Datasets:

Eladio
/

emrqa-msquad

Dataset card Data Studio Files Files and versions Community

Split (2)

train · 131k rows

context stringlengths 762 4.39k	question stringlengths 2 220	answers dict
Mr. Plagmann was admitted to the hospital for management of his decompensated heart failure and prescribed Aldactone 25 mg once a day, K-Dur 40 mEq once a day, lisinopril 2.5 mg once a day, Isordil 20 mg three times a day, digoxin 0.125 once a day, torsemide 200 mg twice, and metolazone p.r.n. for volume overload. To improve his urine output, we started a low-dose dopamine drip at 2 mcg per hour and increased the Lasix drip from 10 mg an hour to 20 mg an hour after 200 mg IV Lasix bolus, with good effectiveness reflected in his total weight. We monitored strict I's and O's, checked daily weight, and monitored the b.i.d. lytes. Eventually, his blood pressures remained stable, his JVP decreased from 18 to 20 on admission to about 10 to 12, and his creatinine was stable at 1.7. Given his potassium, which was always borderline low in the 33 or 35 range, we decided to increase his Aldactone dose to 25 mg b.i.d., but given his underlying renal insufficiency, we have decreased his standing K-Dur from 40 mEq a day to 20 mEq a day. We re-added his Isordil at 10 mg t.i.d. for the last 24 hours and his blood pressures were stable in the 90s. We also added folate 5 mg to his regimen because he had an elevated homocystine level and he also takes Ambien at night p.r.n. for insomnia. He is being discharged to home with plan to follow up with Dr. Grassi in her Thyroid Clinic on 2/11/05. Mr. Plagmann states that his symptoms have drastically improved and he is able to exert himself much more without symptoms of shortness of breath or lightheadedness.	Has the patient taken any medications for insomnia. management	{ "answer_end": [ 1289 ], "answer_start": [ 1239 ], "text": [ "he also takes Ambien at night p.r.n. for insomnia." ] }
An 81-year-old Russian-speaking male with a history of coronary artery disease, multiple strokes, diabetes mellitus type 2, COPD, atrial fibrillation on anticoagulation and a partial pacemaker, congestive heart failure with an ejection fraction of 45-50%, BPH, and hypertension was admitted to Ghampemaw A Hospital for bacteremia with Streptococcus oralis and was treated with a course of IV penicillin through a PICC line, as well as oral Flagyl empirically for an elevated white count. At the rehab facility, he was treated with some sublingual nitroglycerin, and was brought to the Ellwis Medical Center Emergency Room where he was given IV fluid boluses, treated empirically with vancomycin and ceftazidime, and had a CPAP initiated. A head CT was performed which was negative and a right internal jugular line was placed. He was admitted to medicine for further management and a PEG tube placement was done on 4/2/06. His MEDICATIONS ON ADMISSION included Glucotrol 10 mg p.o. b.i.d. and lisinopril 5 mg p.o. q. day, metformin 500 mg p.o. t.i.d., sublingual nitroglycerin p.r.n., nystatin suspension q.i.d., Zyprexa 2.5 mg p.o. q. h.s., Penicillin G 3 million units IV q. 4h x7 days, Milk of Magnesia, Tylenol p.r.n., Dulcolax p.r.n., Colace p.r.n., atenolol 50 mg q. day, Lipitor 20 mg q. day, Senna liquid q. h.s., Flomax 0.4 q. day. He was initially diuresed mildly with Lasix, started on insulin sliding-scale and Lantus, and was kept on potassium and magnesium scales while in hospital. He was given an empiric 7-day course of Ceptaz and Flagyl for aspiration pneumonia, vancomycin, and his vancomycin was switched to IV penicillin and was continued for a full 3-4 week course on 8/14/07. Coumadin was held peri-procedure when he was getting his PEG placed and vitamin K had been administered in view of his supratherapeutic Coumadin. His Coumadin should be restarted on 9/23/07 and Nexium p.o. t.i.d., Flagyl 500 mg p.o. t.i.d. x10 days which was started on 2/5/06. He was oxygenated quickly with 2 liters of oxygen by nasal cannula, restarted on his home doses of aspirin, statin, beta blocker 2 pump, and ACE inhibitor, and his beta blocker and ACE inhibitor were restarted during his hospital stay. He was discharged to rehabilitation where they will focus primarily on his physical therapy and rehab needs.	Has this patient ever been treated with lasix.	{ "answer_end": [ 1385 ], "answer_start": [ 1341 ], "text": [ "He was initially diuresed mildly with Lasix," ] }
Patient Omar J. Coolbaugh, a 71-year-old female post cardiac transplant with allograft coronary artery disease, bilateral carotid disease, TIA, diabetes, and obesity, was admitted on 11/8/2007 and discharged on 4/14/2007 with s/p angioplasty and stenting. The medications on admission included Mycophenolate Mofetil 1000 mg PO BID, Oxybutynin Chloride XL 10 mg PO QD, Insulin Glargine 20 units SC QAM, Furosemide PO QD, Clopidogrel 75 mg PO QD, Pravastatin 40 mg PO QHS, Prednisone 5 mg PO QD, Cyclosporine (Sandimmune) 75 mg PO BID, Metoprolol Succinate Extended Release 50 mg PO QD, and Fenofibrate (Tricor) 48 mg PO QD. Elective cardiac catheterization was performed, revealing double vessel disease and successful PTCA/Stenting of LAD was done using XB3.5 guide, BMW, with no residual stenosis. The patient was advised to take Enteric Coated ASA 325 mg PO Daily, Plavix (Clopidogrel) 75 mg PO Daily, Cyclosporine (Sandimmune) 75 mg PO BID, Tricor (Fenofibrate (Tricor)) 48 mg PO Daily, Lasix (Furosemide) 40 mg PO Daily, Insulin Glargine 20 units SC Daily, Toprol XL (Metoprolol Succinate Extended Release) 50 mg PO Daily, CellCept (Mycophenolate Mofetil) 1,000 mg PO BID, Ditropan XL (Oxybutynin Chloride XL) 10 mg PO Daily, Pravachol (Pravastatin) 40 mg PO Bedtime, Prednisolone Sodium Phosphate 5mg/5ml 5 mg PO Daily, and vitamins, with ASA 325 and Plavix for life and other medications at usual doses, plus TNG 0.4 mg (Nitroglycerin 1/150 (0.4 mg)) 1 tab SL q5min x 3 doses PRN Chest Pain. The importance of both aspirin and taking medications consistently was stressed and the patient understands, with diet house/low chol/low sat. fat and activity light activity with no heavy lifting or driving x 2 days, ok to shower, no swimming or bathing x 5 days and lift restrictions of not lifting greater then 10-15 pounds. Follow up appointments were scheduled for Heart Failure Clinic 2-4 weeks and patient was discharged in stable condition and advised to drink plenty of fluids over the next several days, and to call with any questions or concerns.	Has patient ever been prescribed enteric coated asa	{ "answer_end": [ 866 ], "answer_start": [ 811 ], "text": [ "was advised to take Enteric Coated ASA 325 mg PO Daily," ] }
Patient Mariano Librizzi was admitted on 4/21/2005 with a viral infection and severe pulmonary hypertension, and discharged on 9/22/2005 to go home. The discharge medications included ECASA (Aspirin Enteric Coated) 81 MG PO QD, with a potentially serious interaction with Warfarin & Aspirin, COLACE (Docusate Sodium) 100 MG PO BID, LASIX (Furosemide) 160 MG PO BID, GLIPIZIDE 10 MG PO BID, OCEAN SPRAY (Sodium Chloride 0.65%) 2 SPRAY NA QID, COUMADIN (Warfarin Sodium) 5 MG PO QPM, JERICH, JOSPEH, M.D. on order for ECASA PO (ref #91585860), ZOLOFT (Sertraline) 150 MG PO QD, AMBIEN (Zolpidem Tartrate) 10 MG PO QHS, KCL SLOW RELEASE 20 MEQ PO BID, ATROVENT NASAL 0.06% (Ipratropium Nasal 0.06%) 2 SPRAY NA TID, NEXIUM (Esomeprazole) 20 MG PO QD, TRACLEER (Bosentan) 125 MG PO BID, VENTAVIS 1 neb NEB Q3H Instructions: during wake hours, ALBUTEROL INHALER 2 PUFF INH Q4H PRN Shortness of Breath, Wheezing, home O2 (8L NC). The patient was also prescribed K-Dur 20 BID, Nexium 20, Lasix 160 BID, Tracleer 125 BID, Glipizide 80 BID, Coumadin 5/7.5, ECASA 81, Zoloft 100, MVI, Oceanspray 2 Spray NA QID, Ambien 10 QHS, Ventavis nebs Q3H, Albuterol Inhaler 2 puff INH Q4H, KCl Slow Release 20 MEQ PO BID, Colace 100 MG PO BID, Atrovent Nasal 0.06%. The diet was House/Low chol/low sat. fat and 4 gram Sodium and they were advised to do walking as tolerated, with serial enzymes/EKG to be continued and Lasix, KCl, ASA 81 also advised. The patient had a history of depression which had been worse of late and was advised to continue Zoloft and Ambien, and to avoid high Vitamin-K containing foods and to give on an empty stomach (give 1hr before or 2hr after food). The patient was followed by the AH service with ACEi, cephalopsporins, GERD nexium prophylaxis and Coumadin for pulmonary microclots on Bx in tracleer 125 BID, Glipizide 80 BID, Coumadin 5/7.5, ECASA 81, Zoloft. The discharge condition was satisfactory.	Was the patient ever given albuterol inhaler for wheezing	{ "answer_end": [ 895 ], "answer_start": [ 838 ], "text": [ "ALBUTEROL INHALER 2 PUFF INH Q4H PRN Shortness of Breath," ] }
A 57 year old woman with multiple cardiac risk factors presented with substernal chest pain relieved by two sublingual nitroglycerins, nausea, and an acid taste. She was ruled out for myocardial infarction by enzyme sets respectively, with no change in EKGs. Her physical examination was afebrile with a blood pressure of 132/96, pulse 95, on one liter of oxygen, saturation of 97%, and respiratory rate of 20. She was treated with aspirin, beta blockers, and nitroglycerin and was started on Axid for possibility of gastroesophageal reflux disease, as well as provided with Maalox and told to keep the head of the bed elevated. She was continued on Glucotrol for diabetes mellitus and was instructed on risk factor modifications, including diabetes mellitus control, controlling cholesterol and hypertension. Upon discharge she was prescribed Atenolol 100 mg p.o. q.d., Ecasa 325 mg q.d., Glucotrol 20 mg b.i.d., Hydrochlorothiazide 12.5 mg q.d., Trazadone 50 mg q.h.s., aspirin 1 q.d., Lopressor 75 mg q.d., nitroglycerin sublingual p.r.n., Ambien 5 mg q.h.s., and was instructed on the possibility of gastroesophageal reflux disease, as well as to follow-up with Dr. Jonker as an outpatient for further workup and management of gastroesophageal reflux disease, as well as following her for her cardiac disease via the risk factor modification.	Has the patient ever tried atenolol	{ "answer_end": [ 870 ], "answer_start": [ 825 ], "text": [ "she was prescribed Atenolol 100 mg p.o. q.d.," ] }
A 73-year-old male patient with a history of coronary artery disease, ischemic cardiomyopathy, and valvular heart disease was admitted to the Rose-le Medical Center with a large left foot toe ulcer that was nonhealing, and signs and symptoms of decompensated heart failure and acute on chronic renal failure. During his stay, he was treated with Enteric-coated aspirin 325 mg p.o. daily, Amiodarone 200 mg p.o. daily, Colace 100 mg p.o. b.i.d., insulin NPH 7 units q.a.m. and 3 units q.p.m. subcutaneously, Atrovent HFA inhaler 2 puffs inhaled q.i.d. p.r.n. for wheezing, magnesium gluconate sliding scale p.o. daily, oxycodone 5-10 mg p.o. q. 4h. p.r.n. pain, senna tablets one to two tablets p.o. b.i.d. p.r.n. constipation, spironolactone 25 mg p.o. daily, Coumadin 1 mg p.o. every other day, multivitamin therapeutic one tablet p.o. daily, Zocor 40 mg p.o. daily, torsemide 100 mg p.o. daily, OxyContin 10 mg p.o. b.i.d., Cozaar 25 mg p.o. daily, Remeron 7.5 mg p.o. q.h.s., and aspartate insulin sliding scale, as well as being maintained on subcutaneous heparin and Nexium as DVT and GI prophylaxis, Celexa 20 mg p.o. daily, Coumadin 2.5 mg p.o. daily, Diovan 80 mg p.o. daily, Lantus 25 units every day subcutaneous, Lasix 160 mg p.o. b.i.d., Lipitor 20 mg p.o. q.h.s., Lopressor 50 mg p.o. b.i.d., solsite topical, and 25 mg of hydrochlorothiazide b.i.d. 30 minutes prior to meals, in addition to ciprofloxacin, DuoDERM, BKA site healing with continued aspirin, and inhaled ipratropium. Hyponatremia due to heart failure was improved with diuresis, and the patient was maintained on Coumadin with an INR goal of 2-3, adjusted to 1 mg PO every other day. Diabetes mellitus, insulin-dependent, was covered on NPH QAM and QPM with aspartate sliding scale for duration of hospitalization. The patient was restarted on Celexa per PCP for likely depressive mood response to recent bilateral knee amputation, and later started on Remeron 7.5 mg PO daily in place of Celexa. He was initially treated for urinary tract infection with uncomplicated course with ciprofloxacin, and Wound care nurse consulted for BKA wound and small decubitus on his back, was treated with DuoDERM, BKA site healing well. The patient was maintained on subcutaneous heparin and Nexium as DVT and GI prophylaxis during this hospitalization. He was discharged on Enteric-coated aspirin 325 mg p.o. daily, Amiodarone 200 mg p.o. daily, Atrovent one to two puffs inhaled q.i.d. p.r.n. for wheezing, Celexa 20 mg p.o. daily, Coumadin 2.5 mg p.o. daily, Diovan 80 mg p.o. daily, enteric-coated aspirin 325 mg p.o. daily, Lantus 25 units every day subcutaneous, Lasix 160 mg p.o. b.i.d., Lipitor 20 mg p.o. q.h.s., Lopressor 50 mg p.o. b.i.d., therapeutic multivitamin one tablet p.o. daily, solsite topical, and instructed to follow up with psychiatry to assess depressive disorder/adjustment disorder, start beta-blocker at a low-dose in the outpatient setting, and check creatinine and BUN along with electrolytes to make sure patient is doing well on current maintenance diuretic schedule of 100 mg torsemide PO daily and spironolactone. Code status was full code.	Has this patient ever been on ipratropium	{ "answer_end": [ 1494 ], "answer_start": [ 1451 ], "text": [ "continued aspirin, and inhaled ipratropium." ] }
This 46-year-old male with a history of Insulin dependent diabetes, currently managed with 32 units of NPH Humulin, presented with pain with motion of the subtalar joint or the mid foot. He had a long history of ankle pain on the right side due to two fractures, one as a child and one due to a fall from a ladder, and was controlling his pain with Darvocet as well as intramuscular Tordal 15 to 30 mg four times a day. He was admitted as a same day surgery candidate and underwent tibiotalar fusion with cross-cannulated AO screws and local bone graft, with a tourniquet time of 1 hour and 57 minutes and received 2500 cc of crystalloid intraoperatively. His current medications include NPH Insulin 32 units every morning, Procardia XL 90 mg q.a.m., Lotensin 40 mg p.o. q.d., Lasix 40 mg p.o. q.d., potassium supplement, Ketorolac 15-30 mg intramuscularly q.i.d., and Darvocet N-100 one to four tablets q.d., with no known drug allergies. He was also prescribed Vicodan one to two p.o. q.3-4h. p.r.n., Naprosyn 500 mg p.o. b.i.d. as a substitute for the Tordal, and Halcion 0.125 to 0.25 mg p.o. q.h.s. p.r.n. Post-operatively, his motor and sensory examinations were intact and he was discharged on post-operative day three with the medications prescribed. He will follow-up with Dr. Norman Dutko in approximately three weeks at which time the cast will be changed and stitches removed.	Has the patient ever had lotensin	{ "answer_end": [ 776 ], "answer_start": [ 724 ], "text": [ "Procardia XL 90 mg q.a.m., Lotensin 40 mg p.o. q.d.," ] }
Mr. Gerache is a 59 yo man with poorly controlled diabetes and asthma who presented with chest pain. He had intermittent chest pain with activity lasting 5 minutes, relieved with rest, as well as shortness of breath when climbing stairs. Cardiac catheterization showed LAD prox 40%, no LCX lesions, no RCA lesions, and R PDA mid 30% lesion. Beta blocker was started, cholesterol was checked (elevated triglycerides 308, total cholesterol 146, HDL 29), statin was started and aspirin was held because of the patient's stated allergy to aspirin (causing asthma type symptoms). He was started on low-dose lisinopril and no prior echo was considered as outpatient. Patient was continued on home regimen of NPH insulin but clearly needs better control of his sugars as outpatient. Hemoglobin A1c is 10.7 and he will need better control of his sugars as outpatient. He has had asthma as a child and no record of PFTs but should obtain as outpatient, with home inhalers continued. Mr. Gaulding currently has good renal function but needs to have his Cr checked after starting the lisinopril. The patient was advised to consider carefully his lifestyle, including diet and exercise plans, and to take medications including VENTOLIN NEBULIZER (ALBUTEROL NEBULIZER) 2.5 MG NEB Q4H PRN Shortness of Breath, ATENOLOL 12.5 MG PO QD Starting IN AM (8/7), NPH HUMULIN INSULIN (INSULIN NPH HUMAN) 60 UNITS QAM; 70 UNITS QPM SC 60 UNITS QAM 70 UNITS QPM, LISINOPRIL 5 MG PO QD, ZOCOR (SIMVASTATIN) 20 MG PO QHS, FLOVENT (FLUTICASONE PROPIONATE) 44 MCG INH BID, COMBIVENT (IPRATROPIUM AND ALBUTEROL SULFATE) 2 PUFF INH QID, and make an appointment with his primary care doctor, take his medications as instructed, and follow up with his cardiologist within 4-6 weeks. He was also placed on a House / Low chol/low sat. fat diet, ADA 2100 cals/dy diet, 2 gram Sodium diet. He was discharged with Full code status and disposition to Home.	shortness of breath meds on in past	{ "answer_end": [ 1270 ], "answer_start": [ 1215 ], "text": [ "VENTOLIN NEBULIZER (ALBUTEROL NEBULIZER) 2.5 MG NEB Q4H" ] }
A 58 year old female smoker with a history of Coronary Artery Disease (CAD), Cirrhosis, Diabetes Mellitus Type II (DMII), Hypertension (HTN), and Hyperlipidemia was admitted to the CCU after an elective cardiac catheterization following an abnormal stress test. The cath showed impaired flow in the inferior and posterolateral zones due to obstructive degenerative disease in the SVGs to the RCA and LCF-OM, and a stent was placed in the RCA graft though there was extensive calcification and difficulty obtaining full stent expansion. After the stent deployment there was poor reflow accompanied by mild chest pain and EKG changes, without hemodynamic embarrassment. The patient experienced jaw and chest pain post-procedure which she described as different from previous episodes of angina. The pump-function was preserved, BP low-normal, and rhythm was NSR on telemetry. For pulmonary issues, the patient had a chronic cough due to post nasal drip which was taken off of her antihistamine on admission and CXR was normal with no acute changes. There were no renal issues during the hospital course and the patient was on Lantus, Novolog SS, and FS Glu monitored while in the hospital. Heme-wise, the patient had a cath and subsequent oozing from the site in the groin and was discharged on home meds including Plavix and ASA. Medications prescribed include ENTERIC COATED ASA 325 MG PO DAILY, TESSALON PERLES ( BENZONATATE ) 100 MG PO TID, PLAVIX ( CLOPIDOGREL ) 75 MG PO DAILY, CODEINE PHOSPHATE 15 MG PO Q3H PRN Pain, DEXTROMETHORPHAN HBR 10 MG PO Q6H PRN Other:cough, ZETIA ( EZETIMIBE ) 10 MG PO DAILY, LANTUS ( INSULIN GLARGINE ) 20 UNITS SC BEDTIME, POTASSIUM CHLORIDE IMMED. REL. ( KCL IMMEDIATE... ) 1.Only KCL Immediate Release products may be used for KCL, 4.As per SMH Potassium Chloride Policy: each 20 mEq dose, on order for DIOVAN PO ( ref # 032637277 ), VALSARTAN Reason for override: aware, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach, MAGNESIUM GLUCONATE Sliding Scale PO ( orally ) DAILY: -> Mg-scales cannot be used and magnesium doses must be, If Mg level is less than 1 , then give 3 gm Mg Gluconate, NITROGLYCERIN 1/150 ( 0.4 MG ) 1 TAB SL q5min x 3, OXYCODONE 5-10 MG PO Q6H PRN Pain, PINDOLOL 5 MG PO BID HOLD IF: sbp<90 , HR<50, ZOCOR ( SIMVASTATIN ) 80 MG PO BEDTIME, DIOVAN ( VALSARTAN ) 160 MG PO DAILY, Lantus 40u qd Estradiol 0.05, Diltiazem 180 mg qd HCTZ 25 mg qd, Zetia 10mg qd, Plavix 75 mg qd, Zocor 80 mg qd, ASA 325 mg qd, Famotidine 20 mg BID, Lovenox 40 sc qd, nicotine patch MgSO4 qd, Novolog SS Pt as outpt and heparin and Integrelin have been discontinued, insulin, and was stable post cath, with anticoagulation stopped. The patient was prescribed ENTERIC COATED ASA 325 MG PO DAILY, TESSALON PERLES ( BENZONATATE ) 100 MG PO TID, PLAVIX ( CLOPIDOGREL ) 75 MG PO DAILY, CODEINE PHOSPHATE 15 MG PO Q3H PRN Pain, DEXTROMETHORPHAN HBR 10 MG PO Q6H PRN Other:cough, ZETIA ( EZETIMIBE ) 10 MG PO DAILY, LANTUS ( INSULIN GLARGINE ) 20 UNITS SC BEDTIME, POTASSIUM CHLORIDE IMMED. REL. ( KCL IMMEDIATE... ), 1.Only KCL Immediate Release products may be used for KCL, 4.As per SMH Potassium Chloride Policy: each 20 mE	has the patient had dextromethorphan hbr	{ "answer_end": [ 1573 ], "answer_start": [ 1523 ], "text": [ "DEXTROMETHORPHAN HBR 10 MG PO Q6H PRN Other:cough," ] }
Everett LLOPIS was a 63-year-old male admitted on 1/6/2001 with a history of CAD, MI, s/p CABGx4, h/o PE, h/o CVA on coumadin, NIDDM and h/o recent pneumonia (6/14) who presented with intermittent epigastric pain associated with nausea, diaphoresis and SOB x 2 days which he noted as his anginal equivalent. Labs were notable for Na 133 and Cr 1.7, negative tropnin (0.00) and CK 53, LFTs normal. RUQ ultrasound was notable for normal gall bladder with a fatty liver and gallstones and no sonographic Murphy's. ECG showed NSR at 80 with flat T in I and flipped T waves in 2, 3 (all old) and new T wave inversions V5/V6. V/Q scan was intermediate probability likely secondary to recent pneumonia, but d-dimer 800. Pt had +LENI's. He was put on a House/ADA 2100 cals/dy diet and was to return to work immediately. Follow-up appointments were scheduled with Dr. Shad Palovick in one week and Dr. Emmitt Quire on 0/1/01. The patient was allergic to Procardia (Nifedipine (Immed. Release)), Isordil, and Benadryl (Diphenhydramine Hcl). Dr. Yuenger was consulted and recommended starting the patient on reduced dose Lovenox (50mg sc bid x 2 wk and 40mg sc x 3 mo). Checked heparin level (0.9) so reduced dose of Lovenox to Lovenox 40mg sc bid. LENIS to be repeated in 3 months prior to d/c Lovenox. He was discharged on ASA (Acetylsalicylic Acid) 81 mg PO QD, Gemfibrozil 600 mg PO BID, Zocor (Simvastatin) 20 mg PO QHS, Avandia (Rosiglitazone) 4 mg PO BID, Ocuflox (Ofloxacin 0.3% Oph Solution) 1 drop OS QID, Atenolol 50 mg PO QD, Prilosec (Omeprazole) 20 mg PO QD, Glucophage (Metformin) 1,000 mg PO BID, Altace (Ramipril) 2.5 mg PO QD, Maalox Plus Extra Strength 15 ML PO Q6H PRN Indigestion, and Lovenox (Enoxaparin) 40 mg SC Q12H x 14 Days with food/drug interaction instruction and potentially serious interaction: Potassium Chloride & Ramipril Reason for override: aware. He was discharged in stable condition and will follow-up with Dr. Chadwick Lafone and his primary care doctor with instructions to continue home meds, VNA for assistance with Lovenox and meds, take Lovenox as directed, follow-up LENIS in 3 months before d/c Lovenox, and follow-up with Dr. Dean Cooke AND pcp.	has there been a prior zocor	{ "answer_end": [ 1414 ], "answer_start": [ 1381 ], "text": [ "Zocor (Simvastatin) 20 mg PO QHS," ] }
This is a 46-year-old morbidly obese female with a history of insulin-dependent diabetes mellitus complicated by BKA on two prior occasions, who was admitted to the MICU with BKA, urosepsis, and a non-Q-wave MI. On presentation to the Emergency Department, her vital signs were notable for a blood pressure of 189/92, pulse rate of 120, respiratory rate of 20, and an O2 sat of 90%. She was given insulin, sublingual nitroglycerin x three, 4 mg of morphine, 5 mg of Lopressor, and started on a heparin drip and IV antibiotics, and admitted to the MICU for further management. Her past medical history included insulin-dependent diabetes mellitus for how many years, positive ethanol use, approximately one drink per week, and denied IV drug use or other illicit drug use. She was placed on an insulin drip and hydrated with intravenous fluids, with improvement, and eventually transitioned to NPH with insulin sliding scale coverage. Despite escalating her dose of NPH up to 65 U subcu b.i.d. on the day of discharge, she continued to have elevated blood sugars >200 and required coverage with insulin sliding scale. This issue will need to be addressed as an outpatient. She was also placed on cefotaxime for gram negative coverage, with both her blood cultures and urine cultures growing out E. coli which were sensitive to cefotaxime and gentamycin. As she initially continued to be febrile and continued to have positive blood cultures, one dose of gentamycin was given for synergy, and she was eventually transitioned to p.o. levofloxacin and will take 7 days of p.o. levofloxacin to complete a total 14-day course of antibiotics for urosepsis. She was initially placed on aspirin, heparin, and a beta blocker, and once her creatinine normalized, an ACE inhibitor was also added. Heparin was discontinued once the concern for PE was alleviated, and her beta blocker and ACE inhibitor were titrated up for a goal systolic blood pressure of <140 and a pulse of <70. On admission, the patient was on several pain medicines, including amitriptyline, Flexeril, and Valium for reported history of sciatica and low back pain, which were discontinued and she was placed on Neurontin for likely diabetic neuropathy. She was also placed on GI prophylaxis with Carafate and treated symptomatically with Imodium p.r.n. diarrhea. The patient was discharged with enteric coated aspirin 325 mg p.o. q.d., NPH Humulin insulin 65 U subcu b.i.d., human insulin sliding scale: for blood sugars 151-200 give 4 U, for blood sugars 201-250 give 6 U, for blood sugars 251-300 give 8 U, for blood sugars 301-350 give 10 U, Imodium 2 mg p.o. q. 6 hrs. p.r.n. diarrhea, Niferex 150 mg p.o. b.i.d., nitroglycerin 1/150 one tab sublingual q. 5 min. x 3 p.r.n. chest pain, multivitamin one tab p.o. q.d., simvastatin 10 mg p.o. q.h.s., Neurontin 600 mg p.o. t.i.d., levofloxacin 500 mg p.o. q.d. x 5 days, Toprol XL 400 mg p.o. q.d., lisinopril 40 mg p.o. q.d. The patient was evaluated by the physical therapist, who noted her to walk around the hospital without significant difficulty.	Has the pt. ever been on nitroglycerin 1/150 before	{ "answer_end": [ 2676 ], "answer_start": [ 2649 ], "text": [ "Niferex 150 mg p.o. b.i.d.," ] }
This is a 70-year-old woman with ischemic cardiomyopathy, coronary artery disease status post MI, insulin-dependent diabetes, peripheral vascular disease, and chronic renal insufficiency who presented in volume overload after a previous admission. She had been diuresed with a Lasix drip at 10 mg per hour and Zaroxolyn at 2.5 mg p.o. daily, and her Lopressor was held for a decompensated heart failure. She was then started on amiodarone and Coumadin for a new paroxysmal atrial fibrillation. Her Lasix drip was increased to 20 mg per hour and the Zaroxolyn was increased to b.i.d. After transition from Zaroxolyn to Diuril, which was given 250 mg IV b.i.d., she was prescribed Ativan 0.5 mg p.o. t.i.d. p.r.n. anxiety, Folate 1 mg p.o. daily, Lipitor 80 mg p.o. at bedtime, Lantus 18 units subcutaneously nightly, Lopressor 25 mg p.o. b.i.d., Procrit 40,000 units subcutaneously every other week, Nitroglycerin sublingual p.r.n. chest pain, Aspirin 81 mg p.o. daily, Vitamin B12 subcutaneous injections at clinic, Iron 325 mg p.o. t.i.d., Metolazone p.r.n., Multivitamin one tablet p.o. daily, Torsemide 100 mg q.a.m. and 50 mg q.p.m., Coumadin 1 mg q.p.m., and Amiodarone 200 mg p.o. daily. Despite the dose of Coumadin being decreased from her home dose of 1 mg q.p.m. to a 0.5 mg q.p.m., her INR continued to rise greater than 200. She was started on q.a.c. NovoLog regimen with her Lantus insulin dose decreased from 18 units to 16 units and the NovoLog sliding scale was started. She was monitored on telemetry with no other events and required repletion of both potassium and magnesium despite her renal insufficiency throughout the admission in the setting of injected insulin in the setting of worsening renal failure, so, studies were also normal. She was continued on Aranesp through the admission and was discharged home on a similar regimen to her home regimen simply to Torsemide after the last discharge as her outpatient p.o. Torsemide regimen of 100 mg p.o. q.a.m. and 50 mg q.p.m., Lantus 12 units subcutaneously nightly, Ativan 0.5 mg p.o. t.i.d., Folate 1 mg p.o. daily, Lipitor 80 mg p.o. at bedtime, Multivitamin one tablet p.o. daily, Coumadin 1 mg q.p.m., Metolazone 2.5 mg p.o. daily as needed for fluid retention, Iron 325 mg p.o. t.i.d., and Aspirin 81 mg p.o. daily. She was maintained on a cardiac diet and prophylaxis with Coumadin and Nexium. Potassium and magnesium were repleted as needed and she was maintained on aspirin and Lipitor throughout the admission. She will follow up with her primary care provider, SRRH Cardiology Clinic, and Renal Clinic.	What medicines have previously been tried for prophylaxis	{ "answer_end": [ 2374 ], "answer_start": [ 2320 ], "text": [ "cardiac diet and prophylaxis with Coumadin and Nexium." ] }
Patient, a 37 year old male with multiple admissions for atypical chest pain, morbid obesity, restrictive lung disease by PFTs, sleep apnea, and borderline hypertension, came in complaining of SOB and "asthma attack" and anxiety. He responded well to Nebs and Ativan in the ED and was discharged with ECASA (Aspirin Enteric Coated) 325 MG PO QD, Atenolol 50 MG PO QD with Food/Drug Interaction Instruction to take consistently with meals or on empty stomach, Klonopin (Clonazepam) 1 MG PO TID, Colace (Docusate Sodium) 100 MG PO BID, Prozac (Fluoxetine HCL) 20 MG PO QD, Zestril (Lisinopril) 10 MG PO QD, Niferex-150 150 MG PO BID, Percocet 1 TAB PO Q6H X 7 Days Starting Today (6/1) PRN pain, Azithromycin 250 MG PO QD X 4 Days Starting IN AM (6/1) with Food/Drug Interaction Instruction to take with food, Prednisone Taper PO (60 mg QD X 2 day(s) (0/22/01-09), then 50 mg QD X 2 day(s) (2/26/01-09), then 40 mg QD X 2 day(s) (9/28/01-09), then 30 mg QD X 2 day(s) (4/0/01-09), then 20 mg QD X 2 day(s) (8/26/01-09), then 10 mg QD X 2 day(s) (2/20/01-10), then 5 mg QD X 2 day(s) (3/6/01-10)), on order for Azithromycin PO (ref # 63922816) with Potentially Serious Interaction: Clonazepam & Azithromycin, Prilosec (Omeprazole) 20 MG PO QD, Albuterol Inhaler 2 Puff Inh QID, Atrovent Inhaler (Ipratropium Inhaler) 2 Puff Inh QID, and was instructed to return to work after an appointment with a local physician. He was discharged with a diagnosis of sob of unknown etiology, and other diagnoses included borderline HTN, anxiety disorder, PPD, and morbid obesity.	What is the current dose of klonopin ( clonazepam )	{ "answer_end": [ 493 ], "answer_start": [ 459 ], "text": [ "Klonopin (Clonazepam) 1 MG PO TID," ] }
The patient is a 37-year-old gentleman with known coronary artery disease who underwent coronary artery bypass grafting times three with bilateral internal mammary arteries and a saphenous vein graft. The patient was found to have extremely pronounced atherosclerosis of his coronary arteries and had an entirely smooth postoperative course. He was maintained on low molecular weight Dextran for 48 hours for his endarterectomy and was started on enteric coated aspirin on the first day of his operation. The patient diuresed very well and was started on beta blockers. On discharge, the patient's medications included Tenormin, 75 mg po q day; enteric coated aspirin, one po q day; Carafate, 1 gram po q.i.d.; iron sulfate, 325 mg po q day; Percocet and Colace.	Previous percocet	{ "answer_end": [ 762 ], "answer_start": [ 711 ], "text": [ "iron sulfate, 325 mg po q day; Percocet and Colace." ] }
Mr. Zack Nieman is a 62-year-old white man with ischemic cardiomyopathy, status post coronary artery bypass graft in 1985 with left internal mammary artery to left anterior descending, saphenous vein graft to posterior descending artery, saphenous vein graft to obtuse marginal branch, and a repeat coronary artery bypass graft done in 1995 with saphenous vein graft to first diagonal, saphenous vein graft to obtuse marginal, and saphenous vein graft to posterior descending artery. He had multiple episodes of pulmonary congestion and was admitted to Rorea Valley Health for IV diuresis. EKG revealed atrial flutter with variable block (2:1 versus 3:1), rate around 120, left bundle branche block, and echocardiogram revealed ejection fraction about 25% with 2+ mitral regurgitation. On admission, his temperature was 97.1, pulse 103, blood pressure 148/94, respirations 18, and O2 saturation 97% on two liters. Because of his rapid ventricular response, Digoxin was started with a loading dose of 0.5 mg, then 0.25 mg times two q. six hours, and the patient was then on a maintenance dose of Digoxin at 0.125 mg p.o. q. day, and his Digoxin level has been maintained around 0.9. For his rate control, the amiodarone was also increased to 400 mg q. day, and the patient was started on anticoagulation with heparin. The patient underwent cardioversion through his AICD by the Electrophysiological Service with successful conversion to normal sinus rhythm, and was loaded with Coumadin and meanwhile on heparin until INR between 2-3. The patient developed hyperthyroidism secondary to amiodarone, treated with PTU, then developed hypothyroidism, treated with Levothyroxine. He was discharged on Amiodarone 400 mg p.o. q.d., Captopril 25 mg p.o. t.i.d., clonazepam 1 mg p.o., Lasix 80 mg p.o. b.i.d., glipizide 5 mg p.o. q.d., levothyroxine sodium 100 mcg p.o. q.d., magnesium oxide 420 mg p.o. q.d., Lopressor 25 mg p.o. b.i.d., nitroglycerin 1/150 (0.4 mg) one tab sublingual q. five minutes times three, Coumadin 5 mg p.o. q. day until INR between 2-3 then the dose needs to be adjusted accordingly to maintain INR between 2-3, Simvastatin 20 mg p.o. q. h.s., Klonopin 0.5 mg p.o. q. a.m., Digoxin 0.125 mg p.o. q.d., isosorbide, mononitrate-SR 30 mg p.o. q.d., and troglipazone 400 mg p.o. q. day.	has there been a prior simvastatin	{ "answer_end": [ 2161 ], "answer_start": [ 2089 ], "text": [ "accordingly to maintain INR between 2-3, Simvastatin 20 mg p.o. q. h.s.," ] }
Justin Eans, a 56 year old patient with a history of DM, HTN, hypertryglyceridemia and depression, was admitted to the medical service on 11/4/2004 with 2-day h/o increasing abdominal girth, 1-day h/o shortness of breath, pleuritic CP and an increase in nocturia from 2x to 6x. He was given i.v. Lasix for presumed CHF, and his discharge medications included Tylenol (Acetaminophen) 500 mg PO Q6H PRN Pain, Headache, Atenolol 100 mg PO QD, Calcium Citrate 950 mg PO BID, Colace (Docusate Sodium) 100 mg PO BID, Gemfibrozil 600 mg PO BID, Hydrochlorothiazide 25 mg PO QD, NPH Insulin Human (Insulin NPH Human) 15 UNITS SC At 10 p.m. (bedtime), Lisinopril 40 mg PO QD, Niferex-150 150 mg PO BID, Simethicone 80 mg PO QID PRN Upset Stomach, Vitamin E (Tocopherol-DL-Alpha) 1,200 UNITS PO QD, Vitamin B Complex 1 TAB PO QD, Triamcinolone Acetonide 0.5% (Triamcinolone A...) TOPICAL TP QID, Levofloxacin 500 mg PO QD, Miconazole Nitrate 2% Powder Topical TP BID, Maalox-Tablets Quick Dissolve/Chewable 1-2 TAB PO Q6H PRN Upset Stomach, Metformin XR (Metformin Extended Release) 2,000 mg PO QD, Insulin Regular Human Sliding Scale (subcutaneously) SC AC, and Potassium Chloride Immed. Rel. PO (ref #93677429) with the instruction to separate doses by 2 hours. Overrides were added on 0/28/04 and 3/3/04 by WILBY, BRYANT BRYON, M.D., WASHMUTH, SCOTTIE CLEO, M.D., and BEILER, TOMMY L. respectively. Additionally, the patient was instructed to administer iron products a minimum of 2 hours before or after a levofloxacin or ciprofloxacin dose dose and if on tube feeds, to cycle (hold 1 hr before to 2 hr after) and take 2 hours before or 2 hours after dairy products, with a 14-day course of Levofloxacin and to take ASA/NSAIDs for 6 - 8 weeks. He was discharged in satisfactory condition and was instructed to follow up with Endocrine and PCP re diabetes and lipid management, follow up with PCP for management of chronic medical problems, including GERD, gastric erosions, hypertension, and obstructive sleep apnea, and follow up with an outpatient psychiatrist regarding reinitiation of medications.	Has a patient had tylenol (acetaminophen)	{ "answer_end": [ 416 ], "answer_start": [ 359 ], "text": [ "Tylenol (Acetaminophen) 500 mg PO Q6H PRN Pain, Headache," ] }
Patient DOUGLASS W. DILEO was admitted to CAR with unstable angina and discharged on 11/23/04 with a code status of full code and disposition of home w/ services. The patient has a possible allergy to NSAIDs with reaction unknown and a probable allergy to SIMVASTATIN, NSAIDs, SHELLFISH, and Codeine. The patient was given atropine and Fem stop placed over cath due to femoral hematoma. CT ruled out retroperitoneal bleed and her HCT dropped from 32 to 26, and she was transfused 2 U PRBC. The anti-ischemic regimen at discharge included ENTERIC COATED ASA (ASPIRIN ENTERIC COATED) PO 325 MG QD (ref #57541802), INSULIN NPH HUMAN 36 UNITS QAM; 40 UNITS QPM SC, NEURONTIN (GABAPENTIN) 600 MG PO BID, PLAVIX (CLOPIDOGREL) 75 MG PO QD, ZETIA (EZETIMIBE) 10 MG PO QD, LISINOPRIL 40 MG PO QD, HYDROCHLOROTHIAZIDE 25 MG PO QD, PREVACID (LANSOPRAZOLE) 30 MG PO QD, GLUCOPHAGE (METFORMIN) 1,000 MG PO BID, and ATENOLOL 25 MG PO QD, with no statin due to muscle pain history. The patient was instructed to take 1/2 their regular home dose of Atenolol until they see their cardiologist/PCP, and to follow a diet of house/low chol/low sat. fat and house/ADA 2100 cals/dy. Patient was to follow up with Dr. Brechbiel in 2 weeks and Dr. Damms for right leg ultrasound in 2-4 weeks. The patient also had a below-the knee right tibial vein DVT, was not anticoagulated for this below-the knee clot because of low risk of embolization and her recent HCT drop/hematoma. The patient was also given IBUPROFEN 600-800 MG PO Q6H PRN Pain for left knee pain after a fall one week prior. The patient was instructed to continue home diabetic regimen and followup with PCP/cardiology and schedule a repeat right leg ultrasound test (“LENI”) to follow the small blood clot in her leg in the future.	Was the patient ever prescribed statin	{ "answer_end": [ 966 ], "answer_start": [ 924 ], "text": [ "with no statin due to muscle pain history." ] }
Mr. Wizar is a 51-year-old man who was admitted for repair of left pseudoaneurysm in his groin and was given wet-to-dry dressing changes t.i.d. On 6/3/2003, he was taken to the operating room for left groin closure with flap by Plastic Surgery and Vascular Surgery. He was injected with heparin solution and received serial needle pricks, which improved the appearance of the flap. He was given vancomycin, levofloxacin, and Flagyl for empiric treatment for C. diff, with C. diff cultures being negative on 0/7/2003 and drain cultures showing rare Staphylococcus aureus on 10/6/2003. His Zestril was held secondary to an elevation in creatinine, which gradually resolved. He was also seen by Cardiology and Nutrition and was given supplements, vitamin C, and Zinc for wound healing, with the flap being stable, pink, and viable at the time of discharge. His discharge medications included Aspirin 325 mg once a day; digoxin 0.125 once a day; Ultralente 16 units q.a.m. , 4 units q.p.m.; Zocor 10 mg once a day; Toprol 25 mg once a day; Imdur 30 mg once a day; torsemide 100 mg once a day; lisinopril 2.5 mg once a day; colace; and Percocet.	Has the patient had multiple aspirin prescriptions	{ "answer_end": [ 915 ], "answer_start": [ 854 ], "text": [ "His discharge medications included Aspirin 325 mg once a day;" ] }
This 66 year old African American woman presented with an acute stroke and was brought in by her daughter. She had a CTA done which showed questionable luminal narrowing of the distal left middle cerebral artery, and was given a 9 mg bolus dose of intravenous TPA over two minutes and 81 mg given over the following hour. Her past medical history includes diet controlled diabetes, obesity, hypertension, ulcerative colitis, a prior MI in 1988, and a possible old stroke. Her medications are aspirin 325 mg and Asacol, although she was unsure of the dose. Blood pressure was 138/76, heart rate was 80 and paced, and she had a right field compromise difficulty crossing the midline with a right upper motor neuron seventh weakness and decreased power on the right side of the face. After the TPA, her language returned completely to normal. Protocol for the stroke was followed, including blood pressure monitoring, nasal oxygen, and no antiplatelet therapy for 24 hours. Head of bed was raised to 30 degrees and a head CT was repeated the following morning. An echocardiogram showed normal ventricular size and systolic function, trace aortic insufficiency, trace mitral regurgitation, and persistent atrial flutter. She was coumadinized and discharged without rehabilitation on 0/21/99 on Coumadin with a plan for complete cardioversion within one month.	has there been a prior coumadin	{ "answer_end": [ 1275 ], "answer_start": [ 1217 ], "text": [ "She was coumadinized and discharged without rehabilitation" ] }
A 60 year old Spanish speaking woman with multiple cardiac risk factors and a two to three year history of exertional angina presented complaining of unstable chest pain. Dr. Maximo Bryum in C&O MEDICAL CENTER Clinic initiated an antianginal regimen, however the patient recently stopped taking Aspirin and her symptoms then recurred. The patient was given three sublingual Nitroglycerins after her primary M.D. was called and her pain resolved after approximately 15 minutes. On the 27 of January, 1995, the patient underwent a Dobutamine MIBBE on which she went 6 minutes and 48 seconds reaching a maximal heart rate of 154, a blood pressure of 172/82, with 2 mm ST depressions diffusely and moderate to severe reversible anterior and anteroseptal wall ischemia. Medications on admission included Atenolol 50 mg p.o. q.d., Axid 150 mg p.o. b.i.d., Enteric Coated Aspirin 325 mg p.o. q.d., Coumadin 10 mg p.o. q.h.s., Diltiazem 240 mg p.o. q.d., Lisinopril 10 mg p.o. q.d., Lopipd 600 mg p.o. q.d., Lasix 40 mg p.o. q.d., Insulin NPH 75 units sub-q q.a.m., 50 units q.p.m., Insulin Regular 25 units sub-q q.a.m., Nitroglycerin 1/150th one tablet sublingual q. 5 minutes x 3 p.r.n. chest pain, and Omeprazole 20 mg p.o. q.d. The Cardiology Team was consulted and serial CK, MB and EKG's were done, with Heparin initially started given the possibility that this was unstable angina. The patient's Insulin dosages were adjusted in the manner to keep her blood sugars in the approximately 200 range and she was discharged with medications including Enteric Coated Aspirin 325 mg p.o. q.d., Lasix 40 mg p.o. q.d., Lopid 600 mg p.o. q.d., Insulin NPH 100 units sub-q q.a.m., 70 units sub-q q.h.s., Insulin Regular 25 units sub-q q.a.m., Lisinopril 10 mg p.o. q.d., Nitroglycerin 1/150th one tablet sublingual q. 5 minutes x 3 p.r.n. chest pain, Omeprazole 20 mg p.o. q.d., Coumadin 10 mg p.o. q.h.s., Diltiazem CD 240 mg p.o. q.d., with follow-up care with her primary M.D., Dr. Jarvis Needy in the RINGBURG RITA'S PROPRES MEMORIAL HOSPITAL Clinic.	Is there a mention of of coumadin usage/prescription in the record	{ "answer_end": [ 918 ], "answer_start": [ 891 ], "text": [ "Coumadin 10 mg p.o. q.h.s.," ] }
A 45-year-old female with a history of IDDM, sleep apnea, asthma on chronic prednisone, HTN, and CAD s/p NSTEMI in 6/10 with a stent to the LAD presented with 3 days of worsening dyspnea and chest pressure. She was treated for an asthma exacerbation with Prednisone 40 mg PO QAM x 10 doses, Instructions: Taper: 40mg for 2 days, then 35mg for 2days, then 30mg for 2days, then 25mg for 2days, then 20mg, ECASA (ASPIRIN ENTERIC COATED) 325 mg PO QD, CARDIZEM SR (DILTIAZEM SUSTAINED RELEASE) 120 mg PO QD, Override Notice: Override added on 0/9/05 by DUHART, RANDY M., M.D. on order for LOPRESSOR PO (ref #31219927), POTENTIALLY SERIOUS INTERACTION: DILTIAZEM HCL & METOPROLOL TARTRATE Reason for override: aware, HYDROCHLOROTHIAZIDE 25 MG PO QD, LISINOPRIL 30 MG PO QD, on order for POTASSIUM CHLORIDE IMMED. REL. PO (ref #73021085), POTENTIALLY SERIOUS INTERACTION: LISINOPRIL & POTASSIUM CHLORIDE Reason for override: aware, LORAZEPAM 0.5 MG PO BID PRN Anxiety, LOPRESSOR (METOPROLOL TARTRATE) 12.5 MG PO BID, on order for CARDIZEM SR PO (ref #76249027), on order for CARDIZEM PO (ref #49626929), COMBIVENT (IPRATROPIUM AND ALBUTEROL SULFATE) 2 PUFF INH QID, ADVAIR DISKUS 500/50 (FLUTICASONE PROPIONATE/...), ATOVAQUONE 750 mg PO BID, NAPROSYN (NAPROXEN) 250-500 mg PO BID PRN Pain, CALCIUM CARB + D (600MG ELEM CA + VIT D/200 IU), ZOLOFT 1 TAB PO QD, Alert overridden: Override added on 4/2/05 by : POTENTIALLY SERIOUS INTERACTION: CLOPIDOGREL BISULFATE & NAPROXEN Reason for override: musculoskeletal pain, diabetes mellitus 2/2 chronic steroid use, Ischemia: continue Zocor, Clopidogrel, ECASA, nitrates as needed., Pump: continue lisinopril, HCTZ, Cardizem, Lopressor 12.5 mg PO BID, presentation. Never hospitalized, chronic prednisone therapy, s/p gentle diuresis, Pred, nebs with improvement of symptoms, D-dimer < 200, admission peak flow 150 (baseline NL 300-350), at discharge 275-300, ambulatory O2 sat WNL., Musculoskeletal workup showed reproducible sternal pain on palpation consistent with costochondritis and Naprosyn PRN pain, Psych: Continue Zoloft for depression and Lorazepam for anxiety, PPx was managed with PPI., Discharge condition was stable. Plan was to assess efficacy of Prednisone 20 mg upon completion of taper, status of dyspnea/asthma symptoms on low dose beta-blocker, chest pain/costochondritis with PRN NSAIDs, and ENDO: Chronic steroid use, Insulin SS in-house. -calcium/vit D supplement, with food/drug interaction instruction to give with meals and take with food, to resume regular exercise, and follow up appointments with Dr. BALVANZ, PCP in 2 weeks and ENDO indefinitely.	Has this patient ever been on zoloft	{ "answer_end": [ 2110 ], "answer_start": [ 2046 ], "text": [ "Psych: Continue Zoloft for depression and Lorazepam for anxiety," ] }
An 81-year-old woman with Atrial Fibrillation (AF) on Fondaparinux, no Coumadin secondary to prior epistaxis, Non-small Cell Lung Cancer (NSC Lung Ca), and Pernicious Anemia (Pernicious Anemia) presents with three days of constant chest pain, pleuritic, not exertional, and mostly related to arm movement. Treatment included ACEBUTOLOL HCL 400 MG PO DAILY Starting IN AM ( 8/10 ), ALLOPURINOL 100 MG PO DAILY, VITAMIN C (ASCORBIC ACID) 500 MG PO BID, CALCIUM CARBONATE (500 MG ELEMENTAL CA++) 500 MG PO BID, CIPROFLOXACIN 250 MG PO Q12H X 4 doses (Administer iron products a minimum of 2 hours before or after a Levofloxacin or Ciprofloxacin dose dose), DIGOXIN 0.125 MG PO DAILY, COLACE (DOCUSATE SODIUM) 100 MG PO BID, LOVENOX (ENOXAPARIN) 120 MG SC BEDTIME, TARCEVA (ERLOTINIB) 100 mg PO DAILY, FOLIC ACID 1 MG PO DAILY, FUROSEMIDE 40 MG PO DAILY Starting IN AM ( 4/9 ), DILAUDID (HYDROMORPHONE HCL) 0.5 MG PO Q4H PRN Pain (on order for DILAUDID PO, ref# 925975305, POTENTIALLY SERIOUS INTERACTION: TRAMADOL HCL & HYDROMORPHONE HCL, Reason for override: aware), LIDODERM 5% PATCH (LIDOCAINE 5% PATCH) 1 EA TP DAILY, PRAVACHOL (PRAVASTATIN) 20 MG PO BEDTIME, VITAMIN B6 (PYRIDOXINE HCL) 50 MG PO DAILY, ULTRAM (TRAMADOL) 50 MG PO Q6H PRN Pain (on order for ULTRAM PO, ref# 417339527, POTENTIALLY SERIOUS INTERACTION: MORPHINE & TRAMADOL HCL). CT-PE showed no evidence of PE or Deep Venous Thrombosis (DVT) and post Right Lower Lobe Resection changes, with interval resolution of Left Upper Lobe Nodule without new nodules, and possible chronic subsegmental PE. CXR showed no acute process. Factor Xa level was checked to insure Lovenox dosing was therapeutic. Discharge plan included mammogram next week for evaluation, continue pain control with Lidoderm patch, Ultram and low dose Dilaudid as needed for severe pain, continue Tarceva as per outpatient oncologist, continue Lovenox as outpt, continue Lasix at 40mg daily, complete course of Cipro 250mg BID x 3 days, follow up with cardiologist for continued management of heart conditions, and follow up with rehabilitation specialists to try to regain strength and function. Discharge condition was stable.	Is there history of use of furosemide	{ "answer_end": [ 873 ], "answer_start": [ 824 ], "text": [ "FUROSEMIDE 40 MG PO DAILY Starting IN AM ( 4/9 )," ] }
