Persius/hicric huggingface dataset:
Lopressor injection/adult indications and dosage

# FDA-Labeled Indications and Dosage (Adult)

## Myocardial Infarction
- Upon patient presentation:
- 15 minutes after the full IV dose:
Lopressor injection is indicated in the treatment of hemodynamically stable patients with definite or suspected acute myocardial infarction to reduce cardiovascular mortality when used in conjunction with oral Lopressor maintenance therapy. Treatment with Lopressor injection can be initiated as soon as the patients clinical condition allows.
Early Treatment: During the early phase of definite or suspected acute myocardial infarction, initiate treatment with Lopressor injection as soon as possible after the patients arrival in the hospital. Such treatment should be initiated in a coronary care or similar unit immediately after the patients hemodynamic condition has stabilized. Begin treatment in this early phase with the intravenous administration of three bolus injections of 5 mg of Lopressor injection each; give the injections at approximately 2-minute intervals. During the intravenous administration of Lopressor, monitor blood pressure, heart rate, and electrocardiogram.
In patients who tolerate the full intravenous dose (15 mg), initiate Lopressor tablets, 50 mg every 6 hours, 15 minutes after the last intravenous dose and continue for 48 hours. Thereafter, the maintenance dosage is 100 mg orally twice daily. Start patients who appear not to tolerate the full intravenous dose on Lopressor tablets either 25 mg or 50 mg every 6 hours (depending on the degree of intolerance) 15 minutes after the last intravenous dose or as soon as their clinical condition allows. In patients with severe intolerance, discontinue Lopressor (see Warnings).

# Off-Label Use and Dosage (Adult)

## Cardiac Dysrhythmia
Lopressor injection (range: 215 mg) has been shown to be effective in the treatment of atrial flutter, atrial fibrillation, multifocal atrial tachycardia, and supraventricular tachycardia.

## Injection Site Pain Associated with Propofol
Pretreatment with Lopressor injection (2 mg IV) was shown to be equally as effective as lidocaine in reducing the pain associated with propofol injection.
Myoneurogastrointestinal encephalopathy syndrome
Synonyms and keywords :  mitochondrial neurogastrointestinal encephalopathy disease, MNGIE disease

# Overview
Mitochondrial neurogastrointestinal encephalopathy (MNGIE) disease is a condition that affects several parts of the body, particularly the digestive system and nervous system.   The major features of MNGIE disease can appear anytime from infancy to adulthood, but signs and symptoms most often begin by age 20.   The medical problems associated with this disorder worsen with time.

# Pathophysiology

## Genetics
Mutations in the TYMP gene (previously known as ECGF1) cause this disease.  This gene provides instructions for making an enzyme called thymidine phosphorylase.   Thymidine is a molecule known as a nucleoside, which (after a chemical modification) is used as a building block of DNA.   Thymidine phosphorylase breaks down thymidine into smaller molecules, which helps regulate the level of nucleosides in cells.

# Epidemiology and Demographics
The prevalence of the disease is unknown.   About 70 people with this disorder have been reported.

# Diagnosis

## History and Symptoms
- Satiety after eating only a small amount
- Dysphagia
- Nausea and vomiting
- Odynophagia
- Abdominal pain
- Diarrhea and intestinal blockage.
These gastrointestinal problems lead to extreme weight loss and reduced muscle mass (cachexia).

## Physical Examination

### Eyes
- Ptosis
- Opthalmoplegia

### Neurologic Examination
- Hearing loss
- Tingling, numbness, and weakness in their limbs
- Peripheral neuropathy, particularly in the hands and feet.

### MRI
Leukoencephalopathy, which is the deterioration of a type of brain tissue known as white matter, is a hallmark of MNGIE disease.  These changes in the brain can be seen with magnetic resonance imaging (MRI).
Niacin/lovastatin patient counseling information

# Patient Counseling Information
Patients should be advised of the following:
- to report promptly unexplained muscle pain, tenderness, or weakness particularly if accompanied by malaise or fever or if muscle signs and symptoms persist after discontinuing ADVICOR (see WARNINGS, Myopathy/Rhabdomyolysis);
- to report promptly any symptoms that may indicate liver injury, including fatigue, anorexia, right upper abdominal discomfort, dark urine or jaundice (see WARNINGS, Liver Dysfunction);
- to take ADVICOR at bedtime, with a low-fat snack. Administration on an empty stomach is not recommended;
- to carefully follow the prescribed dosing regimen (see DOSAGE AND ADMINISTRATION);
that flushing is a common side effect of niacin therapy that usually subsides after several weeks of consistent niacin use. Flushing may last for several hours after dosing, may vary in severity, and will, by taking ADVICOR at bedtime, most likely occur during sleep. If awakened byflushing, especially if taking antihypertensives, rise slowly to minimize the potential for dizziness and/or syncope;
- that taking aspirin (up to approximately 30 minutes before taking ADVICOR) may minimize flushing;
- to avoid ingestion of alcohol, hot beverages and spicy foods around the time of ADVICOR administration, to minimize flushing;
- should not be administered with grapefruit juice;
- that if ADVICOR therapy is discontinued for an extended length of time, their physician should be contacted prior to re-starting therapy; re-titration is recommended (see DOSAGE AND ADMINISTRATION);
- to notify their physician if they are taking vitamins or other nutritional supplements containing niacin or related compounds such as nicotinamide (see Drug Interactions);
- to notify their physician if symptoms of dizziness occur;
- if diabetic, to notify their physician of changes in blood glucose;
- that ADVICOR tablets should not be broken, crushed, or chewed, but should be swallowed whole.
Penicillin V potassium dosage and administration

# Dosage and Administration
The dosage of penicillin V should be determined according to the sensitivity of the causative microorganisms and the severity of infection, and adjusted to the clinical response of the patient.
The usual dosage recommendations for adults and children 12 years and over are as follows:
- Streptococcal infections - mild to moderately severe - of the upper respiratory tract and including scarlet fever and erysipelas: 125 to 250 mg (200,000 to 400,000 units) every 6 to 8 hours for 10 days.
- Pneumococcal infections - mild to moderately severe - of the respiratory tract, including otitis media: 250 to 500 mg (400,000 to 800,000 units) every 6 hours until the patient has been afebrile for at least 2 days.
- Staphylococcal infections - mild infections of skin and soft tissue (culture and sensitive tests should be performed): 250 to 500 mg (400,000 to 800,000 units) every 6 to 8 hours.
- Fusospirochetosis (Vincents infection) of the oropharynx. Mild to moderately severe infections: 250 to 500 mg (400,000 to 800,000 units) every 6 to 8 hours.
For the prevention of recurrence following rheumatic fever and/or chorea: 125 to 250 mg (200,000 to 400,000 units) twice daily on a continuing basis.
For prophylaxis against bacterial endocarditis1 in patients with congenital heart disease or rheumatic or other acquired valvular heart disease when undergoing dental procedures or surgical procedures of the upper respiratory tract: 2 gram of penicillin V (1 gram for children under 60 lbs.) 1 hour before the procedure, and then, 1 gram (500 mg for children under 60 lbs.) 6 hours later.
Posttransplantation lymphoproliferative disorder

# Overview
Organ transplant recipients are at risk for posttransplantation lymphoproliferative disorder (PTLD). Risk factors include immunosuppressive therapy and Epstein-Barr virus. Non-Hodgkin lymphoma represents up to 93% of lymphomas in PTLD patients. Early recognition of the disease is essential because spontaneous regression may occur after a decrease in the dosage or even complete cessation of immunosuppressive therapy or with antiviral therapy. The most common sites of involvement are lymph nodes and the gastrointestinal tract.

# Diagnosis
The imaging findings are
- Common features of PTLD include lymph node enlargement, a focal bowel mass with wall thickening, and necrosis or focal hepatic lesions that are hypoechoic at US and hypoattenuating at CT.
- The most common appearance in the chest is multiple pulmonary nodules with or without mediastinal adenopathy.
- CT or MR imaging may demonstrate brain involvement wtih PTLD preferentially involving the periventricular white matter at one or more sites.
Psychiatric and mental health Nurse Practitioner
A Mental Health Nurse Practitioner (MHNP), also known as Psychiatric Nurse Practitioner, works in a primary care facility, outpatient mental health clinic or in a hospital or community health center.  MHNPs evaluate and provide care for patients who have psychiatric disorders, medical mental conditions or substance abuse problems. They are licensed to provide emergency psychiatric services, psychosocial and physical assessment of their patients, treatment plans, and to continually manage patient care. They may also serve as consultants or as educators for families and staff; however, the MHNP has a greater focus on psychiatric diagnosis, including the differential diagnosis of medical disorders with psychiatric symptoms, and on medication treatment for psychiatric disorders.

# Education
A nurse practitioner must obtain at least six years of college education.  First the individual must take a four-year college degree, usually in nursing although there are programs called Masters Entry Level Nursing programs designed around individuals with a Bachelors degree outside of nursing.  After obtaining their Bachelor of Science in Nursing (BSN) degree, they must take the NCLEX-RN, the test for licensure as a registered nurse.  Then, the candidate must complete a state-approved Masters Degree advanced nursing education program which includes at least 600 clinical hours.  Individuals who choose a Masters Entry Level pathway will spend an extra year at the start of the program taking classes necessary to pass the NCLEX-RN.  Some schools will issue a BSN; others will issue a certificate.  The student then continues with the normal MSN program.
There are many schools that offer the education required for this profession.  The cost of education can vary greatly.  Some things that contribute to the varying costs are: Public vs. Private school; traditional vs. Masters entry level; and in-state vs. out-of-state tuition.  For example, at UCSF the cost for the Masters program with in-state tuition is approximately $12,245 a year; for an out-of-state student the tuition is $24,798.  The masters entry-level program is $27,000 a year.
The investment made in a MHNP education reaps its reward.  The average salary for an MHNP in the United States is $75,711 per year. However, it varies between states and cities.  On the west coast, the average is much higher. The average nurse practitioner salary in Fresno is $82,963; in Los Angeles is $84,837; and in Phoenix is $86,539.  There is a wide variety of pay throughout the country.  In addition to the base salary there can also be a wealth of benefits.  Many Nurse Practitioners will receive excellent health and retirement benefits.  Another benefit often provided to Nurse Practitioners is malpractice insurance, which can cost upwards of thousands of dollars a year.
A MHNP can practice in a wide variety of settings with a certain amount of freedom. In at least 20 states in the United States, a MHNP may own his or her own practice.
Rifampin isoniazid pyrazinamide clinical studies

# Clinical Trials
A total of 250 patients were enrolled in an open label, prospective, randomized, parallel group, active controlled trial, for the treatment of pulmonary tuberculosis. There were 241 patients evaluable for efficacy, 123 patients received isoniazid, rifampin and pyrazinamide as separate tablets and capsules for 56 days, and 118 patients received 4 to 6 RIFATER tablets based on body weight for 56 days. RIFATER tablets and the drugs dosed as separate tablets and capsules were administered based on body weight during the intensive phase of treatment according to the following table.
During the continuation phase, both treatment groups received 450 mg of rifampin and 300 mg of isoniazid per day for 4 months if the patient weighed <50 kg or 600 mg of rifampin and 300 mg of isoniazid per day for 4 months if the patient weighed 50 kg. Patients were followed for occurrence of relapses for up to 30 months after the end of therapy.
There were no significant differences in the negative bacteriological sputum results (available in a subset of patients) between the two treatments at 2 and 6 months during the trial and during the follow-up period. See table below.
For adverse events, (See ADVERSE REACTIONS).
Right ventricular myocardial infarction overview

# Overview
Acute myocardial infarction involving only the free wall of the right ventricle is a rare event.   More commonly, right ventricular infarction is associated with infarction of the inferior wall of the left ventricle, occurring in more than one-third of such cases,          even when a thrombolytic therapy is given. 
One study of 113 patients with a first acute inferior wall infarction reported that the presence of preinfarction angina within 72 hours of the infarction was associated with a reduction in the incidence of right ventricular infarction (odds ratio 0.2) and combined hypotension and shock (odds ratio 0.1).  This is possibly the result of ischemic preconditioning.
- Ninety percent of right ventricular infarcts result from occlusion of the proximal right coronary artery, while another 5 to 10 percent arise after occlusion of the left anterior descending artery    
Although more than one-third of cases are clinically silent , the presence of right ventricular infarction often has important implications for both management and prognosis.
Robert Jones and Agnes Hunt Orthopaedic Hospital
The Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust in Oswestry, Shropshire, England provides elective orthopaedic surgery and musculoskeletal medical services.
It was formed in 1933 when the Shropshire Orthopaedic Hospital was renamed The Robert Jones and Agnes Hunt Orthopaedic Hospital.
In 1903 Agnes Hunt sought treatment for her hip condition from a Liverpool surgeon, Robert Jones, and their collaboration began.
Sudden infant death syndrome laboratory findings

# Overview
There are no diagnostic laboratory findings associated with sudden infant death syndrome (SIDS). Some patients with sudden infant death syndrome (SIDS) may have anemia and infection.

# Laboratory Findings
There are no diagnostic laboratory findings associated with sudden infant death syndrome (SIDS).
- Laboratory findings that may be present in the patients of sudden infant death syndrome (SIDS) include:
Anemia if suspected, evaluate by doing complete blood count (CBC)
Infection if suspected, the following levels should be considered testing:
Blood gas analysis (BGA)
Blood lactate level
Blood glucose levels to evaluate hypoglycaemia
Liver enzymes
Lumbar puncture (LP)
Cerebrospinal fluid analysis (CSF)
Serum electrolytes
Blood urea
Calcium levels
Phosphate levels
Urinalysis  and culture
Virology screening
Bacterial screening
- Anemia if suspected, evaluate by doing complete blood count (CBC)
- Infection if suspected, the following levels should be considered testing:
Blood gas analysis (BGA)
Blood lactate level
Blood glucose levels to evaluate hypoglycaemia
Liver enzymes
Lumbar puncture (LP)
Cerebrospinal fluid analysis (CSF)
Serum electrolytes
Blood urea
Calcium levels
Phosphate levels
Urinalysis  and culture
Virology screening
Bacterial screening
- Blood gas analysis (BGA)
- Blood lactate level
- Blood glucose levels to evaluate hypoglycaemia
- Liver enzymes
- Lumbar puncture (LP)
- Cerebrospinal fluid analysis (CSF)
- Serum electrolytes
- Blood urea
- Calcium levels
- Phosphate levels
- Urinalysis  and culture
- Virology screening
- Bacterial screening
- Maternal biomarkers of SIDS risk include the following:
Alpha-fetoprotein which is increased in congenital anomalies like neural tube defects, omphalocele, gastroschisis, and fetal bowel obstructions. These conditions in turn increases the risk of SIDS.
- Alpha-fetoprotein which is increased in congenital anomalies like neural tube defects, omphalocele, gastroschisis, and fetal bowel obstructions. These conditions in turn increases the risk of SIDS.
- Fetal biomarkers of SIDS risk include the following:
Fetal hemoglobin (HbF)
- Fetal hemoglobin (HbF)
Tetracycline hydrochloride indications and usage

# Indications and Usage
To reduce the development of drug-resistant bacteria and maintain the effectiveness of tetracycline hydrochloride and other antibacterial drugs, tetracycline hydrochloride should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Tetracycline is indicated in the treatment of infections caused by susceptible strains of the designated organisms in the conditions listed below:
- Upper respiratory tract infections caused by Streptococcus pyogenes, Streptococcus pneumoniae and Hemophilus influenzae. Note: Tetracycline should not be used for streptococcal disease unless the organism has been demonstrated to be susceptible.
- Lower respiratory tract infections caused by Streptococcus pyogenes, Streptococcus pneumoniae, Mycoplasma pneumoniae (Eaton agent, and Klebsiella sp.)
- Skin and soft tissue infections caused by Streptococcus pyogenes, Staphylococcus aureaus. (Tetracyclines are not the drugs of choice in the treatment of any type of staphylococcalinfections.)
- Infections caused by rickettsia including Rocky Mountain spotted fever, typhus group infections, Q fever, rickettsialpox.
- Psittacosis of ornithosis caused by Chlamydia Psittaci.
- Infections caused by Chlamydia trachomatis such as uncomplicated urethral, endocervical or rectal infections, inclusion conjunctivitis, trachoma, and lymphogranuloma venereum.
- Granuloma inquinale caused by Calymmatobacterium granulomatis.
- Relapsing fever caused by Borrelia sp.
- Bartonellosis caused by Bartonella bacilliformis.
- Chancroid caused by Hemophilus ducreyi.
- Tularemia caused by Francisella tularensis.
- Plaque caused by Yersinia pestis.
- Cholera caused by Vibrio cholerae.
- Brucellosis caused by Brucellaspecies (tetracycline may be used in conjunction with an aminoglycoside).
- Infections due to Campylobacter fetus.
- As adjunctive therapy in intestinal amebiasis caused by Entamoeba histolytica.
- Urinary tract infections caused by susceptible strains of Escherichia coli, Klebsiella, etc.
- Other infections caused by susceptible gram-negative organisms such as E. coli, Enterobacter aerogenes, Shigellasp., Acinetobacter sp., Klebsiella sp., and Bacteroides sp.
- In severe acne, adjunctive therapy with tetracycline may be useful.
When penicillin is contraindicated, tetracyclines are alternative drugs in the treatment of the following infections:
- Syphilis and yaws caused by Treponema pallidum and pertenue, respectively,
- Vincents infection caused by Fusobacterium fusiforme,
- Infections caused by Neisseria gonorrhoeae,
- Anthrax caused by Bacillus anthracis,
- Infections due to Listeria monocytogenes,
- Actinomycosis caused by Actinomyces species,
- Infections due to Clostridium species.
The EKG in the patient treated with procainamide
Electrocardiographic findings of procainamide effects include:
- Unlike Quinidine it is not anticholinergic
- EKG changes are less pronounced than those accompanying quinidine
- The QRS interval is increased in proportion to the plasma level
- The QTc interval is prolonged but to a lesser degree than quinidine
- U waves become more prominent
- In high or toxic doses, it may cause high-degree block and marked widening of the QRS duration, PVCs, VT, Torsades de pointes, VF or asystole. These effects are seen more frequently with the IV preparation than the oral preparation
Transmissible spongiform encephalopathy overview
Please help WikiDoc by adding more content here.  It's easy!  Click  here  to learn about editing.

