Difference between revisions of "Form:CalcBenzo"
From Psychiatrienet
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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> | ||
|- | |- | ||
! | ! | ||
| − | ! | + | ! drug |
| − | ! | + | ! dosage |
| + | ! | ||
|- | |- | ||
| Benzodiazepine 1 | | Benzodiazepine 1 | ||
| {{{field|benzo1|mandatory|values from category=Benzodiazepine}}} | | {{{field|benzo1|mandatory|values from category=Benzodiazepine}}} | ||
| − | | {{{field|dose1|mandatory|type=Number}}} | + | | {{{field|dose1|mandatory|input type=Number}}} |
| + | | mg/day | ||
|- | |- | ||
| Benzodiazepine 2 | | Benzodiazepine 2 | ||
| {{{field|benzo2|values from category=Benzodiazepine}}} | | {{{field|benzo2|values from category=Benzodiazepine}}} | ||
| − | | {{{field|dose2|type=Number}}} | + | | {{{field|dose2|input type=Number}}} |
| + | | mg/day | ||
|- | |- | ||
| Benzodiazepine 3 | | Benzodiazepine 3 | ||
| {{{field|benzo3|values from category=Benzodiazepine}}} | | {{{field|benzo3|values from category=Benzodiazepine}}} | ||
| − | | {{{field|dose3|type=Number}}} | + | | {{{field|dose3|input type=Number}}} |
| + | | mg/day | ||
|- | |- | ||
| Benzodiazepine 4 | | Benzodiazepine 4 | ||
| {{{field|benzo4|values from category=Benzodiazepine}}} | | {{{field|benzo4|values from category=Benzodiazepine}}} | ||
| − | | {{{field|dose4|type=Number}}} | + | | {{{field|dose4|input type=Number}}} |
| + | | mg/day | ||
|- | |- | ||
| Benzodiazepine 5 | | Benzodiazepine 5 | ||
| {{{field|benzo5|values from category=Benzodiazepine}}} | | {{{field|benzo5|values from category=Benzodiazepine}}} | ||
| − | | {{{field|dose5|type=Number}}} | + | | {{{field|dose5|input type=Number}}} |
| + | | mg/day | ||
|} | |} | ||
| + | |||
{{{end template}}} | {{{end template}}} | ||
</includeonly> | </includeonly> | ||
