fix(medications): reach lithium, retire the dead z-drugs term, make lexicon review flags evidence-bearing

data/medication-interaction-index.json

@@ -3,10 +3,10 @@
   "generatedFrom": "data/medications-snapshot.json",
   "sourceRowCount": 523,
   "stats": {
-    "resolvedRows": 355,
-    "unresolvedRows": 168,
-    "rowsWithCatalogueTarget": 417,
-    "medicationsWithUnresolvedRows": 149
+    "resolvedRows": 362,
+    "unresolvedRows": 161,
+    "rowsWithCatalogueTarget": 423,
+    "medicationsWithUnresolvedRows": 142
   },
   "names": {
     "acamprosate": "Acamprosate",
@@ -520,7 +520,8 @@
             "nicotine-mouth-spray",
             "nicotine-patch",
             "nicotine-sublingual-tablet",
-            "olanzapine-pamoate-lai"
+            "olanzapine-pamoate-lai",
+            "olanzapine-wafer-odt"
           ],
           "termIds": ["acidic-drinks", "smoking"],
           "resolved": true,
@@ -544,7 +545,8 @@
             "nicotine-mouth-spray",
             "nicotine-patch",
             "nicotine-sublingual-tablet",
-            "olanzapine-pamoate-lai"
+            "olanzapine-pamoate-lai",
+            "olanzapine-wafer-odt"
           ],
           "termIds": ["acidic-drinks", "smoking"],
           "resolved": true,
@@ -592,7 +594,8 @@
             "nicotine-lozenge",
             "nicotine-mouth-spray",
             "nicotine-sublingual-tablet",
-            "olanzapine-pamoate-lai"
+            "olanzapine-pamoate-lai",
+            "olanzapine-wafer-odt"
           ],
           "termIds": ["smoking"],
           "resolved": true,
@@ -952,7 +955,7 @@
           "rowKey": "Pharmacokinetic",
           "rowIndex": 0,
           "severity": "critical",
-          "counterparties": ["bupropion-sr", "fluoxetine", "morphine-sr-mr", "paroxetine"],
+          "counterparties": ["bupropion-sr", "fluoxetine", "morphine-ir-iv", "morphine-sr-mr", "paroxetine"],
           "termIds": ["cyp-inhibitors"],
           "resolved": false,
           "note": "CRITICAL — **CYP2D6** Inhibitors (Fluoxetine, Paroxetine, Bupropion). These completely block the liver from converting Codeine to Morphine. The patient will get zero pain relief."
@@ -1373,13 +1376,13 @@
           "rowKey": "Pharmacokinetic",
           "rowIndex": 2,
           "severity": "high",
-          "counterparties": [],
-          "termIds": [],
-          "resolved": false,
+          "counterparties": ["lithium-carbonate-ir-sr"],
+          "termIds": ["lithium"],
+          "resolved": true,
           "note": "HIGH — Lithium (massively raises lithium levels)."
         }
       ],
-      "unresolvedRowCount": 1
+      "unresolvedRowCount": 0
     },
     "ibuprofen": {
       "rows": [
@@ -1537,8 +1540,8 @@
           "rowKey": "Pharmacokinetic",
           "rowIndex": 2,
           "severity": "high",
-          "counterparties": ["methotrexate"],
-          "termIds": [],
+          "counterparties": ["lithium-carbonate-ir-sr", "methotrexate"],
+          "termIds": ["lithium"],
           "resolved": true,
           "note": "HIGH — Lithium and Methotrexate (Reduces their renal clearance, causing toxic spikes)."
         }
@@ -1596,8 +1599,8 @@
           "rowKey": "Pharmacokinetic",
           "rowIndex": 2,
           "severity": "high",
-          "counterparties": ["methotrexate"],
-          "termIds": [],
+          "counterparties": ["lithium-carbonate-ir-sr", "methotrexate"],
+          "termIds": ["lithium"],
           "resolved": true,
           "note": "HIGH — Lithium and Methotrexate (Naproxen heavily blocks their renal clearance, causing toxic spikes)."
         }
@@ -2128,12 +2131,9 @@
             "atenolol",
             "bisoprolol",
             "carvedilol",
-            "hydromorphone-ir-iv",
             "labetalol",
             "metoprolol",
-            "morphine-ir-iv",
             "propranolol",
-            "sodium-valproate-oral-iv",
             "sotalol"
           ],
           "termIds": ["beta-blockers"],
@@ -2328,8 +2328,8 @@
           "rowKey": "Pharmacodynamic",
           "rowIndex": 1,
           "severity": "high",
-          "counterparties": ["digoxin"],
-          "termIds": [],
+          "counterparties": ["digoxin", "lithium-carbonate-ir-sr"],
+          "termIds": ["lithium"],
           "resolved": true,
           "note": "HIGH — Enhances lithium toxicity. Increases risk of digoxin toxicity via hypokalemia."
         }
@@ -2342,8 +2342,8 @@
           "rowKey": "Pharmacodynamic",
           "rowIndex": 0,
           "severity": "high",
-          "counterparties": ["indapamide"],
-          "termIds": ["thiazide-diuretics"],
+          "counterparties": ["indapamide", "lithium-carbonate-ir-sr"],
+          "termIds": ["lithium", "thiazide-diuretics"],
           "resolved": true,
           "note": "HIGH — Lithium (thiazides reduce lithium clearance by 25-40%, causing severe toxicity)."
         },
@@ -2374,9 +2374,9 @@
           "rowKey": "Pharmacodynamic",
           "rowIndex": 0,
           "severity": "high",
-          "counterparties": [],
-          "termIds": [],
-          "resolved": false,
+          "counterparties": ["lithium-carbonate-ir-sr"],
+          "termIds": ["lithium"],
+          "resolved": true,
           "note": "HIGH — Lithium (decreases clearance, high toxicity risk)."
         },
         {
@@ -2389,7 +2389,7 @@
