anthonyyazdaniml/CT-ADE-SOC huggingface dataset:
Intervention: Prasugrel
Trial phase: Phase 3
ATC code: B01AC22
SMILES: CC(=O)Oc1cc2c(s1)CCN(C(C(=O)C1CC1)c1ccccc1F)C2
Sex: All
Age groups: Child
Healthy volunteers: No
Participants at risk: 170
Group description: Participants will be titrated from initial daily dose of 0.08 milligram per kilogram (mg/kg) of orally administered prasugrel monotherapy at randomization to a dose that will achieve a P2Y12 reaction units (PRU) level of 231 to 136, as measured by VerifyNow instrument. This corresponds to a range of platelet inhibition of approximately 30% to 60%. The maximum possible dose allowed is 0.12 mg/kg daily, not to exceed 10 mg daily.
Eligibility criteria:
Inclusion Criteria:

Have SCD [homozygous sickle cell (HbSS) or hemoglobin (HbS) Beta^0 thalassemia]
Are participants with SCD who have had ≥2 episodes of vaso-occlusive crisis (VOC) in the past year
Have a body weight ≥19 kilograms (kg) and are ≥2 and <18 years of age, inclusive at the time of screening
If participants are ≥2 and ≤16 years of age, must have had a transcranial Doppler within the last year

Exclusion Criteria:

History of: transient ischemic attack (TIA)/ ischemic or hemorrhagic stroke, severe head trauma, intracranial hemorrhage, intracranial neoplasm, arteriovenous malformation, or aneurysm
History of abnormal or conditional [velocity in middle or anterior cerebral, or internal carotid artery ≥170 centimeter per second (cm/sec)] transcranial Doppler within the last year
History of, or are undergoing treatment with, chronic red blood cell (RBC) transfusion therapy
Are at an increased risk for bleeding complications
Are receiving chronic treatment with nonsteroidal anti-inflammatory drug (NSAID)s and cannot be switched to another analgesic
Intervention: CANDESARTAN CILEXETIL
Trial phase: Phase 4
SMILES: CCOc1nc2cccc(C(=O)OC(C)OC(=O)OC3CCCCC3)c2n1Cc1ccc(-c2ccccc2-c2nn[nH]n2)cc1
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 1
Group description: For subjects who do not remit to sertraline, they will receive candesartan for 12 weeks, with doses ranging from 4mg - 32mg daily.

Candesartan: 4mg - 32mg daily
Eligibility criteria:
Inclusion Criteria:

Age 60 years or older
Diagnosis of Major Depressive Disorder, single or recurrent episode, without psychotic features by Diagnostic and Statistical Manual IV Text Revision (DSMIV-TR) criteria
Presence of hypertension (defined as systolic > 140 or diastolic > 90 or currently receiving antihypertensive therapy)
Minimum depression severity of ≥ 15 on the Montgomery-Asberg Depression Rating Scale (MADRS)
Cognitively intact or with mild cognitive deficits, with a minimum score ≥ 23 on the Montreal Cognitive Assessment (MoCA).

Exclusion Criteria:

Other psychiatric Axis I disorders
Acute suicidality
Electroconvulsive therapy in the last 6 months
Primary neurological disorder, including dementia and stroke
Significant cardiovascular disease, specifically diagnosis of congestive heart failure, known bilateral renal artery stenosis, symptomatic hypotension, or critical aortic or mitral stenosis
Myocardial infarction or open-heart surgery in last 6 weeks
Serum creatinine ≥ 265 micromol /L
Serum potassium ≥ 5.5 mmol/L
MRI contraindications
Known allergy to sertraline or candesartan specifically or known allergy to other SSRIs or ARBs.
History of prolonged (> 3 weeks) or self-described severe discontinuation syndrome in the past after stopping an antidepressant.
Current use of an angiotensin receptor blocker
Current or planned psychotherapy
Need for continuous oxygen use or any medical disorder where the hypercapnia challenge would be contraindicated or put the subject at increased risk. This would include acute respiratory disease, chronic angina, or other unstable cardiac conditions.
Intervention: Remifentanil
Trial phase: Phase 2
ATC code: N01AH06
SMILES: CCC(=O)N(c1ccccc1)C1(C(=O)OC)CCN(CCC(=O)OC)CC1
Sex: All
Age groups: Child | Adult
Healthy volunteers: No
Participants at risk: 63
Group description: This arm will receive remifentanil alone as is the current practice.

