Concepts Representing a Substance or its Modifications
Overview
The substance redesign project has made a number of decisions regarding the representation of a substance and its modifications.
Modification indicates that the concept is a structural modification of another concept, where the intrinsic physicochemical properties of the substance do not change.
The intrinsic physicochemical properties do not encompass non-intrinsic characteristics of a substance, such as toxicity, bioavailability, or extended release (in the case of medicinal products).
Modification concepts that exist to group modifications or derivatives of a specific substance are not to be created.
Metabolite groupers in the substances hierarchy are considered roles. No further concepts of this format will be created in the |Substance| hierarchy. Existing concepts will only be retained where there is a specific requirement and will be modeled as a child of |Metabolite (substance)|. See .
Structural groupers that reference modifications as a chemical group will be retained. Where the structural group name also refers to a specific chemical, the grouper will be re-termed “Substance with X structure”. See relative section .
There is no requirement to introduce a new semantic tag in order to distinguish concepts representing a substance or its modifications from any other type of concept in the |Substance| hierarchy.
The following illustrates the stated view of 125691000 |Sotalol hydrochloride (substance)|:
The following illustrates the inferred view for 125691000 |Sotalol hydrochloride (substance)|:
For example,
Morphine hydrochloride (substance)
For example,
Fluorothymidine (18-F) (substance)
For example,
Caffeine hydrate (substance) IS MODIFICATION OF Caffeine (substance).
This is the stated view:
This is the inferred view:
For example,
Clindamycin hydrochloride monohydrate (substance) IS MODIFICATION OF Clindamycin hydrochloride (substance).
This is the stated view:
This is the inferred view:
For example,
Calcium lactate pentahydrate (substance) IS MODIFICATION OF Calcium lactate (substance)
This is the stated and inferred view.
For example,
Theophylline anhydrous (substance) IS MODIFICATION OF Theophylline (substance).
This is the stated view:
This is the inferred view:
For example,
Pamidronate monosodium (substance) IS MODIFICATION OF Pamidronic acid (substance). This is the stated and inferred view.
For example,
Daunorubicin citrate liposome (substance)|
For example,
785674001 |Turoctocog alfa pegol (substance)|
For example,
414246008 |Fenofibrate micronized (substance)|
Dried gels have an |Is modification of (attribute)| relationship to the gel substance.
For example, 768558006 |Dried aluminium hydroxide gel (substance)| has an |Is modification of (attribute)| relationship of |Algeldrate (substance)|.
This is because there is no requirement for the |Has active ingredient (attribute)| of medicinal products containing prodrug substances to use any relationship to the active substance to manage relationships within the medicinal product hierarchy.
For example, aspirin is not generally considered a modification of the substance salicylic acid.
Between a glycan and its glycoconjugate.
For example, 259289005 |Trimethylene glycol (substance)| is not a modification of 52086008 |Glycol (substance)|.
To genetic engineering process variations (e.g., Somatropin(epr), Somatropin(rbe), or Somatropin(rmc)), as SNOMED CT does not generally differentiate substances based on production process.
Between a chemical element and its salt.
For example, 387307005 |Calcium carbonate (substance)| is not a modification of |Calcium (substance)|.
When the potential target would have been a grouper concept.
Semantic tag
(substance)
Definition status
Primitive
Attribute:
Is modification of
Range: < 105590001 |Substance (substance)|
Modeling
Exemplar
Guidelines for | Is modification of (attribute)|
Substances may have zero to many |Is modification of (attribute)|(s).
Hydrates have an | Is modification of (attribute)| relationship to the unspecified salt.
Anhydrous salts have an 738774007 | Is modification of (attribute)| relationship to the unspecified salt.
The salts are modeled with | Is modification of (attribute)| of the acid substance.
Liposomal preparations are modifications of the chemical substance.
Pegylated substances are modeled with |Is modification of (attribute)| generic substance, if such a substance has been made available. Not all pegylated medicinal substances have a non-pegylated form, as the non-pegylated form may have been too immunogenic or too toxic.
Concepts specifying a particular physical form (e.g., micronized, macrocrystal, microsphere) should have a parent concept that relates to the structure of the substance and also an |Is modification of (attribute)| relationship to the unspecified substance concept.
In general, an |Is modification of (attribute)| is not applicable to prodrugs.
When a prodrug is an esterified form of substance, there should be an 738774007 | Is modification of (attribute)| relationship between the substance and its esterified form.
For example,
715220007 |Tenofovir alafenamide (substance)|
89678001 |Cefuroxime axetil (substance)|
|Is modification of (attribute)| is not applicable: