MED_LIST_INTERP_COD medical data_error ai_generated true

AI misinterprets a medication list by translating 'Tylenol #3' as acetaminophen 300 mg with codeine 30 mg without flagging the codeine component for pediatric patients under 12

ID: medical/medication-list-interpretation

Also available as: JSON · Markdown · 中文
78%Fix Rate
87%Confidence
1Evidence
2024-01-10First Seen

Root Cause

'Tylenol #3' is a brand name for acetaminophen 300 mg + codeine 30 mg; AI fails to recognize the codeine component and its FDA black box warning for children under 12 years after tonsillectomy or for any child under 18 with respiratory risk.

generic

中文

‘Tylenol #3’是对乙酰氨基酚300毫克和可待因30毫克的品牌名；AI未能识别可待因成分及其FDA黑框警告——12岁以下儿童扁桃体切除术后或任何18岁以下有呼吸风险的儿童禁用。

Official Documentation

https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-restricts-use-prescription-codeine-pain-and-cough-medicines-children

Workarounds

  1. 90% success Parse 'Tylenol #3' as a fixed combination: acetaminophen 300 mg + codeine 30 mg. Flag for pediatric patients under 12 years: 'Codeine is contraindicated in children under 12 years due to risk of respiratory depression.' Example: if patient is 8 years old, do not recommend this medication. 
    Parse 'Tylenol #3' as a fixed combination: acetaminophen 300 mg + codeine 30 mg. Flag for pediatric patients under 12 years: 'Codeine is contraindicated in children under 12 years due to risk of respiratory depression.' Example: if patient is 8 years old, do not recommend this medication.
  2. 85% success Use a medication database lookup (e.g., RxNorm, DrugBank) to resolve brand names into active ingredients with warnings. For any codeine-containing product, automatically check patient age and surgical history. 
    Use a medication database lookup (e.g., RxNorm, DrugBank) to resolve brand names into active ingredients with warnings. For any codeine-containing product, automatically check patient age and surgical history.

中文步骤

  1. Parse 'Tylenol #3' as a fixed combination: acetaminophen 300 mg + codeine 30 mg. Flag for pediatric patients under 12 years: 'Codeine is contraindicated in children under 12 years due to risk of respiratory depression.' Example: if patient is 8 years old, do not recommend this medication.
  2. Use a medication database lookup (e.g., RxNorm, DrugBank) to resolve brand names into active ingredients with warnings. For any codeine-containing product, automatically check patient age and surgical history.

Dead Ends

Common approaches that don't work:

  1. 90% fail

    The '#3' suffix specifically indicates codeine 30 mg per tablet; interpreting it as quantity leads to missing the opioid component.

  2. 95% fail

    Codeine is a prodrug metabolized to morphine; ultra-rapid metabolizers (CYP2D6) can have fatal respiratory depression. FDA warns against all codeine use in children under 12.

  3. 85% fail

    Omits the opioid component entirely, leading to under-treatment of pain or missed drug interaction warnings.