Persius/hicric huggingface dataset:
4-(p-Bromophenyl)-4-(dimethylamino)-1-phenethylcyclohexanol

# Overview
4-(p-Bromophenyl)-4-(dimethylamino)-1-phenethylcyclohexanol is a potent -opioid agonist with a distinctive chemical structure which is not closely related to other established families of opioid drugs. It was invented by the chemists Daniel Lednicer and Philip VonVoigtlander in 1979.
This compound was found to be around 10,000x more potent than morphine in animal studies (although newer data suggest it is much less potent than this, perhaps only ~600x morphine), however due to its structural differences from other opioid drugs it would be difficult to represent as being "substantially similar in chemical structure" to any controlled drugs. This makes it likely that it would be legal throughout the world.
It has never been used in humans, but would be expected to produce effects similar to those of other potent opioid agonists, including strong analgesia, sedation, euphoria, constipation, itching and respiratory depression which could be harmful or fatal. Tolerance and dependence would be expected to develop rapidly based on the potency of the drug, as it is of a similar strength to carfentanil and so would most likely cause pronounced tachyphylaxis following repeated dosing, as is seen with the potent fentanyl analogues.

# See Also
- C-8813
Arterial and venous thrombosis differences and similarities

# Overview
More than a century ago, Virchow postulated that a triad of conditions (later called virchow's triad) leads to thrombus formation. Venous thrombosis has been associated with red blood cell and fibrin rich red clot while arterial thrombosis occur on atherosclerotic lesions with active inflammation, and are rich in platelets and give an appearance of white clot. Furthermore certain studies have indicated the role of platelet in Venous thrombosis. Thus, traditionally, venous thrombosis and arterial thrombosis has been described as distinct diseases with different risk factors, pathology and treatment. However, recent studies have shown an association between them.

# Similarities
The two vascular complications, venous and arterial thrombosis, share many risk factors, most of which are associated with increaased risk of atherosclerosis and endothelial wall injury due to the nature of arterial thrombosis development; these risk factors include:
- Obesity
- Hypertension
- Tobacco use
- Dyslipidemia
- Diabetes mellitus
- Metabolic syndrome
- Diet
- Age
- Hormonal replacement/contraceptive therapy
Furthermore there are many diseases that causes both arterial and venous thrombosis, such as:
- Antiphospholipid antibody syndrome
- Hyperhomocysteinemia
- Malignancies
- Infections
- Nephrotic syndrome
- Hormonal treatment
- Bechet's disease
- Poplitial artery aneurysm (Large aneurysm can compress the poplitial vein and cause DVT)
Although arterial and venous thrombosis are being treated as separate entities due to the pathophysiological point of view; recent studies have emphasized  the strong correlation between atherothrombotic events risk and VTE risk. The discovered shared risks of arterial and venous thrombotic events are to the extent that it is suggested to treat the whole thrombotic risk of an individual as a single entity rather than categorize it.

# Differences
Arterial thrombosis occur at places of arterial plaque rupture where the shear rate is higher, in contrast vein thrombosis occur at places where the vein wall is normal and blood flow and shear rate is low.
Cardiac allograft vasculopathy optical coherence tomography

# Overview
In 2010, U.S FDA approved coronary optical cohorence tomography (OCT) as a new catheter based intra-vascular imaging modality with a resolution higher than intravascular ultrasound (IVUS). OCT uses near infra-red light and constructs images from the reflected light which is in the same phase (i.e cohorent) with the emitted light. This eliminated the interference from scattered light, thereby producing images with higher resolution.

# Coronary Optical Cohorence Tomography

## Advantages
- Allows rapid imaging of coronaries with a higher radial resolution.
- Detects more subtle changes in the intima-media thickness compared to IVUS in patients with early CAV.
- Accurate plaque characterization.

