@erosolaraijs/cure 1.0.0 → 1.0.2

package/dist/patient/patientPortal.js.map

@@ -0,0 +1 @@
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package/dist/safety/drugInteractions.d.ts

@@ -0,0 +1,230 @@
+/**
+ * Drug Interaction and Safety Checking System
+ *
+ * Provides comprehensive drug safety checks:
+ * - Drug-drug interactions
+ * - Contraindication checking
+ * - Dosing validation
+ * - Allergy cross-reactivity
+ * - Organ function-based adjustments
+ * - Pregnancy/lactation safety
+ * - QT prolongation risk assessment
+ * - CYP450 interaction analysis
+ *
+ * Data sources would include:
+ * - FDA drug labels
+ * - DrugBank
+ * - PharmGKB
+ * - Clinical Pharmacology databases
+ */
+import { EventEmitter } from 'events';
+export interface Drug {
+    name: string;
+    genericName: string;
+    brandNames?: string[];
+    drugClass: string;
+    rxNormId?: string;
+    ndc?: string;
+    atcCode?: string;
+    mechanism?: string;
+    metabolism?: {
+        cyp450?: CYP450Profile;
+        renalExcretion?: number;
+        hepaticMetabolism?: number;
+    };
+}
+export interface CYP450Profile {
+    substrates?: string[];
+    inhibitors?: string[];
+    inducers?: string[];
+}
+export interface DrugInteraction {
+    drug1: string;
+    drug2: string;
+    severity: 'contraindicated' | 'major' | 'moderate' | 'minor';
+    type: 'pharmacokinetic' | 'pharmacodynamic' | 'additive' | 'synergistic' | 'antagonistic';
+    mechanism: string;
+    clinicalEffect: string;
+    management: string;
+    documentation: 'established' | 'theoretical' | 'case-report';
+    references?: string[];
+}
+export interface Contraindication {
+    drug: string;
+    condition: string;
+    severity: 'absolute' | 'relative';
+    reason: string;
+    alternatives?: string[];
+}
+export interface DosingGuideline {
+    drug: string;
+    indication: string;
+    standardDose: string;
+    renalAdjustment?: {
+        gfrThreshold: number;
+        adjustment: string;
+    }[];
+    hepaticAdjustment?: {
+        childPughClass: 'A' | 'B' | 'C';
+        adjustment: string;
+    }[];
+    ageAdjustment?: {
+        ageThreshold: number;
+        adjustment: string;
+    }[];
+    weightBasedDosing?: {
+        formula: string;
+        maxDose?: string;
+    };
+}
+export interface AllergyCheck {
+    reportedAllergy: string;
+    drugToCheck: string;
+    crossReactivity: boolean;
+    riskLevel: 'high' | 'moderate' | 'low' | 'none';
+    relatedAllergens: string[];
+    recommendation: string;
+}
+export interface SafetyAlert {
+    id: string;
+    type: 'interaction' | 'contraindication' | 'allergy' | 'dosing' | 'organ-function' | 'pregnancy' | 'qt-prolongation' | 'black-box';
+    severity: 'critical' | 'high' | 'moderate' | 'low';
+    title: string;
+    description: string;
+    affectedDrugs: string[];
+    recommendation: string;
+    overridable: boolean;
+    requiresDocumentation: boolean;
+    references?: string[];
+}
+export interface PatientSafetyProfile {
+    patientId: string;
+    allergies: {
+        allergen: string;
+        reactionType: 'anaphylaxis' | 'rash' | 'angioedema' | 'gi' | 'other';
+        severity: 'severe' | 'moderate' | 'mild';
+    }[];
+    renalFunction: {
+        gfr: number;
+        creatinine: number;
+        dialysis: boolean;
+    };
+    hepaticFunction: {
+        childPughClass?: 'A' | 'B' | 'C';
+        bilirubin?: number;
+        albumin?: number;
+        inr?: number;
+        ascites?: 'none' | 'mild' | 'moderate-severe';
+        encephalopathy?: 'none' | 'grade-1-2' | 'grade-3-4';
+    };
+    cardiacStatus: {
+        qtcInterval?: number;
+        lvef?: number;
+        arrhythmiaHistory?: boolean;