# Overview
Transmissible spongiform encephalopathies are a group of progressive conditions that affect the brain and nervous system of humans and animals and are transmitted by prions. Mental and physical abilities deteriorate and myriad tiny holes appear in the cortex causing it to appear like a sponge (hence 'spongiform') when brain tissue obtained at autopsy is examined under a microscope. The disorders cause impairment of brain function, including memory changes, personality changes and problems with movement that worsen over time. Prion diseases of humans include classic Creutzfeldt-Jakob disease, new variant Creutzfeldt-Jakob disease (a human disorder related to mad cow disease), Gerstmann-Straussler-Scheinker syndrome, fatal familial insomnia and kuru. These conditions form a spectrum of diseases with overlapping signs and symptoms.

# Pathophysiology
Unlike other kinds of infectious disease which are spread by microbes, the infectious agent in TSEs is a specific protein called prion protein. Misshaped prion proteins carry the disease between individuals and cause deterioration of the brain. TSEs are unique diseases in that their aetiology may be genetic, sporadic or infectious via ingestion of infected foodstuffs and via iatrogenic means (e.g. blood transfusion) (reviewed in Prusiner, 1991; Collinge, 2001).

# Epidemiology and Demographics
These spontaneous disorders in humans are very rare affecting only about one person per million worldwide each year.
Venereal disease research laboratory (VDRL) test

# Overview
The Venereal Disease Research Laboratory test (VDRL) is a nontreponemal serological screening for syphilis, the monitoring of the response to therapy, the detection of CNS involvement, and as an aid in the diagnosis of congenital syphilis. The basis of the test is that an antibody produced by a patient with syphilis reacts with an extract of ox heart (diphosphatidyl glycerol). It therefore detects anti-cardiolipin antibodies (IgG, IgM or IgA).
Many other conditions can produce false positive results, including some viruses (mononucleosis, hepatitis), drugs, rheumatic fever, rheumatoid arthritis, lupus, and leprosy. 
The syphilis anti-cardiolipin antibodies are beta-2 glycoprotein independent, where as those that occur in the antiphospholipid antibody syndrome (associated to lupus for example) are beta-2 glycoprotein dependent, and this can be used to tell them apart in an ELISA assay.  This test is very useful as the trend of titres are correlated to disease activity (i.e. falling titres indicate successful treatment). It has a very good sensitivity for syphilis, except in late tertiary form.
FTA-ABS is a far more specific test for syphilis and, in the presence of a positive VDRL test, indicates active infection.

# Related chapters
- Syphilis
Valproic acid capsule/solution contraindications

# Contraindications
Depakene should not be administered to patients with hepatic disease or significant hepatic dysfunction .
Depakene is contraindicated in patients known to have mitochondrial disorders caused by mutations in mitochondrial DNA polymerase  (POLG; e.g., Alpers-Huttenlocher Syndrome) and children under two years of age who are suspected of having a POLG-related disorder .
Depakene is contraindicated in patients with known hypersensitivity to the drug .
Depakene is contraindicated in patients with known urea cycle disorders .