## Limitations
- Complete blood washout from the coronaries is necessary to obtain good quality images.
- Deep tissue penetration is not as good as IVUS.
Cefazolin sodium compatibility reconstitution and stability

# Compatibility, Reconstitution, and Stability

## Reconstitution
Parenteral drug products should be SHAKEN WELL when reconstituted, and inspected visually for particulate matter prior to administration. If particulate matter is evident in reconstituted fluids, the drug solutions should be discarded.
When reconstituted or diluted according to the instructions below, Cefazolin for Injection is stable for 24 hours at room temperature or for 10 days if stored under refrigeration (5C or 41F).
Reconstituted solutions may range in color from pale yellow to yellow without a change in potency.
Single-Dose Vials
For IM injection, IV direct (bolus) injection or IV infusion, reconstitute with Sterile Water for Injection according to the following table. SHAKE WELL.
Coronary stent discharge instructions (patient information)

# Overview
An intraluminal coronary artery stent is a small, self-expanding, stainless steel mesh tube that is placed within a coronary artery to keep the vessel open. It may be used during a coronary artery bypass graft surgery to keep the grafted vessel open, after balloon angioplasty to prevent reclosure of the blood vessel, or during other heart surgeries.

# When could I drive after the procedure?
You should not drive for 48 hours after the procedure.

# What medications should I take after the procedure?
- Aspirin every day - usually for the rest of your life. Ask your doctor about the dose you should take.
- Plavix (clopidogrel) and Effient (prasugrel) may be used in addition to Aspirin to decrease the risk of a blood clot forming in the heart artery.
You will be given a list of all medicines you should take once you are at home. Ask your doctor whether you should go back to taking the medications you were on before the procedure. Be sure your doctor knows about everything you are taking.

# Should I take any OTC pain medications?
You may take acetaminophen (Tylenol) every six hours as needed for pain in the area where the catheter was placed.  Please be sure you are not taking more than one product containing acetaminophen, and do not take more Tylenol than what is recommended on the label.

# When may I resume my regular activities?
You may resume your regular activities one week after the procedure. Avoid lifting, pushing, or pulling anything heavier than 10 pounds in the first week after the procedure. Also avoid any exercise that causes you to hold your breath and bear down with your abdominal muscles. Begin your exercise program one week after the procedure at half your usual routine, then gradually work back to your full routine. Please ask your doctor about your exercise instructions.

# When could I bathe or swim?
Usually after one week, when the puncture site is healed. This usually takes about a week.
You may shower on the day after the procedure after removing the Band-Aid over your puncture site.

# When can I go back to work?
It depends on the type of your work. You can ask your doctor when you can go back to work.

# Follow-up care
Make an appointment to see your doctor within two weeks.

# When to seek urgent medical care?
Call your doctor if:
- There is bleeding at the catheter insertion site that does not stop when you apply pressure.
- There is swelling at the catheter site.
- Your leg or arm below where the catheter was inserted changes color, becomes cool to touch, or is numb.
- The small incision for your catheter becomes red or painful, or yellow or green discharge is draining from it.
- You have chest pain or shortness of breath that does not go away with rest.
- Your pulse feels irregular -- very slow (fewer than 60 beats), or very fast (over 100 to 120 beats) a minute.
- You have dizziness, fainting, or you are very tired.
- You are coughing up blood or yellow or green mucus.
- You have problems taking any of your heart medicines.
- You have chills or a fever over 101 F.

# Sources
Differentiating Hashimoto's thyroiditis from other diseases

# Overview
Hashimoto's thyroiditis must be differentiated from other causes of thyroiditis, such as De Quervain's thyroiditis, Riedel's thyroiditis, and suppurative thyroiditis. Hashimoto's thyroiditis must also be differentiated from other diseases which cause hypothyroidism. As Hashimoto's thyroiditis may cause transient thyrotoxic symptoms, the diseases causing thyrotoxicosis must also be considered in the differential diagnosis.

# Differentiating Hashimoto's Thyroiditis from other Diseases

## Differentiating Hashimoto's thyroiditis from other causes of thyroiditis
- Hashimoto's thyroiditis must be differentiated from other causes of thyroiditis, such as De Quervain's thyroiditis, Riedel's thyroiditis, and suppurative thyroiditis.

## Differentiating Hashimoto's thyroiditis from other causes of hypothyroidism
- Hashimoto's thyroiditis must be differentiated from other causes of hypothyroidism on the basis of history and symptoms and laboratory findings:
()T3RU; Triiodothyronine Resin uptake. (^)TPOAb; Thyroid peroxidase antibodies. (*)TSH may be decreased transiently in the thyrotoxicosis. ()TPOAb may be present in drug-induced hypo/hyperthyroidism such as Interferon-alpha, interleukin-2, and lithium.

## Differentiating Hashimoto's thyroiditis from other causes of thyrotoxicosis
- Hashimoto's thyroiditis can initially present with thyrotoxicosis (hashitoxicosis) which must be differentiated from other causes of thyrotoxicosis.
()T3RU; Triiodothyronine Resin uptake. (^)TPOAb; Thyroid peroxidase antibodies.
Elvitegravir cobicistat emtricitabine tenofovir description

# Description
STRIBILD is a fixed-dose combination tablet containing elvitegravir, cobicistat, emtricitabine, and tenofovir DF for oral administration.
Elvitegravir is an HIV-1 integrase strand transfer inhibitor.
Cobicistat is a mechanism-based inhibitor of cytochrome P450 (CYP) enzymes of the CYP3A family.
Emtricitabine is a synthetic nucleoside analog of cytidine. EMTRIVA is the brand name for emtricitabine.
Tenofovir DF is converted in vivo to tenofovir, an acyclic nucleoside phosphonate (nucleotide) analog of adenosine 5'-monophosphate. VIREAD is the brand name for tenofovir DF.
Each tablet contains 150 mg of elvitegravir, 150 mg of cobicistat, 200 mg of emtricitabine, and 300 mg of tenofovir DF (equivalent to 245 mg of tenofovir disoproxil). The tablets include the following inactive ingredients: lactose monohydrate, microcrystalline cellulose, silicon dioxide, croscarmellose sodium, hydroxypropyl cellulose, sodium lauryl sulfate, and magnesium stearate. The tablets are film-coated with a coating material containing indigo carmine (FD&C Blue #2) aluminum lake, polyethylene glycol, polyvinyl alcohol, talc, titanium dioxide, and yellow iron oxide.
Elvitegravir: The chemical name of elvitegravir is 6-(3-Chloro-2-fluorobenzyl)-1--7-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid.
It has a molecular formula of C23H23ClFNO5 and a molecular weight of 447.9. It has the following structural formula:
Elvitegravir is a white to pale yellow powder with a solubility of less than 0.3 micrograms per mL in water at 20 C.
Cobicistat: The chemical name for cobicistat is 1,3-thiazol-5-ylmethyl methyl}carbamoyl)amino]-4-(morpholin-4-yl)butanoyl]amino}-1,6-diphenylhexan-2-yl]carbamate.
It has a molecular formula of C40H53N7O5S2 and a molecular weight of 776.0. It has the following structural formula:
Cobicistat is adsorbed onto silicon dioxide. Cobicistat on silicon dioxide is a white to pale yellow solid with a solubility of 0.1 mg per mL in water at 20 C.
Emtricitabine: The chemical name of emtricitabine is 5-fluoro-1-cytosine. Emtricitabine is the (-)enantiomer of a thio analog of cytidine, which differs from other cytidine analogs in that it has a fluorine in the 5-position.
It has a molecular formula of C8H10FN3O3S and a molecular weight of 247.25. It has the following structural formula:
Emtricitabine is a white to off-white crystalline powder with a solubility of approximately 112 mg per mL in water at 25 C.
Tenofovir Disoproxil Fumarate: Tenofovir DF is a fumaric acid salt of the bis-isopropoxycarbonyloxymethyl ester derivative of tenofovir. The chemical name of tenofovir DF is 9--methoxy]phosphinyl]methoxy]propyl]adenine fumarate (1:1). It has a molecular formula of C19H30N5O10P  C4H4O4 and a molecular weight of 635.51. It has the following structural formula:
Tenofovir DF is a white to off-white crystalline powder with a solubility of 13.4 mg per mL in water at 25 C. All dosages are expressed in terms of tenofovir DF except where otherwise noted.
Primary Prevention and Screening Guidelines Recommendations