           "note": "CRITICAL — NSAIDs + ACEi + Indapamide."
         }
       ],
-      "unresolvedRowCount": 1
+      "unresolvedRowCount": 0
     },
     "spironolactone": {
       "rows": [
@@ -2757,14 +2757,14 @@
         {
           "rowKey": "Pharmacodynamic",
           "rowIndex": 0,
-          "severity": "unknown",
+          "severity": "none",
           "counterparties": [],
           "termIds": [],
-          "resolved": false,
+          "resolved": true,
           "note": "NONE."
         }
       ],
-      "unresolvedRowCount": 1
+      "unresolvedRowCount": 0
     },
     "dulaglutide": {
       "rows": [
@@ -4156,8 +4156,8 @@
           "rowKey": "Pharmacokinetic",
           "rowIndex": 0,
           "severity": "high",
-          "counterparties": ["digoxin"],
-          "termIds": [],
+          "counterparties": ["digoxin", "lithium-carbonate-ir-sr"],
+          "termIds": ["lithium"],
           "resolved": true,
           "note": "HIGH — Physically binds and traps other oral medications in the gut gel. Must separate Psyllium from ALL other drugs (especially Digoxin/Lithium) by at least 2 hours."
         }
@@ -5260,27 +5260,27 @@
           "rowKey": "Pharmacokinetic",
           "rowIndex": 0,
           "severity": "critical",
-          "counterparties": [],
+          "counterparties": ["sodium-valproate-oral-iv"],
           "termIds": [],
-          "resolved": false,
+          "resolved": true,
           "note": "CRITICAL — Sodium Valproate. Ertapenem rapidly destroys valproate blood levels, dropping them to sub-therapeutic levels within 24 hours, guaranteeing breakthrough seizures in epileptics. AVOID."
         }
       ],
-      "unresolvedRowCount": 1
+      "unresolvedRowCount": 0
     },
     "meropenem": {
       "rows": [
         {
           "rowKey": "Pharmacokinetic",
           "rowIndex": 0,
           "severity": "critical",
-          "counterparties": [],
+          "counterparties": ["sodium-valproate-oral-iv"],
           "termIds": [],
-          "resolved": false,
+          "resolved": true,
           "note": "CRITICAL — Sodium Valproate (Epilim). Meropenem rapidly accelerates the hepatic breakdown of Valproate. Blood levels drop to zero within 24 hours. The interaction cannot be overcome by increasing Valproate dose. Use alternative antibiotic or antiepileptic."
         }
       ],
-      "unresolvedRowCount": 1
+      "unresolvedRowCount": 0
     },
     "metronidazole": {
       "rows": [
@@ -6446,7 +6446,7 @@
           "rowKey": "Pharmacodynamic",
           "rowIndex": 0,
           "severity": "critical",
-          "counterparties": ["fentanyl", "morphine-sr-mr"],
+          "counterparties": ["fentanyl", "morphine-ir-iv", "morphine-sr-mr"],
           "termIds": [],
           "resolved": true,
           "note": "CRITICAL — Fentanyl / Morphine. The combination of Midazolam + Fentanyl is synergistic for procedural sedation but synergistic for fatal apnoea."
@@ -8131,7 +8131,7 @@
           "rowKey": "Pharmacokinetic",
           "rowIndex": 1,
           "severity": "high",
-          "counterparties": [],
+          "counterparties": ["olanzapine-wafer-odt"],
           "termIds": ["smoking"],
           "resolved": true,
           "note": "HIGH — Smoking induces CYP1A2, accelerating olanzapine clearance."
@@ -8299,7 +8299,7 @@
             "naproxen",
             "perindopril"
           ],
-          "termIds": ["acei", "arbs", "nsaids", "thiazide-diuretics"],
+          "termIds": ["acei", "arbs", "lithium", "nsaids", "thiazide-diuretics"],
           "resolved": true,
           "note": "CRITICAL — NSAIDs, ACEi/ARBs, and Thiazide Diuretics. All three of these completely destroy the kidney's ability to excrete Lithium, doubling blood levels and causing lethal toxicity. DO NOT prescribe Ibuprofen, Perindopril, or HCTZ to a Lithium patient."
         }
@@ -8960,7 +8960,7 @@
           "rowKey": "Pharmacodynamic",
           "rowIndex": 0,
           "severity": "critical",
-          "counterparties": ["buprenorphine-patch"],
+          "counterparties": ["buprenorphine-patch", "buprenorphine-sl-depot"],
           "termIds": [],
           "resolved": true,
           "note": "CRITICAL — Buprenorphine (Suboxone). Buprenorphine binds so tightly to the receptor that standard doses of Naloxone cannot displace it. Massive doses (or continuous infusions) are required."
@@ -9309,13 +9309,13 @@
           "rowKey": "Pharmacodynamic",
           "rowIndex": 0,
           "severity": "high",
-          "counterparties": [],
-          "termIds": [],
-          "resolved": false,
+          "counterparties": ["lithium-carbonate-ir-sr"],
+          "termIds": ["lithium"],
+          "resolved": true,
           "note": "HIGH — Lithium (Additive hypothyroid effect)."
         }
       ],
-      "unresolvedRowCount": 1
+      "unresolvedRowCount": 0
     },
     "iron": {
       "rows": [
@@ -9453,14 +9453,14 @@
         {
           "rowKey": "Pharmacodynamic",
           "rowIndex": 0,
-          "severity": "unknown",
+          "severity": "none",
           "counterparties": [],
           "termIds": [],
-          "resolved": false,
+          "resolved": true,
           "note": "NONE."
         }
       ],
-      "unresolvedRowCount": 1
+      "unresolvedRowCount": 0
     },
     "selenium": {
       "rows": [