Remifentanil
Eligibility criteria:
Inclusion Criteria:

Patients older than 12, and younger than 19 years of age undergoing posterior spinal fusion for idiopathic scoliosis
American Society of Anesthesiologist (ASA) physical status I or II
Parents/Guardian willing and able to authorize informed consent
Patients willing and able to authorize assent

Exclusion Criteria:

Patients presenting with neuromuscular scoliosis
Patients deemed at increased risk of adverse reactions due to the presence of pre-existing severe organ system dysfunction, including debilitating lung disease, severe obstructive sleep apnea, severe congenital or acquired heart disease, and/or severe renal impairment
Patients who are both being currently treated for a psychological disorder and have a history of hospitalization for said disorder
Intervention: Magnesium Sulfate
Trial phase: Phase 2
ATC code: A06AD04 | A12CC02 | B05XA05 | D11AX05 | V04CC02
SMILES: O=S(=O)([O-])[O-].[Mg+2]
Sex: All
Age groups: Child | Adult
Healthy volunteers: No
Participants at risk: 63
Group description: This arm will receive the current analgesic remifentanil plus an adjunct dose of magnesium sulfate.

Magnesium Sulfate: This drug will be given with remifentanil as an adjunct analgesic. Remifentanil + magnesium (50 mg/kg bolus over 30 minutes followed by 10 mg/kg/hour).
Eligibility criteria:
Inclusion Criteria:

Patients older than 12, and younger than 19 years of age undergoing posterior spinal fusion for idiopathic scoliosis
American Society of Anesthesiologist (ASA) physical status I or II
Parents/Guardian willing and able to authorize informed consent
Patients willing and able to authorize assent

Exclusion Criteria:

Patients presenting with neuromuscular scoliosis
Patients deemed at increased risk of adverse reactions due to the presence of pre-existing severe organ system dysfunction, including debilitating lung disease, severe obstructive sleep apnea, severe congenital or acquired heart disease, and/or severe renal impairment
Patients who are both being currently treated for a psychological disorder and have a history of hospitalization for said disorder
Intervention: SODIUM CHLORIDE
Trial phase: Phase 4
ATC code: A12CA01 | B05CB01 | B05XA03 | S01XA03
SMILES: [Cl-].[Na+]
Sex: All
Age groups: Child
Healthy volunteers: No
Participants at risk: 27
Group description: Sodium chloride 1 meq/kg (0.4 ml/kg of 2.5meq/ml formulation for injection)q6hrs on days of life 7-35. Intervention was given enterally if feedings were at least 100 ml/kg/day; otherwise medication was diluted in equal amounts of dextrose 5% water and administered intravenously.

Sodium chloride
Eligibility criteria:
Inclusion Criteria:

infants born at less than 32 weeks postmenstrual age

Exclusion Criteria:

infants with major malformations deemed incompatible with life disease states characterized by edema renal failure, defined as an increase in serum creatinine by 0.5 mg/dl/day or urine output less than 0.5 ml/kg/hour
Intervention: Amikacin
Trial phase: Phase 1
ATC code: D06AX12 | J01GB06 | J01RA06 | S01AA21
SMILES: NCC[C@H](O)C(=O)N[C@@H]1C[C@H](N)[C@@H](O[C@H]2O[C@H](CN)[C@@H](O)[C@H](O)[C@H]2O)[C@H](O)[C@H]1O[C@H]1O[C@H](CO)[C@@H](O)[C@H](N)[C@H]1O
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 21
Group description: Subjects were assigned to receive a single and multiple 400 mg oral dose Mesylate Imatinib Capsule
Eligibility criteria:
Inclusion Criteria:

Patients with chronic myeloid leukemia;
Age: 18-65 years,gender:both.
Weight: standard weight ± 20% within, and avoid weight disparity is too large;
No previous radiation therapy, chemotherapy, or surgery within 1 weeks before treatment with imatinib;
Performance status 0 to 3 (WHO scale); Life expectancy greater than 3 months;
No other malignancy;
Adequate hepatic, renal, and bone marrow function (WBC≥3.0×109/L，ANC≥1.5×109/L，PLT≥80×109/L. Serum bilirubin≤1.5×the institutional upper limit of normal, ALT、ALP≤2.5×the institutional upper limit of normal, creatinine≤1.5×the institutional upper limit of normal);
Ability to understand objectives of the study, the study procedure, the pharmacological properties of the drug and possible adverse reactions and the willingness to sign a written informed consent.

Exclusion Criteria:

Suffering from heart, liver, kidney disease or severe acute and chronic gastrointestinal diseases;
Pregnant or lactating women and be sensitive to drug;
Subjects are thought unsuitable for the study by investigators;
Inability to comply with protocol or study procedures in the opinion of the investigator;
Attending other clinical trials or attended other clinical trials 3 months ago.
Intervention: Imatinib Mesylate
Trial phase: Phase 1
SMILES: CS(=O)(=O)O.Cc1ccc(NC(=O)c2ccc(CN3CCN(C)CC3)cc2)cc1Nc1nccc(-c2cccnc2)n1
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 21
Group description: Subjects were assigned to receive a single and multiple 400 mg oral dose Glivec
Eligibility criteria:
Inclusion Criteria:

Patients with chronic myeloid leukemia;
Age: 18-65 years,gender:both.
Weight: standard weight ± 20% within, and avoid weight disparity is too large;
No previous radiation therapy, chemotherapy, or surgery within 1 weeks before treatment with imatinib;
Performance status 0 to 3 (WHO scale); Life expectancy greater than 3 months;
No other malignancy;
Adequate hepatic, renal, and bone marrow function (WBC≥3.0×109/L，ANC≥1.5×109/L，PLT≥80×109/L. Serum bilirubin≤1.5×the institutional upper limit of normal, ALT、ALP≤2.5×the institutional upper limit of normal, creatinine≤1.5×the institutional upper limit of normal);
Ability to understand objectives of the study, the study procedure, the pharmacological properties of the drug and possible adverse reactions and the willingness to sign a written informed consent.

Exclusion Criteria:

Suffering from heart, liver, kidney disease or severe acute and chronic gastrointestinal diseases;
Pregnant or lactating women and be sensitive to drug;
Subjects are thought unsuitable for the study by investigators;
Inability to comply with protocol or study procedures in the opinion of the investigator;
Attending other clinical trials or attended other clinical trials 3 months ago.
Intervention: TERIPARATIDE
Trial phase: Phase 3
ATC code: H05AA02
SMILES: CC[C@H](C)[C@H](NC(=O)[C@H](CCC(=O)O)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@@H](N)CO)C(C)C)C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CCSC)C(=O)N[C@@H](Cc1cnc[nH]1)C(=O)N[C@@H](CC(N)=O)C(=O)N[C@@H](CC(C)C)C(=O)NCC(=O)N[C@@H](CCCCN)C(=O)N[C@@H](Cc1cnc[nH]1)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CC(N)=O)C(=O)N[C@@H](CO)C(=O)N[C@@H](CCSC)C(=O)N[C@@H](CCC(=O)O)C(=O)N[C@@H](CCCNC(=N)N)C(=O)N[C@H](C(=O)N[C@@H](CCC(=O)O)C(=O)N[C@@H](Cc1c[nH]c2ccccc12)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CCCNC(=N)N)C(=O)N[C@@H](CCCCN)C(=O)N[C@@H](CCCCN)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H](CC(=O)O)C(=O)N[C@H](C(=O)N[C@@H](Cc1cnc[nH]1)C(=O)N[C@@H](CC(N)=O)C(=O)N[C@@H](Cc1ccccc1)C(=O)O)C(C)C)C(C)C
Sex: Female
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 214
Group description: Participants received 20 μg/day teriparatide administered by subcutaneous injection for 12 months.
Eligibility criteria:
Inclusion Criteria:

Postmenopausal women, aged ≥ 55 to ≤ 90.
Received oral bisphosphonate therapy for at least 3 years immediately prior to screening
BMD T-score ≤ -2.50 at the lumbar spine, total hip or femoral neck
History of nonvertebral fracture after age 50, or vertebral fracture.