The patient is an 83-year-old man with a history of CAD, s/p MI in 1973, s/p CABG x3, T2DM, and hypertension who was admitted with chest pressure and feeling numb in his arms and legs and around his head. He took some SL nitro but does not remember if it helped and denies shortness of breath. His EKG was A-paced and unchanged from March, his CXR had no acute process, and his cardiac enzymes were negative. His stress test from March 2005 revealed a small to medium sized region of myocardial scar/hibernation in the distribution of the PDA coronary artery and no evidence of stress induced ischemia at a low cardiac workload. He went into V-paced rhythm when given dobutamine and the test was submaximal with max HR 98 (77% predicted). No reversible ischemia was seen. He was continued on B-blocker, statin, and persantine, with no aspirin since history of GIB with it, and monitored on telemetry without any events. He also had an adenosine MIBI on 2/8/05 with results as above. Held oral hypoglycemic while in house. Covered with SSI regular qac. His PM was evaluated by EP to r/o pAF and EP interrogation revealed no mode shifts. He was weaned O2 to sat>93%, his creatinine remained at baseline, he avoided aspirin and was continued on PPI, was covered with SSI regular qac, and was given a PT consult. He was discharged with a full code status, home with services, and on a House/Low chol/low sat. fat and House/ADA 1800 cals/dy diet, and instructed to take medication consistently with meals or on an empty stomach, and to avoid grapefruit unless instructed otherwise and to walk as tolerated. Follow up appointments were scheduled with Dr. Widowski March at 3:30 PM and Dr. Caris 11/10/06. Allergies included Penicillins, Aspirin, DILTIAZEM, and ATORVASTATIN. The discharge medications included TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Headache, PERSANTINE (DIPYRIDAMOLE) 50 MG PO BID, LASIX (FUROSEMIDE) 10 MG PO QD, ATIVAN (LORAZEPAM) 3.5 MG PO QHS, NTG 1/150 (NITROGLYCERIN 1/150 (0.4 MG)), NITROGLYCERIN PASTE 2% 1 INCHES TP BID, INDERAL (PROPRANOLOL HCL) 10 MG PO QID, SUCRALFATE 1 GM PO QID Food/Drug Interaction Instruction, PAXIL (PAROXETINE) 10 MG PO QD, NORVASC (AMLODIPINE) 2.5 MG PO QD, on order for NORVASC PO 5 MG QD (ref #913242331), IMDUR ER (ISOSORBIDE MONONITRATE (SR)) 30 MG PO BID, COZAAR (LOSARTAN) 50 MG PO QD, PROTONIX (PANTOPRAZOLE) 40 MG PO QD, GLYBURIDE 2.5 MG PO QD, ZETIA (EZETIMIBE) 10 MG PO QD, ATIVAN (LORAZEPAM) 2 MG PO QID PRN Anxiety, Lescol 20 mg po qd, and 1 TAB SL Q5MIN X 3 doses PRN Chest Pain. Number of Doses Required (approximate): 3. He was also given instructions to take medication consistently with meals or on an empty stomach, and to avoid grapefruit unless instructed otherwise and to walk as tolerated. Follow up appointments were scheduled with Dr. Widowski March at 3:30 PM and Dr. Caris 11/10/06. Allergies included Penicillins, Aspirin, DILTIAZEM, and ATORVASTATIN. The discharge medications included TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Headache, PERSANTINE (DIPYRIDAMOLE) 50 MG PO BID, LASIX (FUROSEMIDE) 10 MG PO QD, ATIVAN (LORAZEPAM) 3.5 MG PO QHS, NTG 1/150 (NITROGLYCERIN 1/150 (0.4 MG)), NITROGLYCERIN	What is the current dose of norvasc	{ "answer_end": [ 2258 ], "answer_start": [ 2209 ], "text": [ "on order for NORVASC PO 5 MG QD (ref #913242331)," ] }
Ms. Dozois is a 64-year-old female admitted to MICU on 2/19/2005 for neutropenia, nausea, vomiting, abdominal pain, and shortness of breath, requiring intubation and pressors. Her medical problems included severe COPD (on home O2 2 liters baseline sat below 90s), nonsmall cell lung cancer (diagnosed in 1999, status post multiple chemotherapy regimens, most recently ALIMTA from 1/29/2005 to 09), diabetes, obesity, and chronic renal insufficiency. Her MEDICATIONS ON ADMISSION included Avapro, Lipitor, Decadron, ranitidine, Humalog, allopurinol, Alimta, Flonase, Vitamin D, B12, and Colace. She was initially treated with vancomycin, Levaquin, and aztreonam along with Flagyl empirically, and later changed to Levaquin only on 10/25/2005 to treat an enterococcal UTI and possible nosocomial pneumonia. She had thrombocytopenia and required multiple red blood transfusions to maintain her hematocrit greater than 26, though she was never hemodynamically unstable. She also required multiple platelet transfusions to keep her platelets greater than 30,000. She responded well initially to three units of packed red blood cells over 7/28/2005 and 09. However, in the setting of her GI bleed from a sloughing mucosa secondary to resolving neutropenic enteritis and recent chemo, she required multiple further RBC transfusions to keep her hematocrit greater than 30. Hematology was consulted secondary to suboptimal busted platelet levels status post transfusions, which was felt to be secondary to poor marrow response in the setting of recent chemo (workup was negative for other possible causes refractory thrombocytopenia, nystatin, allopurinol, were held given possible worsening of her thrombocytopenia). Surgery was consulted and she was managed conservatively with antibiotics initially and then with bowel rest. TPN was started on 4/21/2005, given her bowel rest for a neutropenic enteritis. She was changed to standing insulin on 10/25/2005 and her Lantus was up titrated along with sliding scale insulin to maintain blood sugars in the 80s to 120s. She is no longer neutropenic and was off Neupogen for one week and will stay and finish the 14-day course of Levaquin for coverage. On discharge her hematocrit and platelets were stable respectively at 29.8 and 46,000 and she had not required a transfusion in greater than 24 hours prior to discharge. Her DISCHARGE MEDICATIONS included Tylenol 650 to 1000 mg PO q. 6h PRN pain, headache, if fever is greater than 101, Peridex mouth wash 10 mL twice a day, nystatin mouth wash 10 mL swish and swallow 4 x day as needed, oxycodone 5 mg PO q. 6h PRN pain, simethicone 80 mg PO q.i.d. PRN gaseousness, trazodone 25 mg PO at bedtime, miconazole nitrate 2% powder topical BID to areas between skin folds including under the right breast, Nexium 20 mg PO daily, Lantus 30 mg subcutaneous daily, DuoNeb 3/0.5 mg Nebs q. 3 h. PRN shortness of breath, aspart 4 units before each meal subcutaneously, folate 3 mg PO daily, Avapro 150 mg PO daily, meclizine 25 mg PO TID, Combivent 2 puffs inhaled q.i.d., Vitamin D 125 0.25 mcg PO daily. She will follow up with infectious disease and hematology for her neutropenia, which has since resolved, and will stay and finish the 14-day course of Levaquin for UTI coverage.	Why is the patient taking red blood transfusions	{ "answer_end": [ 965 ], "answer_start": [ 875 ], "text": [ "to maintain her hematocrit greater than 26, though she was never hemodynamically unstable." ] }
Mr. Esbenshade is a 70-year-old Caucasian male with CAD, stented five years ago, known as calcific aortic stenosis with progression of exertional dyspnea. He was admitted to CSS and stabilized for surgery on 9/13/06, which included AVR with a 25 CE magna valve, CABG x2 with LIMA to LAD and SVG1 to PDA, pulmonary vein isolation, and left atrial appendage resection, with no complications. He is currently on 5 liters of O2 and some pulmonary edema, improving with Lasix 20 mg IV t.i.d. and diuresis, on Osmolite tube feeds at 20 mL an hour, with prophylactic antibiotics for chest tubes, medications IV, Toprol 50 mg q.a.m. and 25 mg q.p.m., Coumadin, Lasix 20 mg daily, atorvastatin 20 mg daily, Neurontin 100 mg t.i.d., metformin 1000 mg b.i.d., and glipizide 2.5 mg b.i.d. Cardiac meds include Aspirin, Lopressor, and Coumadin. He has been followed by psych for postoperative confusion/possible suicidal ideation, with Celexa ordered per psych. He is also on Acetaminophen 325-650 mg q. 4h. p.r.n. pain or temperature greater than 101, DuoNeb q. 6h. p.r.n. wheezing, enteric-coated aspirin 81 mg daily, Dulcolax 10 mg PR daily p.r.n. constipation, Celexa 10 mg daily, Colace 100 mg t.i.d., Nexium 20 mg daily, K-Dur 10 mEq daily for five days, Toprol-XL 200 mg b.i.d., miconazole nitrate powder topical b.i.d., Niferex 150 mg b.i.d., simvastatin 40 mg at bedtime, multivitamin therapeutic one tab daily, INR, and Boudreaux's Butt Paste topical apply to effected areas. He has been running a bit fast in Afib and is on Coumadin and aspirin for atrial fibrillation, and is awaiting a rehabilitation bed. Cipro x3 days has been started due to a UA from 10/5/06 with probable enterogram-negative rods. His mood has improved and beta-blocker has been titrated. He has been advised to make all follow-up appointments, local wound care, wash wounds daily with soap and water, shower patient daily, keep legs elevated while sitting/in bed, watch all wounds for signs of infection, redness, swelling, fever, pain, discharge, and to call PCP/cardiologist or Anle Health Cardiac Surgery Service at 282-008-4347 with any questions.	Is there a mention of of celexa. usage/prescription in the record	{ "answer_end": [ 948 ], "answer_start": [ 899 ], "text": [ "suicidal ideation, with Celexa ordered per psych." ] }
This 66-year-old male with a history of CAD, MI, CABG, and PCI was admitted with chest pain and ongoing risk factors. His enzyme on presentation was negative and EKG showed nonspecific T wave flat in II, III and V2-V3. In the ED, he had a BP of 86/118 and was given NITROGLYCERIN 1/150 (0.4 mg) SL q5min x 3 with no relief; his CP was 10/10 and reduced to 4/10 with NITROGLYCERIN. Labs showed elevated BUN/Cr and mild-mod lateral wall ischemia. He was prescribed ASA 325 mg PO QD, AMIODARONE 200 mg PO BID, LOPRESSOR (METOPROLOL TARTRATE) 50 mg PO BID, ISOSORBIDE DINITRATE 30 mg PO TID (hold if sbp<100), IMDUR 60 mg PO BID, PLAVIX 75 mg PO QD, Protonix, KEFLEX (CEPHALEXIN) 500 mg PO QID, Lasix 60 mg PO BID, KCl 40 mg PO QD, Metformin 500 mg PO BID, Micronase 10 mg PO BID, Tylenol with Codeine PRN, and Ativan 5 mg PRN. He was also advised to follow-up with his PCP to discuss starting Coumadin therapy given his history of atrial fibrillation, and was instructed to take PPI for GERD and a PPI and SC Hep for ppx. He was discharged with stable condition, and lab results showed normal WBC and no signs of acute infection. The patient was also advised to continue taking POTASSIUM CHLORIDE & RAMIPRIL, ALTACE (RAMIPRIL) 1.25 mg PO QD, NEXIUM (ESOMEPRAZOLE) 20 mg PO QD, DIET: House/Low chol/low sat. fat, ACTIVITY: Resume regular exercise, and FOLLOW UP APPOINTMENT(S): Please see your PCP in Own within 2 weeks.	Is the patient currently or have they ever taken plavix ( clopidogrel )	{ "answer_end": [ 645 ], "answer_start": [ 626 ], "text": [ "PLAVIX 75 mg PO QD," ] }
Ms. Dozois is a 64-year-old female admitted to MICU on 2/19/2005 for neutropenia, nausea, vomiting, abdominal pain, and shortness of breath, requiring intubation and pressors. Her medical problems included severe COPD (on home O2 2 liters baseline sat below 90s), nonsmall cell lung cancer (diagnosed in 1999, status post multiple chemotherapy regimens, most recently ALIMTA from 1/29/2005 to 09), diabetes, obesity, and chronic renal insufficiency. Her MEDICATIONS ON ADMISSION included Avapro, Lipitor, Decadron, ranitidine, Humalog, allopurinol, Alimta, Flonase, Vitamin D, B12, and Colace. She was initially treated with vancomycin, Levaquin, and aztreonam along with Flagyl empirically, and later changed to Levaquin only on 10/25/2005 to treat an enterococcal UTI and possible nosocomial pneumonia. She had thrombocytopenia and required multiple red blood transfusions to maintain her hematocrit greater than 26, though she was never hemodynamically unstable. She also required multiple platelet transfusions to keep her platelets greater than 30,000. She responded well initially to three units of packed red blood cells over 7/28/2005 and 09. However, in the setting of her GI bleed from a sloughing mucosa secondary to resolving neutropenic enteritis and recent chemo, she required multiple further RBC transfusions to keep her hematocrit greater than 30. Hematology was consulted secondary to suboptimal busted platelet levels status post transfusions, which was felt to be secondary to poor marrow response in the setting of recent chemo (workup was negative for other possible causes refractory thrombocytopenia, nystatin, allopurinol, were held given possible worsening of her thrombocytopenia). Surgery was consulted and she was managed conservatively with antibiotics initially and then with bowel rest. TPN was started on 4/21/2005, given her bowel rest for a neutropenic enteritis. She was changed to standing insulin on 10/25/2005 and her Lantus was up titrated along with sliding scale insulin to maintain blood sugars in the 80s to 120s. She is no longer neutropenic and was off Neupogen for one week and will stay and finish the 14-day course of Levaquin for coverage. On discharge her hematocrit and platelets were stable respectively at 29.8 and 46,000 and she had not required a transfusion in greater than 24 hours prior to discharge. Her DISCHARGE MEDICATIONS included Tylenol 650 to 1000 mg PO q. 6h PRN pain, headache, if fever is greater than 101, Peridex mouth wash 10 mL twice a day, nystatin mouth wash 10 mL swish and swallow 4 x day as needed, oxycodone 5 mg PO q. 6h PRN pain, simethicone 80 mg PO q.i.d. PRN gaseousness, trazodone 25 mg PO at bedtime, miconazole nitrate 2% powder topical BID to areas between skin folds including under the right breast, Nexium 20 mg PO daily, Lantus 30 mg subcutaneous daily, DuoNeb 3/0.5 mg Nebs q. 3 h. PRN shortness of breath, aspart 4 units before each meal subcutaneously, folate 3 mg PO daily, Avapro 150 mg PO daily, meclizine 25 mg PO TID, Combivent 2 puffs inhaled q.i.d., Vitamin D 125 0.25 mcg PO daily. She will follow up with infectious disease and hematology for her neutropenia, which has since resolved, and will stay and finish the 14-day course of Levaquin for UTI coverage.	What medication has the patient take for nonsmall cell lung cancer	{ "answer_end": [ 353 ], "answer_start": [ 291 ], "text": [ "diagnosed in 1999, status post multiple chemotherapy regimens," ] }
Mr. Zack Nieman is a 62-year-old white man with ischemic cardiomyopathy, status post coronary artery bypass graft in 1985 with left internal mammary artery to left anterior descending, saphenous vein graft to posterior descending artery, saphenous vein graft to obtuse marginal branch, and a repeat coronary artery bypass graft done in 1995 with saphenous vein graft to first diagonal, saphenous vein graft to obtuse marginal, and saphenous vein graft to posterior descending artery. He had multiple episodes of pulmonary congestion and was admitted to Rorea Valley Health for IV diuresis. EKG revealed atrial flutter with variable block (2:1 versus 3:1), rate around 120, left bundle branche block, and echocardiogram revealed ejection fraction about 25% with 2+ mitral regurgitation. On admission, his temperature was 97.1, pulse 103, blood pressure 148/94, respirations 18, and O2 saturation 97% on two liters. Because of his rapid ventricular response, Digoxin was started with a loading dose of 0.5 mg, then 0.25 mg times two q. six hours, and the patient was then on a maintenance dose of Digoxin at 0.125 mg p.o. q. day, and his Digoxin level has been maintained around 0.9. For his rate control, the amiodarone was also increased to 400 mg q. day, and the patient was started on anticoagulation with heparin. The patient underwent cardioversion through his AICD by the Electrophysiological Service with successful conversion to normal sinus rhythm, and was loaded with Coumadin and meanwhile on heparin until INR between 2-3. The patient developed hyperthyroidism secondary to amiodarone, treated with PTU, then developed hypothyroidism, treated with Levothyroxine. He was discharged on Amiodarone 400 mg p.o. q.d., Captopril 25 mg p.o. t.i.d., clonazepam 1 mg p.o., Lasix 80 mg p.o. b.i.d., glipizide 5 mg p.o. q.d., levothyroxine sodium 100 mcg p.o. q.d., magnesium oxide 420 mg p.o. q.d., Lopressor 25 mg p.o. b.i.d., nitroglycerin 1/150 (0.4 mg) one tab sublingual q. five minutes times three, Coumadin 5 mg p.o. q. day until INR between 2-3 then the dose needs to be adjusted accordingly to maintain INR between 2-3, Simvastatin 20 mg p.o. q. h.s., Klonopin 0.5 mg p.o. q. a.m., Digoxin 0.125 mg p.o. q.d., isosorbide, mononitrate-SR 30 mg p.o. q.d., and troglipazone 400 mg p.o. q. day.	What treatments has patient been on for anticoagulation in the past	{ "answer_end": [ 1316 ], "answer_start": [ 1260 ], "text": [ "the patient was started on anticoagulation with heparin." ] }
This 64-year-old patient had a past medical history of non-small cell lung cancer, status post XRT and chemotherapy, right MC embolic stroke, status post right carotid endarterectomy, Graves’ disease, depression, diabetes, hypertension, asthma, temporal lobe epilepsy, and history of subclavian steal syndrome. On admission, her blood pressure was 66/44, pulse of 100, respiratory rate normal, and blood sugar of 133. She was found to be difficult to arouse and had 1 gm of vancomycin, magnesium and Levaquin 500 mg. Her medication on admission included Mechanical soft diet, aspirin 81 mg, baclofen 5 mg t.i.d., B12 1000 mg daily, iron sulfate 325 mg daily, Cymbalta 20 mg p.o. b.i.d., Neurontin 100 mg b.i.d., Lamictal 200 mg b.i.d., Prilosec 20 daily, levothyroxine, Glucophage 500 once a day, Reglan 10 once a day, niacin 500 once a day, Senna 2 tabs b.i.d., Zocor 20 mg once a day, Nicoderm patch, Colace 100 mg p.o. b.i.d., Lopressor 100 mg p.o. b.i.d., lidoderm 5% patch to the low back, Tylenol, ducolox, Mylanta, lactulose, Seroquel 100 mg, prednisone 50 mg, and Dilaudid 1 mg. She completed a ten-day course of vancomycin for a MRSA urinary tract infection and was treated with tramadol and Tylenol for pain. Her laboratory data showed creatinine of 1, ALT 25, AST 35, hematocrit 33, white count 6.6, and platelets 241,000. She was covered with antibiotics initially, then transitioned over to a ciprofloxacin 700 mg p.o. b.i.d. regime for a total of 12 days for a presumed urinary tract infection. She had a significant polypharmacy and enumerable sedating medications, including baclofen, Dilaudid and trazodone. Her Cymbalta was continued per outpatient follow-up and her Lamictal, as well as her Cymbalta, were maintained for her history of depression. Neurologically, she had a left-sided hemiparesis, as well as agnosia on the left side, and her mental status included intermittent disorientation. She was maintained on Novolog sliding scale for diabetes, QTc monitored with serial EKGs, and prior use of Haldol and other antipsychotics for behavioral modification. She was also continued on a replacement dose levothyroxine for her history of Graves' and a history of radioiodine ablation. For behavioral modification, as well as intermittent agitation and disorientation, the patient was maintained on p.r.n. Seroquel 100 mg p.o. b.i.d., as well as Zydis 5 mg p.o. b.i.d. p.r.n., which was titrated from standing to p.r.n. over the course of her hospitalization in order to try to decrease any sedating medications that may be altering her alertness and orientation.	Has the patient had multiple lactulose prescriptions	{ "answer_end": [ 1012 ], "answer_start": [ 1004 ], "text": [ "ducolox," ] }
Jonas G Fosselman was admitted from office on 4/1/01 for infected L THR. Aspiration demonstrated purulent material, and he was started on Ceftriaxone per ID consult recs. with MIC to both PCN and Ceftriaxone pending. MRI of pelvis completed 10/10/01 as pre-op eval. TU Cardiology was consulted for pre-op clearance given extensive H/O cardiomyopathy and unstentable CAD per last cardiac cath 8/7. On further d/w PT, he was adament about being allowed to be D/C home on Abx for August holiday. Given that his clinical picture was much improved on antibiotics, both Dr Salkeld and ID MD agreed to this on provision that he return immediately for any evidence of progressing infection. His R hip pain and exam were much improved by time of discharge. Will plan for IV lon line to be placed prior to D/C for home dosing of QD Ceftriaxone. ID to be re-consulted on admission post-op 10/5 for re-eval of abx choice. By that time it is presumed that the MIC for PCN/CTX will be available for ascertation of proper long-term Abx care. Discharge medications included TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN headache, VENTOLIN (ALBUTEROL INHALER) 1-2 PUFF INH QID PRN sob/wheeze, ECASA (ASPIRIN ENTERIC COATED) 325 MG PO QD, ATENOLOL 25 MG PO QD Food/Drug Interaction Instruction Take consistently with meals or on empty stomach., CEFTRIAXONE 2,000 MG IV QD (Number of Doses Required (approximate): 2), COLACE (DOCUSATE SODIUM) 100 MG PO BID, ENALAPRIL (ENALAPRIL MALEATE) 2.5 MG PO QD, PERCOCET 1-2 TAB PO Q4H PRN pain, ZOCOR (SIMVASTATIN) 5 MG PO QHS Food/Drug Interaction Instruction Avoid grapefruit unless MD instructs otherwise., ISOSORBIDE MONONITRATE 30 MG PO QD Food/Drug Interaction Instruction Give on an empty stomach (give 1hr before or 2hr after food) (Number of Doses Required (approximate): 15), and NEXIUM (ESOMEPRAZOLE) 20 MG PO QD. Discharge instructions included IV Abx, D/C home with services for QD CTX dosing, IV long line placement, re-admission for removal of infected hardware and spacer placement 9/24/01, and IV Ceftriaxone per VNA 2 Gr IV QD for 10/9/01. Return immediately for increasing temps/shaking chills/pain at R hip. Discharge condition was stable. Follow-up appointment(s) included Dr Lobato 9/24/01, VH pre-admit for OR I&D/removal hardware. 9/24/01 scheduled, and Return to Work after eval by Dr Ashurst. Allergy: Shellfish, Morph	enalapril ( enalapril maleate )	{ "answer_end": [ 1478 ], "answer_start": [ 1435 ], "text": [ "ENALAPRIL (ENALAPRIL MALEATE) 2.5 MG PO QD," ] }
This 54-year-old female with end-stage renal disease on hemodialysis had an apparent VFib arrest at hemodialysis and was admitted to the CCU after being intubated in the Vibay General Hospital ED. She was intubated, received amiodarone and dopamine, as her BP was low. An x-ray revealed diffuse bilateral opacities, possible pulmonary edema versus aspiration pneumonia, and an EKG showed normal sinus rhythm 100 beats per minute with no acute ST changes. Her first set of cardiac enzyme revealed a creatinine kinase of 116 and the MB fraction of 0.7 and troponin T of less than assay and lactate of 1.8. A fistulogram and angioplasty of her right AV fistula was performed on 9/14/06 with prednisone premedication but it was unsuccessful and therefore a left IJ tunneled dialysis catheter was inserted on 10/18/06 with the tip ending in the right atrium. HOME MEDICATIONS at the time of admission included amitriptyline 25 mg p.o. bedtime, enteric-coated aspirin 325 mg p.o. daily, enalapril 20 mg p.o. b.i.d., Lasix 200 mg p.o. b.i.d., Losartan 50 mg p.o. daily, Toprol-XL 200 mg p.o. b.i.d., Advair Diskus 250/50 one puff inhaler b.i.d., insulin NPH 50 units q.a.m. subcu and 25 units q.p.m. subcu, insulin lispro 18 units subcu at dinner time, Protonix 40 mg p.o. daily, sevelamer 1200 mg p.o. t.i.d., tramadol 25 mg p.o. q.6 h. p.r.n. pain. A bronchoscopy was performed on 9/14/06 with prednisone premedication but it was negative for aspiration. The patient had difficulty weaning from vent and was finally extubated on 0/22/06. She had a single set of coag-negative Staph positive blood cultures from Quinton catheter on 8/8/06 and was treated with vancomycin dose by renal levels. An Echo on 8/1/06 showed an EF of 60 to 65% with mild concentric left ventricular hypertrophy and no wall motion abnormalities. The patient was continued on telemetry and treated with her home dose of beta-blocker with good response and was gradually advanced to an oral diet with no signs of aspiration status post extubation. She was also given heparin subcutaneously and Nexium as prophylaxis. The patient is full code and will likely need rehab and is being screened by PT and OT and will likely be discharged to rehab when bed is available.	Is there history of use of vancomycin	{ "answer_end": [ 1686 ], "answer_start": [ 1637 ], "text": [ "was treated with vancomycin dose by renal levels." ] }
This is a 51 year-old female with fibromyalgia, hypertension, and migraine headaches who presented to the Emergency Room with two months of dyspnea at night, paroxysmal nocturnal dyspnea, and orthopnea, and an episode of severe substernal chest pressure associated with shortness of breath after carrying water bottles from her car. In the Emergency Department, V/Q scan was very low probability and lower extremity noninvasive studies were also unremarkable. Her medications on admission included Nortriptyline, methyldopa, hydrochlorothiazide, Zantac, estrogen, Advil, ALternaGEL. She smokes one and one-half packs per day for 30 years. Physical examination showed temperature 97.4, respiratory rate 22, heart rate 100, blood pressure 150/90, anicteric, bibasilar crackles about one-quarter of the way up, regular rate and rhythm with II/VI systolic murmur and no rubs or gallops, benign abdomen, guaiac negative in the Emergency Department, 1+ pedal edema bilaterally, right greater than left, and nonfocal neurological. Laboratory data on admission showed hematocrit 41.6, BUN 13, creatinine 0.6, chest x-ray showed mild pulmonary edema, and electrocardiogram showed normal sinus rhythm at 91, no ischemic changes. She had serial CPKs which were all negative, and was treated with two doses of intravenous Lasix (20 milligrams each) resulting in a moderate diuresis and resolution of her shortness of breath symptoms. An exercise test was done with arm ergometry (30 watts) and her heart rate went from 100 to 129, blood pressure went from 130 systolic to 172, and electrocardiogram showed no ischemic changes. An echocardiogram showed vigorous systolic function of 86%, no valvular lesions, no wall motion abnormalities, and evidence of thickening in her ventricular walls. Given the fact that the patient had an elevated diastolic pressure and did show some early evidence of thickening in her ventricular walls, the decision was then made to begin her on a calcium channel blocker (Verapamil 240 milligrams p.o. q.d.) in addition to her usual medications. She was discharged to home in good condition with discharge medications including Verapamil SR 240 milligrams p.o. q.d., Zantac 300 milligrams q.d., estrogen 1.25 milligrams q.d., Advil 800 milligrams p.o. b.i.d. p.r.n., hydrochlorothiazide 25 milligrams p.o. q.d., methyldopa 250 milligrams q.d., and Nortriptyline 125 milligrams p.o. q.h.s., and an appointment to see a new primary physician at Dowsna Medical Center scheduled for May 1996.	methyldopa	{ "answer_end": [ 553 ], "answer_start": [ 476 ], "text": [ "on admission included Nortriptyline, methyldopa, hydrochlorothiazide, Zantac," ] }
Mr. Lewter is a 65-year-old gentleman with a history of non-insulin-dependent diabetes mellitus, hypertension, dyslipidemia, and peripheral vascular disease who presented to Tci Prosamp Memorial Hospital on 5/1/06 with unstable angina. EKG revealed sinus tachycardia with a new incomplete left bundle-branch block and downsloping 1-1.5 mm ST depressions in V3 through V6 and 1 mm depression in aVL. Cardiac catheterization revealed an ostial 100% stenosis in the left circumflex coronary artery, a proximal 60% stenosis and a mid 50% stenosis in the left anterior descending coronary artery, a proximal 80% stenosis and a mid 60% stenosis in the right coronary artery, a right dominant circulation, an ejection fraction of 30%, and collateral flow from the second diagonal to the third marginal in the right posterior left ventricular branch to the second marginal, as well as left ventricular hypokinesis and severe inferior and apical. The patient was not heparinized due to the fact that he was on Coumadin for peripheral vascular disease with a therapeutic INR. On 9/18/06, the patient underwent coronary artery bypass graft x3 with left internal mammary artery to left anterior descending coronary artery, a sequential graft and a vein graft connecting from the aorta to the second obtuse marginal coronary artery and then to the left ventricular branch. He was on medications including Lopressor 37.5 mg b.i.d., aspirin 325 mg daily, Colace 100 mg b.i.d., Pepcid 20 mg IV q.12h., insulin sliding scale, atorvastatin 80 mg daily, glipizide, Avandia, Zestril, metformin, meclizine, lactulose, vitamin C, Protonix, Niaspan, Neurontin, Zincate, and Coumadin for peripheral vascular disease. The patient was started on oral medication of glipizide 5 mg and was covered with a NovoLog sliding scale, was transfused 3 units of packed red blood cells, re-started on Coumadin for his reinsertion, and was started on Flomax 0.4 mg once a day. He had some urinary retention postoperatively and did require Foley catheter placement. He was discharged on Enteric-coated aspirin 81 mg QD, Colace 100 mg b.i.d. while taking Dilaudid, Lasix 40 mg QD x3 doses, glipizide 5 mg daily, Dilaudid 2-4 mg every three hours p.r.n. pain, lisinopril 2.5 mg daily, Niferex 150 mg b.i.d., Toprol-XL 150 mg QD, Lipitor 80 mg daily, Flomax 0.4 mg QD, potassium chloride slow release 10 mEq QD x3 doses with Lasix and Coumadin QD per INR result, and the patient will receive 4 mg of Coumadin this evening for his reinsertion and was instructed to remain on his Flomax until that time. Mr. Jana was discharged to rehab in stable condition and will follow up with his cardiologist Dr. Reuben Duttinger in one week, his heart failure cardiologist Dr. Wilton Durkee on 11/10/06 at 1:30 in the afternoon, and Urology Clinic at the Centsson Medical Center for his urinary retention in one week.	Is the patient currently or have they ever taken meclizine	{ "answer_end": [ 1637 ], "answer_start": [ 1575 ], "text": [ "meclizine, lactulose, vitamin C, Protonix, Niaspan, Neurontin," ] }
Lupe Rumble, a 42 year old female with a history of asthma, hypertension, obesity, hyperlipidemia, hyperglycemia, hirsutism, chiari malformation, spinal stenosis, and spinal syrinx, was admitted to the hospital with a recent asthma flare, productive cough, low grade fevers, shortness of breath, and wheezing. Her chest x-ray showed a linear opacity in the right lower lobe most consistent with platelike atelectasis, but could not rule out resolving or new pneumonia. Treatment included ALBUTEROL INHALER 2 PUFF INH QID, ALBUTEROL NEBULIZER 2.5 MG NEB Q4H, Advair Diskus 500/50 (Fluticasone Propionate/...), Combivent (Ipratropium and Albuterol Sulfate) 2 PUFF INH TID, LISINOPRIL 20 MG PO DAILY, Singulair (Montelukast) 10 MG PO DAILY, and a prednisone taper starting at 60 mg q 24 h x 2 doses, then 50 mg daily x 3 days, then 40 mg daily x 3 days, then 30 mg daily x 3 days, then 20 mg daily x 3 days, and then 10 mg daily x 2 days and stop. The peak flow had improved to 250 and ambulating oxygen saturation was 92-94% at discharge. The patient was also advised to try a nicotine patch and was given Lovenox as a prophylaxis. Her lisinopril was increased to 20mg due to hypertension, and she was discharged on order for KCL IMMEDIATE RELEASE PO (ref #) with instructions to continue all home medications, a prednisone taper, nebs, and advair, singulair, albuterol, and combivent. Smoking cessation was encouraged and she was interested in trying a nicotine patch.	What medications has the patient been prescribed for shortness of breath	{ "answer_end": [ 557 ], "answer_start": [ 522 ], "text": [ "ALBUTEROL NEBULIZER 2.5 MG NEB Q4H," ] }
The patient is a 55 year old male with a history of noninsulin dependent diabetes mellitus, a significant heavy smoking history, and a family history of cardiac disease who was admitted with chest pain and worsening right great toe ulceration with lymphangitis. He had completed a course of Cipro and was given a dose of oxacillin before being sent to Sidecrestso Community Hospital for IV antibiotics and work-up. MEDICATIONS ON ADMISSION included Tylenol #3 and glyburide 10 mg p.o. q. day. No known drug allergies. He was then treated for the right toe cellulitis with IV antibiotics of gentamicin and Clindamycin, and was placed on atenolol with the dose increased to 75 mg p.o. q. day. On discharge, the patient was switched from Nitropaste to Isordil 10 mg p.o. t.i.d., and his glyburide was increased to 20 mg p.o. q. day. MEDICATIONS ON DISCHARGE included atenolol, aspirin, 325 mg po q day, Glyburide, 20 mg po q day, Tylenol #3, two tablets po x one p.r.n. for pain, and sublingual nitroglycerin, p.r.n. The patient was discharged to home and was to follow-up with Dr. Netti as an outpatient and with Dr. Frasso of AMH Cardiology.	How much aspirin does the patient take per day	{ "answer_end": [ 938 ], "answer_start": [ 874 ], "text": [ "aspirin, 325 mg po q day, Glyburide, 20 mg po q day, Tylenol #3," ] }
A 83 year old female with hereditary angioedema was admitted to the hospital with abdominal pain which was not relieved by Stanazolol, and she had diarrhea, nausea/vomiting, sweats, and decreased PO intake. She was given 6 units FFP with premedication of IV Benadryl on the first night of her hospitalization, Stanazolol 4 mg q4h overnight, which was changed to bid on second hospital day, Zantac, and Lovenox. The patient was maintained on Acetylsalicylic Acid 81 mg PO qd, Vit C 500 mg PO bid, Atenolol 75 mg PO qd, hold if sbp <100 or hr <60, Digoxin 0.125 mg PO qod (Sun, Tues, Thurs), Potentially serious interaction: Digoxin & Levothyroxine Sodium, Vit E 400 units PO qd, Pepcid 20 mg PO qd, Colace 100 mg PO bid PRN constipation, Senna Tablets 2 tab PO bid PRN constipation, Lasix 20 mg PO qd, Keflex 500 mg PO qid x 28 doses, and on order for Synthroid PO (ref. #66804792), Lasix PO (ref. #91042032), and Keflex PO (ref. #63524947). She was also continued on her home dose of Synthroid, Rhinocort (Budesonide Nasal Inhaler) 2 spray na bid, and Allegra (Fexofenadine HCl) 60 mg PO bid. She was discharged with instructions to follow up with allergy and to call her doctor if she develops fevers, worsening of her abdominal pain, or other concerning symptoms. Follow up appointments were made with Dr. Morrell and Dr. Guadagnolo or Dr. Yoes for 1-2 weeks.	What is the dosage of colace ( docusate sodium )	{ "answer_end": [ 736 ], "answer_start": [ 698 ], "text": [ "Colace 100 mg PO bid PRN constipation," ] }