# Primary Prevention and Screening Guidelines Recommendations

## 2011 American Heart Association/American Stroke Association Guidelines for the Primary Prevention of Stroke

## 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease (DO NOT EDIT)

### Carotid Artery Evaluation and Revascularization Before Cardiac Surgery (DO NOT EDIT)
Texas Tech University Health Sciences Center El Paso Campus
Texas Tech University Health Sciences Center El Paso Campus is a branch of the Texas Tech University Health Sciences Center (TTUHSC) in El Paso, Texas. It opened in 1969 as the Regional Academic Health Center and became affiliated with R.E. Thomason Hospital in 1973 as part of the TTUHSC.
The facility now has approximately to 1,200 faculty and staff members. Third and fourth year medical students currently train at the El Paso campus, along with residents in eight accredited programs. It operates eleven community clinics throughout the city and County of El Paso. In addition to its partnership with Thomason Hospital, it has partnerships with William Beaumont Army Medical Center located on Fort Bliss and Providence Hospital.
The facility is currently building three new buildings and has completed another building for the projected 2009 opening of the full 4-year medical school. This will be the first four-year medical school on the U.S./Mexico border and is expected to improve the local economy by US$1.31-billion by the year 2013. TTUHSC at El Paso will also fill a niche in border and Hispanic health by leading research that will have a huge impact on the nation by contributing to literature dealing with Hispanics and diseases that affect the El Paso areadiabetes, obesity, and depression.
In 2005 TTUHSC at El Paso launched the Infinity Campaign, seeking to raise $25-million of private funds towards the building of the four-year medical school in El Paso. On August 4, 2007, Paul Foster, President and CEO of Western Refining, made a $50-million donation to the school. This is the largest donation in the history of the Texas Tech University System.
The WikiDoc Living Textbook of Kidney and Urologic Diseases

# KIDNEY EMBRYOLOGY
Pronephros | Mesonephros | Metanephros | Ureteric bud | Nephron | Collecting system | Vasculature

# KIDNEY ANATOMY

## A. Nephron
i) Glomerulus: Podocytes | Endothelial cells | Mesangial cells | Glomerular basement membrane | Bowman capsule
ii) Juxtaglomerular Apparatus: Juxtaglomerular granular cells | Extraglomerular mesangium | Macula densa
iii) Proximal Tubule: Pars convoluta | Pars recta
iv) Loop of Henle: Descending loop | Thick Ascending Limb | Thin Ascending Limb

### v) Distal Convoluted Tubule

### vi) Connecting Tubule

## B. Collecting Ducts
Cortical Collecting Duct | Outer Medullary Collecting Duct | Inner Medullary Collecting Duct

## C. Interstitium
Medullary Interstitium | Cortical Interstitium

## D. Lymphatics

## E. Vasculature

## F. Innervation

# RENAL PHYSIOLOGY
A. Renal Blood Flow
B. Glomerular Ultrafiltration:  Determinants of Glomerular Ultrafiltration | Regulation of Glomerular Ultrafiltration
C. Blood Pressure Regulation
D. Markers of Glomerular Function: Renal Clearance | Inulin clearance | Creatinine clearance | Cockroft-Gault Formula | Urea | Cystatin C | Other biomarkers
E. Markers of tubular function and Damage:  LDH | Kim-1

# KIDNEY PATHOLOGY

# PROCEDURES

# Anatomy and Physiology

# Embryology

# Disease States

# Congenital Disease States

# Pharmacotherapy

# Surgery
Unstable angina NSTEMI Antiplatelet therapy recommendations

# Overview
The current most updated guidelines state that for UA/NSTEMI patients presenting to the hospital, aspirin should be administered immediately, and if the patient cannot take aspirin, another anti-platelet agent, namely clopidogrel or prasugrel (in PCI treated patients) should be given. UA/NSTEMI patients at moderate to high risk who will be undergoing PCI should be given dual antiplatelet therapy consisting of aspirin and one of the following; clopidogrel, ticagrelor, eptifibatide and prasugrel, depending on whether the second agent is given before or during PCI. Addtional situation specific guidelines are given below.

# 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease (Updating the 2014 AHA/ACC Guideline for the Management of Patients With NonST-Elevation Acute Coronary Syndromes (DO NOT EDIT))

# Recommendations for Duration of DAPT in Patients With ACS Treated With Medical Therapy Alone

## Initial Oral and Intravenous Antiplatelet Therapy in Patients With Definite or Likely NSTEACS Treated With an Initial Invasive or Ischemia-Guided Strategy

## PCIAntiplatelet and Anticoagulant Therapy

### Oral and Intravenous Antiplatelet Agents

### Recommendation for aspirin dosing in patients treated with DAPT

## Recommendations for duration of DAPT in patients with ACS treated with PCI

## Medical Regimen and Use of Medications at Discharge

### Combined Oral Anticoagulant Therapy and Antiplatelet Therapy in Patients With NSTEACS

# 2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/NonST-Elevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update) (DO NOT EDIT)