Exclusion Criteria:

Use of other agents affecting bone metabolism including Strontium ranelate, fluoride (for osteoporosis), odanacatib (MK-0822) or any other cathepsin K inhibitor, IV bisphosphonates, denosumab, teriparatide (TPTD) or any parathyroid hormone (PTH) analogs, Systemic oral or transdermal estrogen, selective estrogen receptor modulators (SERMs), activated vitamin D3, vitamin K2, calcitonin, tibolone, cinacalcet, systemic glucocorticosteroids:
History of metabolic or bone disease (except osteoporosis) that may interfere with the interpretation of study results, such as sclerosteosis, Paget's disease, rheumatoid arthritis, osteomalacia, osteogenesis imperfecta, osteopetrosis, ankylosing spondylitis, Cushing's disease, hyperprolactinemia, and malabsorption syndrome.
Vitamin D insufficiency, defined as 25 (OH) vitamin D levels < 20 ng/mL, as determined by the central laboratory.
Current hyper- or hypocalcemia
Current, uncontrolled hyper- or hypothyroidism
Intervention: Citalopram
Trial phase: Phase 4
ATC code: N06AB04 | N06AB10
SMILES: CN(C)CCCC1(c2ccc(F)cc2)OCc2cc(C#N)ccc21
Sex: Female
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 5
Group description: Escitalopram tablet, 10mg, daily, 9 weeks.
Eligibility criteria:
Inclusion Criteria:

Diagnosis of major depression based on DSM-IV criteria;
age 18-70 years;
Greater than 15 on MADRS for severity of depression;
HIV seropositive;
no new antiviral medications over the past 2 months;
involved in active treatment for HIV disease,
negative serum pregnancy test
Those subjects who are actively being treated for depression but show no improvement as defined by self-reported failure to improve with current treatment or residual depression as demonstrated by a MADRS of 15 or greater will be asked to participate in the study as well.

Exclusion Criteria:

The presence of an active and significant psychiatric disease other than Major Depressive Disorder as diagnosed on MINI in the last 3 months;
meeting DSM-IV criteria for an Axis I disorder within the last three months, or meeting criteria for substance abuse within the last 12 months;
current pregnancy or lactation if breast feeding;
history of hypersensitivity, intolerance, or contraindication to LEX;
baseline creatinine of 2.5 or greater;
patients taking anticoagulants;
history of diagnosed gastric or duodenal ulcer;
history within past year of bleeding or clotting diathesis;
lifetime history of myocardial infarction or cerebrovascular accident;
history of surgery within the past 3 months;
inability to follow study procedures or complete the study;
the use of any antidepressant medications within 5 half-lives of randomization;
women of child-bearing potential who will not agree to use approved means of birth control during the trial;
other reason that the primary investigator believes that the subject will be unable to complete trial or has medical/psychiatric contraindications to the trial.
Individuals who are currently being treated for depression and show significant improvements in their depression such that discontinuing their current antidepressant therapy would likely have negative clinical consequences will be excluded from participating in this study.
Individuals who are or become suicidal will be excluded from this study.
Intervention: Ranolazine
Trial phase: Phase 2 | Phase 3
ATC code: C01EB18
SMILES: COc1ccccc1OCC(O)CN1CCN(CC(=O)Nc2c(C)cccc2C)CC1
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 20
Group description: Ranolazine 500mg bid orally 7 days Ranolazine 750mg bid orally 35 days

Ranolazine: Improvement of myocardial microcirculation
Eligibility criteria:
Inclusion Criteria:

Proof of acute cardiac ischemia by elevated serum Troponin T-hs levels > 14 pg/nl
Proof of myocardial dyskinesia with functional echocardiography ("speckle tracking")
Stable angina pectoris >/= CCS II in patient history
Stabilized (i.e. normalized vital parameters) patients after coronary angioplasty or angiography
Coronary angioplasty or angiography not older than 24 hours
Written informed consent
Established standard therapy for coronary artery disease (i.e. Beta-Blocker, ACE-Inhibitor or AT1-Inhibitor, ASS, Clopidogrel, Statins)

Exclusion Criteria:

Patients younger than 18 years of age
Acute cardio-pulmonary decompensation
Middle and high grade liver insufficiency (Child-Pugh Score B and C)
High grade renal insufficiency (Creatinine-Clearance < 30 ml/min)
Concomitant treatment with potent inhibitors of CYP3A4
Concomitant administration of class Ia (e.g. quinidine) or class III (e.g. dofetilide, sotalol) antiarrhythmics, except for amiodarone
Concomitant administration of > 20 mg simvastatin/day
Patients with heart failure classification NYHA III and NYHA IV
Homeless patients and drug-addicted patients
Pregnant and/or breast-feeding women
Treatment with Ranolazine prior to enrolment in RIMINI-Trial
Allergy against Ranolazine
Intervention: Doxycycline
Trial phase: Phase 4
ATC code: A01AB22 | J01AA02 | J01AA20
SMILES: [H][C@@]12C(=C(O)[C@]3(O)C(=O)C(C(N)=O)=C(O)[C@@H](N(C)C)[C@]3([H])[C@H]1O)C(=O)c1c(O)cccc1[C@@H]2C
Sex: All
Age groups: Child | Adult | Older Adult
Healthy volunteers: No
Participants at risk: 113
Group description: Participants received mechanical periodontal therapy, oral hygiene instructions and antibiotic (Doxycycline 100mg x 14 pills)

Doxycycline: Participants received mechanical periodontal therapy, oral hygiene instructions and Doxycycline 100mg x 14 pills (to be taken one a day for 14 days)
Eligibility criteria:
Inclusion Criteria:

Gullah African Americans;
With type 2 diabetes mellitus defined according to the American Diabetes Association criteria;

Other inclusion criteria are presented under each Specific Aim:

AIM 1: Participants who have received oral, dental, periodontal, diabetes and genotype assessment through enrollment in Dr. J. Fernandes' COBRE project.
AIM 2 and 3: Participants with severe chronic periodontitis, as defined by at least one tooth surface with probing depth (PD)≥5mm.

Exclusion Criteria:

Severe concurrent illnesses / conditions that would limit their daily life or require extensive systemic treatment, such as malignancy, severe cardiovascular disease, organ transplant, or inadequate understanding due to mental disorders;
Finger stick blood glucose measurement of more than 350mg/dl or less than 70mg/dl after second measurement;
Systolic blood pressure of more than 180mm Hg or diastolic pressure of more than 100mm Hg;
Fasting serum C-peptide < 1ng/ml (documentation or test);
Serum creatinine ≥ 1.6mg/dl;
Abnormal hepatic function;
Hemoglobinopathy (sickle cell trait/hemolytic anemia) interfering with HbA1c monitoring;
Other underlying illness/conditions which, in the doctor's judgment, may prevent patient from adherence to the study protocol;
Unwillingness to sign the informed consent form or enter the study;
Pregnant women;
Patients in need of antibiotic prophylaxis prior to dental procedures or patients that have been treated with any kind of antibiotics in the past 3 months.
Intervention: Progesterone
Trial phase: Not Applicable
ATC code: G03DA04 | G03FA04
SMILES: [H][C@@]12CCC3=CC(=O)CC[C@]3(C)[C@@]1([H])CC[C@]1(C)[C@@H](C(C)=O)CC[C@@]21[H]
Sex: Female
Age groups: Adult
Healthy volunteers: Accepts Healthy Volunteers
Participants at risk: 24
Group description: Take micronized natural progesterone capsule by mouth, twice daily (approximately at 8 am and 8 pm) for four weeks beginning on postpartum day 4.

Progesterone: Take micronized natural progesterone capsule by mouth, twice daily (approximately at 8 am and 8 pm) for four weeks beginning on postpartum day 4.
Eligibility criteria:
Inclusion Criteria:

Woman
18-35 years old
Zero CPD for past 4 weeks
5 or more CPD for at least 6 out of past 12 months
Motivated to remain abstinent (7 or higher out of 10)
Stable physical/mental health
Established prenatal care
Stable physical/mental health
Willing to take Progesterone
Willing to use double-barrier protection if sexually active
English fluency
Able to provide informed consent

Exclusion Criteria:

Psychotropic medications
Illicit drugs
Other types of tobacco, NRT, smoking cessation medications
Pregnancy complications (Diabetes, Anomaly, Fetal growth restriction, HTN, Hx of >2 miscarriages)
Current use of: Finasteroid (propecia), Efavirenz, Red Clover, Ketoconazole, CYP3A4 Inhibitors
History of: Thrombophelitis, Deep vein thrombosis, Pulmonary embolus, Clotting disorder, Bleeding disorder, Heart disease, Diabetes, Stroke, Peanut allergy, Liver dysfunction, Hypersensitivity to progesterone
Intervention: Lovenox
Trial phase: Phase 4
SMILES: CC(=O)NC1C(O)OC(COS(=O)(=O)O)C(OC2OC(C(=O)O)C(OC3OC(CO)C(OC4OC(C(=O)O)C(O)C(O)C4OS(=O)(=O)O)C(OS(=O)(=O)O)C3NS(=O)(=O)O)C(O)C2OS(=O)(=O)O)C1O
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 62
Group description: Enoxaparin 0.8 mg/kg (using total body weight) twice daily