docs/branch-review-records/391382c28f5fc43b1b7d8431141b1d93508d4082b9d44d6117ce2e92409a407b.record.md

@@ -0,0 +1 @@
+| 2026-08-13 | claude/patient-interactions-drug-alerts-3tztvw | 2812a8f5e0069047b7a8625d44d498f924cb0be6 | parenthesised-name root cause, unreachable-counterparty verdict guard, outstanding-issue capture | 9 further rows across 4 drugs were silently unresolvable and now resolve; green is no longer reachable when an entered drug is one no interaction row names, with the uncovered drugs stated on screen; 3 durable items queued to the issues inbox | verify:pr-local 18/18 green on merged tree (failed: none, not reached: none), 6402 unit tests; verify:ui deliberately skipped - text notice inside an existing section, covered by 4 DOM cases |

docs/branch-review-records/7e4c7356d18ff24114e7666fb83b869513525f74d9ccc2d5d3d5ae56a6bc925a.record.md

@@ -0,0 +1 @@
+| 2026-08-13 | claude/patient-interactions-drug-alerts-3tztvw | f44bb3f897b2c56adefa095b067b4d38b61241c8 | bare absence-declaration rows resolve instead of parsing as unreadable | triamcinolone and riboflavin no longer held at grey by a NONE. row they could always read; carve-out restricted to absence tokens and pinned both ways; 362/523 resolved, 186 of 328 can show green, zero unparsed severities | verify:pr-local 18/18 green (failed: none, not reached: none), 6404 unit tests |

docs/branch-review-records/e1f0256afe336c5f770289f51ee5c1e6ebeab67c19506620ecf3317979301fbd.record.md

@@ -0,0 +1 @@
+| 2026-08-13 | claude/patient-interactions-drug-alerts-3tztvw | 4b5f9b0da8351c752b8342155c70dd3e52c08a59 | lexicon dead-term removal, evidence-bearing review flags, lithium name alias, coverage boundary section | lithium reachable from 8 previously-silent HIGH rows (NSAIDs/thiazides); z-drugs retired as dead; antipsychotics and acei/arbs verified correct and their speculative flags replaced by a missed-class-member check | verify:pr-local 18/18 green on merged tree (failed: none, not reached: none), 6395 unit tests; check:production-readiness ran (2 FAILs are absent provider secrets in this container) |