## Antiplatelet therapy (DO NOT EDIT)
Valganciclovir hydrochloride patient counseling information

# Directions For Use
How do I give Valcyte for oral solution?
Your pharmacist will mix Valcyte for oral solution for you.
Be sure that you read, and that you understand and follow these instructions carefully to ensure proper dosing of the oral solution. To take a dose of Valcyte for oral solution, you will need the bottle of medicine and an oral dispenser. See Figure 1 below.
- Shake closed bottle well for about 5 seconds before each use.
- Remove the child-resistant bottle cap.
- Before inserting the tip of the oral dispenser into bottle adapter, push the plunger completely down toward the tip of the oral dispenser.
- Insert tip firmly into opening of the bottle adapter.
Turn the entire unit (bottle and oral dispenser) upside down (see Figure 2).
- Make sure the dosing dispenser stays connected to the bottle. Pull the plunger down slowly until the prescribed amount of medicine is withdrawn into the oral dispenser
- Turn the entire unit right side up and remove the oral dispenser slowly from the bottle.
- Give the dose of medicine directly into mouth and swallow. Do not mix with any liquid before giving the dose.
- Close the bottle with child-resistant bottle cap after each use.
- After taking your medicine, take apart (disassemble) the oral dispenser right away and rinse under running tap water. Then air dry before next use.
Avoid skin contact with Valcyte for oral solution. If you come in contact with Valcyte for oral solution, wash the area well with soap and water.
Do not use Valcyte for oral solution after the expiration date on the bottle.
Call your pharmacist if your oral dispenser is lost or damaged, and they will tell you how to continue to take your medicine.
Valproic acid capsule delayed release indications and usage

# Indications And Usage

### 1.1 Mania
Stavzor is indicated for the treatment of the manic episodes associated with bipolar disorder. A manic episode is a distinct period of abnormally and persistently elevated, expansive, or irritable mood. Typical symptoms of mania include pressure of speech, motor hyperactivity, reduced need for sleep, flight of ideas, grandiosity, poor judgment, aggressiveness, and possible hostility.
The efficacy of valproate was established in 3-week trials with patients meeting DSM-III-R criteria for bipolar disorder who were hospitalized for acute mania .
The safety and effectiveness of valproate for long-term use in mania, i.e., more than 3 weeks, has not been systematically evaluated in controlled clinical trials. Therefore, physicians who elect to use Stavzor for extended periods should continually reevaluate the long-term usefulness of the drug for the individual patient.

### 1.2 Epilepsy
Stavzor is indicated as monotherapy and adjunctive therapy in the treatment of adult patients and pediatric patients down to the age of 10 years with complex partial seizures that occur either in isolation or in association with other types of seizures. Stavzor is also indicated for use as sole and adjunctive therapy in the treatment of simple and complex absence seizures, and adjunctively in patients with multiple seizure types that include absence seizures.
Simple absence is defined as very brief clouding of the sensorium or loss of consciousness accompanied by certain generalized epileptic discharges without other detectable clinical signs. Complex absence is the term used when other signs are also present.

### 1.3 Migraine
Stavzor is indicated for prophylaxis of migraine headaches. There is no evidence that Stavzor is useful in the acute treatment of migraine headaches.

### 1.4 Important Limitations
Because of the risk to the fetus of decreased IQ, neural tube defects, and other major congenital malformations, which may occur very early in pregnancy, valproate should not be administered to a woman of childbearing potential unless the drug is essential to the management of her medical condition .
Stavzor is contraindicated for prophylaxis of migraine headaches in women who are pregnant.
Amitriptyline hydrochloride patient counseling information

# Patient Counseling Information

### Information for Patients
Prescribers or other health professionals should inform patients, their families, and their caregivers about the benefits and risks associated with treatment with amitriptyline and should counsel them in its appropriate use. A patient Medication Guide about Antidepressant Medicines, Depression and other Serious Mental Illness and Suicidal Thoughts or Actions is available for amitriptyline. The prescriber or health professional should instruct patients, their families, and their caregivers to read the Medication Guide and should assist them in understanding its contents. Patients should be given the opportunity to discuss the contents of the Medication Guide and to obtain answers to any questions they may have. The complete text of the Medication Guide is reprinted at the end of this document.
Patients should be advised of the following issues and asked to alert their prescriber if these occur while taking amitriptyline.
While on therapy with amitriptyline hydrochloride, patients should be advised to the possible impairment of mental and/or physical abilities required for the performance of hazardous tasks, such as operating machinery or driving a motor vehicle.