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Overdose concepts representing a substance base should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|.

Example:

• 295184007 |Morphine overdose (disorder)|

Expected classification:

• Classification results are expected to be consistent with the modeling of the concept selected as the Causative agent in the Substance hierarchy.

Overdose concepts representing a substance modification should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|. Concepts representing substance modifications are exceptions and may be included if the overdose profile is significantly different from the substance base.

Exception examples:

• Chemical element with multiple modifications (e.g. 422232005 |Calcium lactate gluconate (substance)|)
• Liposome or lipid complex substances (e.g. 412088006 |Amphotericin B liposome (substance)|, 426490000 |Vincristine liposome (substance)|)
• Pegylated substance (e.g. 385544005 |Pegfilgrastim (substance)|, 770965008 |Pegvaliase (substance)|)
• Salt forms (e.g. 273948005 |Chloral hydrate (substance)|)

Example:

• 296213007 |Fluphenazine decanoate overdose (disorder)|
• 296217008 |Fluphenazine enanthate overdose (disorder)|

Expected classification:

• Classification results are expected to reflect that the concept modeled with the modified substance is a descendant of the concept modeled with the base substance (if such a concept exists.

Adverse reaction concepts representing multiple substances should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|; preferentially modeling with the base rather than a modification unless the adverse reaction profile is significantly different from the substance base.

Example:

• 292984002 |Ampicillin and cloxacillin adverse reaction (disorder)|
• 292987009 |Piperacillin and tazobactam adverse reaction (disorder)|
• 292989007 |Ticarcillin and clavulanic acid adverse reaction (disorder)|

Expected classification (Agreed 21-Jan-2020):

• Classification results are expected to be consistent with the modeling of the concept selected as the Causative agent in the Substance hierarchy.

Overdose concepts representing a disposition grouper should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|.

Example:

• 297053006 |Overdose of angiotensin-converting-enzyme inhibitors (disorder)|
• 296515004 |Opiate antagonist overdose (disorder)|

Expected classification results:

• Classification results are expected to reflect that the overdose concepts are descendants of the appropriate disposition grouper based on the modeling of the 726542003 |Has disposition (attribute)| attribute in the substance hierarchy (e.g. 296516003 |Naloxone overdose (disorder)| has inferred parent 296515004 |Opiate antagonist overdose (disorder)|)be consistent with the modeling of the concept selected as the Causative agent in the Substance hierarchy.

Adverse reaction Overdose concepts representing a role grouper should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|. Note that role groupers will be transitioned to the 763158003 |Medicinal product (product)| hierarchy in a future release.

Example:

• 430136001 |Adverse reaction caused by antiparkinsonism drug 297006008 |Diuretic overdose (disorder)|292040004 |Analgesic adverse reaction
• 295217003 |Non-steroidal anti-inflammatory overdose (disorder)|

Expected classification results (Agreed 21-Jan-2020):

to be revised when concepts are remodeled using Medicinal product ):

• Classification results are expected to be consistent with the modeling of the concept selected as the Causative agent in the Substance hierarchy for concepts modeled with an attribute value from the Substance hierarchy.

Adverse reaction concepts representing a structure grouper should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|.

Example:

• 218638005 |Adverse reaction caused by hydantoin derivative (disorder)|
  
• 419885006 |Beta lactam adverse reaction (disorder)|
  

Expected classification (Agreed 21-Jan-2020):

• Classification results are expected to be consistent with the modeling in the Substance hierarchy and with other existing concepts in the subhierarchy.