Enoxaparin: Twice daily dosing
Eligibility criteria:
Inclusion Criteria:

Planned treating with twice daily enoxaparin
BMI >= 40 kg/m2

Exclusion Criteria:

< 18 years of age
CrCl < 30 ml/min
Pregnancy
Prisoner
Active bleeding
Already received 3 consecutive doses of enoxaparin
Use of therapeutic enoxaparin for more than 5 consecutive days within the last 3 months
Intervention: Lovenox
Trial phase: Phase 4
SMILES: CC(=O)NC1C(O)OC(COS(=O)(=O)O)C(OC2OC(C(=O)O)C(OC3OC(CO)C(OC4OC(C(=O)O)C(O)C(O)C4OS(=O)(=O)O)C(OS(=O)(=O)O)C3NS(=O)(=O)O)C(O)C2OS(=O)(=O)O)C1O
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 62
Group description: Enoxaparin 1 mg/kg (using total body weight) twice daily

Enoxaparin: Twice daily dosing
Eligibility criteria:
Inclusion Criteria:

Planned treating with twice daily enoxaparin
BMI >= 40 kg/m2

Exclusion Criteria:

< 18 years of age
CrCl < 30 ml/min
Pregnancy
Prisoner
Active bleeding
Already received 3 consecutive doses of enoxaparin
Use of therapeutic enoxaparin for more than 5 consecutive days within the last 3 months
Intervention: Pituitrin
Trial phase: Not Applicable
SMILES: NC(=O)CCC1NC(=O)C(Cc2ccccc2)NC(=O)C(Cc2ccc(O)cc2)NC(=O)C(N)CSSCC(C(=O)N2CCCC2C(=O)NC(CCCN=C(N)N)C(=O)NCC(N)=O)NC(=O)C(CC(N)=O)NC1=O.NCCCCC(NC(=O)C1CCCN1C(=O)C1CSSCC(N)C(=O)NC(Cc2ccc(O)cc2)C(=O)NC(Cc2ccccc2)C(=O)NC(CCC(N)=O)C(=O)NC(CC(N)=O)C(=O)N1)C(=O)NCC(N)=O
Sex: All
Age groups: Child | Adult | Older Adult
Healthy volunteers: No
Participants at risk: 60
Group description: In the liberal approach group, we will titrate vasopressors to maintain mean arterial pressures between 75 and 80 mmHg.

Vasopressors
Eligibility criteria:
Inclusion Criteria:

Who are receiving vasopressors for distributive shock
Who are older than 16 years of age at the time of eligibility.
Who are under the direct care of the ICU team regardless of location.
Who have received a minimum of 30 mL/kg of intravenous fluids (2100 mL for a 70 kg patient) before enrolment OR the most responsible physician has good reasons to believe that more fluid resuscitation is no longer required and could be harmful.
Who the treating physician believes will need vasopressors for at least 6 hours once enrolled.

Exclusion Criteria:

Have received vasopressors for more than 24 consecutive hours; if vasopressors are discontinued for >= 2 hours then restarting vasopressors will constitute a distinct vasopressor episode and the clock will be reset.
Are judged by the treating physician to be in obvious cardiogenic shock after an acute myocardial infarction (based on new ST segment elevations on ECG or obvious echocardiographic findings).
Have obvious haemorrhagic shock as a consequence of a clearly identified source of blood loss.
Require vasopressors after cardiac surgery as a result of cardiopulmonary bypass-induced hypotension.
Who have a specific indication for catecholamine therapy other than shock (i.e. angioedema or intracranial hypertension).
If the attending team has agreed to withhold or withdraw life sustaining care.
Concurrent enrollment in interventional trials that do not meet guidelines (see ccctg.ca) for co-enrollment (co-enrollment is permissible if there is no potential interaction between the protocols; this will be addressed case by case).
Prior randomization in this study.