+        pacemakerIcd?: boolean;
+    };
+    currentMedications: {
+        drug: string;
+        dose: string;
+        frequency: string;
+        startDate?: Date;
+    }[];
+    demographics: {
+        age: number;
+        weight: number;
+        gender: 'male' | 'female';
+        pregnant?: boolean;
+        breastfeeding?: boolean;
+    };
+    geneticFactors?: {
+        cyp2d6?: 'poor' | 'intermediate' | 'normal' | 'rapid' | 'ultra-rapid';
+        cyp2c19?: 'poor' | 'intermediate' | 'normal' | 'rapid' | 'ultra-rapid';
+        dpyd?: 'deficient' | 'intermediate' | 'normal';
+        ugt1a1?: '*28/*28' | '*28/*1' | '*1/*1';
+        tpmt?: 'poor' | 'intermediate' | 'normal';
+    };
+}
+export declare class DrugSafetyService extends EventEmitter {
+    private interactionDatabase;
+    private contraindicationDatabase;
+    private dosingGuidelines;
+    private allergenCrossReactivity;
+    private qtProlongingDrugs;
+    private blackBoxWarnings;
+    constructor();
+    /**
+     * Perform comprehensive safety check
+     */
+    performSafetyCheck(patient: PatientSafetyProfile, proposedDrugs: {
+        drug: string;
+        dose: string;
+        route: string;
+    }[]): Promise<{
+        safe: boolean;
+        alerts: SafetyAlert[];
+        summary: {
+            criticalAlerts: number;
+            highAlerts: number;
+            moderateAlerts: number;
+            lowAlerts: number;
+            overallRisk: 'critical' | 'high' | 'moderate' | 'low' | 'minimal';
+        };
+        recommendations: string[];
+    }>;
+    /**
+     * Check drug-drug interactions
+     */
+    checkDrugInteractions(drugs: string[]): Promise<SafetyAlert[]>;
+    /**
+     * Check contraindications
+     */
+    checkContraindications(drugs: string[], patient: PatientSafetyProfile): Promise<SafetyAlert[]>;
+    /**
+     * Check allergy cross-reactivity
+     */
+    checkAllergies(drugs: string[], allergies: PatientSafetyProfile['allergies']): Promise<SafetyAlert[]>;
+    /**
+     * Check dosing based on organ function
+     */
+    checkDosing(drugs: {
+        drug: string;
+        dose: string;
+        route: string;
+    }[], patient: PatientSafetyProfile): Promise<SafetyAlert[]>;
+    /**
+     * Check QT prolongation risk
+     */
+    checkQTProlongation(drugs: string[], patient: PatientSafetyProfile): Promise<SafetyAlert[]>;
+    /**
+     * Check pregnancy and lactation safety
+     */
+    checkPregnancySafety(drugs: string[], patient: PatientSafetyProfile): Promise<SafetyAlert[]>;
+    /**
+     * Check black box warnings
+     */
+    checkBlackBoxWarnings(drugs: string[]): Promise<SafetyAlert[]>;
+    /**
+     * Check pharmacogenomic considerations
+     */
+    checkPharmacogenomics(drugs: string[], genetics: NonNullable<PatientSafetyProfile['geneticFactors']>): Promise<SafetyAlert[]>;
+    /**
+     * Get recommended alternatives for a contraindicated drug
+     */
+    getAlternatives(drug: string, reason: string, patientProfile: PatientSafetyProfile): string[];
+    private initializeDatabases;
+    private addInteraction;
+    private findInteraction;
+    private mapInteractionSeverity;
+    private checkCrossReactivity;
+    /**
+     * Generate a medication reconciliation report
+     */
+    generateMedicationReconciliation(patient: PatientSafetyProfile): Promise<{
+        currentMedications: string[];
+        interactions: DrugInteraction[];
+        recommendations: string[];
+        summary: string;
+    }>;
+}
+export default DrugSafetyService;
+//# sourceMappingURL=drugInteractions.d.ts.map

package/dist/safety/drugInteractions.d.ts.map

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