + | | {{{field|dose1|mandatory|input type=Number|size=5}}} |
| mg/day | | mg/day | ||
|- | |- | ||
| Benzodiazepine 2 | | Benzodiazepine 2 | ||
| − | | {{{field|benzo2|values from category=Benzodiazepine}}} | + | | {{{field|benzo2|input type=dropdown|values from category=Benzodiazepine}}} |
| − | | {{{field|dose2|input type=Number}}} | + | | {{{field|dose2|input type=Number|size=5}}} |
| mg/day | | mg/day | ||
|- | |- | ||
| Benzodiazepine 3 | | Benzodiazepine 3 | ||
| − | | {{{field|benzo3|values from category=Benzodiazepine}}} | + | | {{{field|benzo3|input type=dropdown|values from category=Benzodiazepine}}} |
| − | | {{{field|dose3|input type=Number}}} | + | | {{{field|dose3|input type=Number|size=5}}} |
| mg/day | | mg/day | ||
|- | |- | ||
| Benzodiazepine 4 | | Benzodiazepine 4 | ||
| − | | {{{field|benzo4|values from category=Benzodiazepine}}} | + | | {{{field|benzo4|input type=dropdown|values from category=Benzodiazepine}}} |
| − | | {{{field|dose4|input type=Number}}} | + | | {{{field|dose4|input type=Number|size=5}}} |
| mg/day | | mg/day | ||
|- | |- | ||
| Benzodiazepine 5 | | Benzodiazepine 5 | ||
| − | | {{{field|benzo5|values from category=Benzodiazepine}}} | + | | {{{field|benzo5|input type=dropdown|values from category=Benzodiazepine}}} |
| − | | {{{field|dose5|input type=Number}}} | + | | {{{field|dose5|input type=Number|size=5}}} |
| mg/day | | mg/day | ||
|- | |- | ||
| − | | Conversion drug | + | | colspan="4" | |
| − | | {{{field|replacement|mandatory|values=diazepam,oxazepam | + | |- |
| − | + | | '''Conversion drug''' | |
| − | + | | colspan="3" | {{{field|replacement|mandatory|input type=dropdown|values=diazepam,oxazepam,chlordiazepoxide|default=diazepam }}} | |
|} | |} | ||
{{{end template}}} | {{{end template}}} | ||