Mrs. Wetterauer is a 54-year-old female with coronary artery disease status post inferior myocardial infarction in March of 1997, with sick sinus syndrome, status post permanent pacemaker placement, and paroxysmal atrial fibrillation controlled with amiodarone; also with history of diabetes mellitus and hypertension. On 1/11, she experienced severe respiratory distress and was unable to be intubated on the field. She was ultimately intubated at Sirose, and an echocardiogram showed an ejection fraction of 25 to 30 percent with flat CKs. She was diuresed six liters and a right heart catheterization showed a pulmonary artery pressure of 40/15, wedge of 12, and cardiac output of 5.2. Hemodynamics indicated her cardiac output was dependent on her SVR. At the outside hospital, a right upper lobe infiltrate was noted and she was given gentamicin 250 mg times one, and clindamycin 600 mg. She was diagnosed with pneumonia and treated with clindamycin, which caused resolution of her white count. She was also given Solu-Medrol 40 mg intravenous q.6 hours for possible asthma, and had an increase in her Lasix and lisinopril dose, as well as her amiodarone. Her last admission was on 10/6 for atypical chest pain, and she was placed on Bactrim Double Strength b.i.d. times a total of seven days, as well as Lovenox 60 mg b.i.d., aspirin 325 p.o. q.d., lisinopril 40 mg p.o. b.i.d., digoxin 0.25, Lopressor 100 mg b.i.d., Zantac, Albuterol, Flovent, Solu-Medrol, and amiodarone 300 mg once a day. Home medications include amiodarone 200 mg p.o. q.d., Glyburide 5 mg p.o. q.d., Lopressor 50 mg p.o. b.i.d., Prempro 0.625/2.5 p.o. q.d., lisinopril 40 mg p.o. q.d., Coumadin, nitroglycerin sublingual, Zantac, beclomethasone, and Ventolin. Medications on transfer, Lovenox 60 mg b.i.d., aspirin 325 p.o. q.8, digoxin 0.25, Lopressor 100 mg b.i.d., Zantac, Albuterol, Flovent, Solu-Medrol, and amiodarone 300 mg once a day. The patient was also placed on Tapazole 10 mg p.o. b.i.d., Zantac 150 mg p.o. b.i.d., Coumadin 5.0 mg p.o. q.p.m., Bactrim Double Strength one tablet p.o. b.i.d., Tapazole 10 mg p.o. b.i.d., Zantac 150 mg p.o. b.i.d., Coumadin 5.0 mg p.o. q.p.m., Bactrim Double Strength one tablet p.o. b.i.d., Glyburide 5 mg p.o. q.d., Lasix 20 mg p.o. q.d., atenolol 150 mg p.o. q.d., diltiazem CD 240 mg p.o. q.d., and resolved with 20 mg of Lasix p.o. q.d. Mrs. Wetterauer was admitted to the Aley Coness-o Meoak Medical Center for paroxysmal atrial fibrillation controlled with amiodarone, and had an increase in her Lasix and lisinopril dose, as well as her amiodarone. She was also given Solu-Medrol 40 mg intravenous q.6 hours for possible asthma. For her anxiety, the patient was treated acutely with Ativan and her problem resolved quite well, and she became more comfortable in the hospital. Diabetes Mellitus was managed with Glyburide held initially on admission, covered with insulin sliding scale, and restarted on discharge. Edema was managed with Lasix 20 mg p.o. q.d. and resolved with 20 mg of Lasix p.o. q.d. Urinary Tract Infection was managed with antibiotics. She was discharged with medications including amiodarone 200 mg p.o. q.d., lisinopril 40 mg p.o. b.i.d., Tapazole 10 mg	What is her current dose of lopressor	{ "answer_end": [ 1578 ], "answer_start": [ 1553 ], "text": [ "Glyburide 5 mg p.o. q.d.," ] }
The patient is a 61-year-old man with a history of ischemic cardiomyopathy and congestive heart failure, who was initially treated with afterload reduction, digoxin and Lasix. A PA line was placed with RA 8, RV 76/4, TA 80/36, pulmonary capillary wedge pressure 34, and cardiac index 1.49. He was then treated with dobutamine, intravenous TNG, and nitroprusside with symptomatic relief and hemodynamic stabilization with wedge pressure falling to 18. TNG and Nipride were successfully weaned, however, the patient remained dobutamine dependent. One week prior to transfer, the patient was admitted to Ment Hospital for management of his congestive heart failure and grew gram positive cocci from two blood cultures. He was then started on vancomycin and defervesced, and subsequently grew gram negative rods in one out of four blood culture specimens. These were gram negative enteric rods, pan-sensitive, for which the patient was started on ampicillin 2 gm IV q. 6. At the time of discharge, the patient was stable, dobutamine dependent, without chest pain, able to ambulate from chair to commode without shortness of breath, palpitations, or light-headedness. His medications at time of discharge included dobutamine at 15 mcg per kilogram per minute; captopril 25 mg p.o. t.i.d.; digoxin 0.125 mg p.o. q.d.; Lasix 160 mg p.o. b.i.d.; potassium chloride 20 mEq p.o. b.i.d.; Coumadin 1 mg p.o. q.d.; Atrovent, two puffs q.i.d.; Azmacort, eight puffs b.i.d.; Pepcid 20 mg p.o. b.i.d.; Colace 100 mg p.o. t.i.d.; vancomycin 1 gm q. 12, discontinued 9-23 a.m. after 14 days; ampicillin 2 gm IV q. 6 (24 of June equals day number five); Halcion 0.125 p.o. q.h.s. prn; Serax 15 mg p.o. q. 6 hours prn. The patient's condition at time of discharge is fair and will be continuing care in the coronary care unit of the hospital inpatient near patient's home under the care of Doctor Daren Swasey.	Was the patient ever given medication for gram positive cocci	{ "answer_end": [ 715 ], "answer_start": [ 633 ], "text": [ "his congestive heart failure and grew gram positive cocci from two blood cultures." ] }
The patient, a 60M with newly-diagnosed DM, hyperlipidemia, glaucoma, h/o EtOH abuse, and erectile dysfunction, presented to the ED for the second time in 3 days with unsteadiness and sleepiness. Workup including head CTA and MRI were negative, and he was discharged with Metformin and plans for Holter and TTE. He returned to the ED with BS 277. No fevers, headaches, focal neuro findings, vertigo, visual changes, CP, SOB, n/v, abd pain, dysuria, or joint pain were found. Labs were significant for glucose 314, elevated lipids (Chol 302, Trig 323, LDL 189), and HbA1c 11.1%. EKG had old j-point elevation laterally, physical and neuro exam were normal. Explanations for episodes considered were TIA of posterior circulation vs. seizure, less likely atypical migraine or sleep disorder. At the time of discharge, the patient was stable and feeling very good. He was given ACETYLSALICYLIC ACID 81 MG PO DAILY, LIPITOR (ATORVASTATIN) 10 MG PO DAILY, GLYBURIDE 2.5 MG PO DAILY X 60 doses, METFORMIN 500 MG PO BID, a low-fat house diet, and acyclovir this week but stopped Wed for possible neuro side effects. Aspirin dose was increased from 81 mg to 325 mg qd and a prescription for an automatic BP cuff for monitoring at home was given. To better manage blood sugars, glyburide was added which should be taken once a day in addition to metformin twice a day, and he should check his blood sugars 3-4 times per day. He will followup with Dr. Clesen on Monday, and will be evaluated this week with TTE with bubble-study to r/o intracardiac source or PFO and EEG if Neurology deems possibility of seizure.	Has a patient had lipitor ( atorvastatin )	{ "answer_end": [ 949 ], "answer_start": [ 911 ], "text": [ "LIPITOR (ATORVASTATIN) 10 MG PO DAILY," ] }
Ms. Leezer is a 50 year-old woman with a history of end stage renal disease, status post renal transplant, and a history of coronary artery disease, status post coronary artery bypass grafting. She had an episode of chest pain which was relieved by Nitroglycerin and passed out while saying goodbye to her husband, as well as several episodes of skipped heart beats during and after which she feels short of breath, and slurred speech for a few minutes. On admission her temperature was 98.8, pulse 96, blood pressure 120/70, and respirations 18. During her stay she was given a 250 cc fluid bolus, transfused two units of blood and her hematocrit went up to 31. Laboratory data revealed a sodium of 137, potassium 4.4, chloride 104, bicarbonate 15, BUN 86, creatinine 3.1, ALT 6, AST 11, alkaline phosphatase 44, bilirubin total 0.4, direct bilirubin 0.1, calcium 9.5, cholesterol 360, and HDL 40. An exercise tolerance test MIBI was performed, which was negative for ischemia, and the patient's ejection fraction was approximated to be 69%. Carotid noninvasives revealed moderate internal carotid plaque on the right and mild stenosis of the other arteries. An echocardiogram revealed concentric left ventricular hypertrophy with an ejection fraction of 65%. The patient was taken to Electrophysiology Study which revealed nonsustained ventricular tachycardia with possible right ventricular outflow tract origin. It was hoped that she could be maintained on Lopressor and Verapamil; however, her blood pressure did not tolerate the medication, so she was already on Atenolol for Beta blockade and Verapamil was tried. Her discharge medications included Aspirin 81 mg p.o. q. day, Vitamin C 100 mg p.o. q. day x14 days, Epogen 2,000 subcu q. week, Lasix 60 mg p.o. q. day, Gemfibrozil 300 mg p.o. b.i.d., Lisinopril 5 mg p.o. q. day, Prilosec 20 mg p.o. q. day, Prednisone 5 mg p.o. on even days, 10 mg p.o. on odd days, MVI with minerals one tablet p.o. q. day, Thiamine 50 mg p.o. b.i.d., Bicitra 15 ml p.o. b.i.d., Nephrocaps one tablet p.o. q. day, Cyclosporine 125 mg p.o. in the morning and 100 mg p.o. in the afternoon, Insulin sliding scale, Cellcept 1,000 mg p.o. b.i.d., and Prempro 0.625/0.25 mg p.o. q. day. Her triglycerides were checked during the hospitalization and found to be very high in the 1,500 range, so she was taken off Simvastatin and started on Gemfibrozil. She was discharged in stable condition the next day.	Has the patient ever tried lopressor	{ "answer_end": [ 1485 ], "answer_start": [ 1416 ], "text": [ "It was hoped that she could be maintained on Lopressor and Verapamil;" ] }
The patient is a 42-year-old woman admitted for treatment of two pulmonary embolisms and a urinary tract infection. Twenty years ago she suffered a pulmonary embolism which was poorly documented after a tubal ligation. She was treated with heparin and Coumadin and had been well since that time. On 1 of October she underwent elective total abdominal hysterectomy secondary to fibroids and menorrhagia. Before admission, she noted shortness of breath and a temperature to 101, as well as pleuritic chest pain. Upon physical examination, her temperature was 102.5, blood pressure 110/80, heart rate 120, and O2 saturation on room air was 99%. Labs showed electrolytes within normal limits, BUN 6, creatinine 0.8, glucose 114, white count 12.2, hematocrit 26, platelets 508,000, PT 13.4, PTT 25.6. Chest x-ray showed bilateral basilar atelectasis and EKG showed sinus tachycardia at 104 with normal interval and axis. The patient was admitted and started on heparin and the PTT was quickly therapeutic. She had ultrasound of the thighs which failed to show deep venous thrombosis and underwent pulmonary angiography which showed two small pulmonary embolisms on the left side. The patient developed a UTI and was treated with ceftizoxime and converted to p.o. Bactrim. Upon discharge, the patient's condition was good and she was transferred to the Critmi Ganstown Community Medical Center under the care of Dr. Jamie Perman with a PT that was likely in the range of 18 to 20 and was discharged on Bactrim one double strength tablet p.o. b.i.d., iron sulfate 325 mg p.o. q.d., Motrin 800 mg p.o. t.i.d., Colace 100 mg p.o. t.i.d., and Coumadin 1 mg p.o. q. h.s.	Has this patient ever been prescribed heparin	{ "answer_end": [ 247 ], "answer_start": [ 184 ], "text": [ "documented after a tubal ligation. She was treated with heparin" ] }
A 73-year-old male patient with a history of coronary artery disease, ischemic cardiomyopathy, and valvular heart disease was admitted to the Rose-le Medical Center with a large left foot toe ulcer that was nonhealing, and signs and symptoms of decompensated heart failure and acute on chronic renal failure. During his stay, he was treated with Enteric-coated aspirin 325 mg p.o. daily, Amiodarone 200 mg p.o. daily, Colace 100 mg p.o. b.i.d., insulin NPH 7 units q.a.m. and 3 units q.p.m. subcutaneously, Atrovent HFA inhaler 2 puffs inhaled q.i.d. p.r.n. for wheezing, magnesium gluconate sliding scale p.o. daily, oxycodone 5-10 mg p.o. q. 4h. p.r.n. pain, senna tablets one to two tablets p.o. b.i.d. p.r.n. constipation, spironolactone 25 mg p.o. daily, Coumadin 1 mg p.o. every other day, multivitamin therapeutic one tablet p.o. daily, Zocor 40 mg p.o. daily, torsemide 100 mg p.o. daily, OxyContin 10 mg p.o. b.i.d., Cozaar 25 mg p.o. daily, Remeron 7.5 mg p.o. q.h.s., and aspartate insulin sliding scale, as well as being maintained on subcutaneous heparin and Nexium as DVT and GI prophylaxis, Celexa 20 mg p.o. daily, Coumadin 2.5 mg p.o. daily, Diovan 80 mg p.o. daily, Lantus 25 units every day subcutaneous, Lasix 160 mg p.o. b.i.d., Lipitor 20 mg p.o. q.h.s., Lopressor 50 mg p.o. b.i.d., solsite topical, and 25 mg of hydrochlorothiazide b.i.d. 30 minutes prior to meals, in addition to ciprofloxacin, DuoDERM, BKA site healing with continued aspirin, and inhaled ipratropium. Hyponatremia due to heart failure was improved with diuresis, and the patient was maintained on Coumadin with an INR goal of 2-3, adjusted to 1 mg PO every other day. Diabetes mellitus, insulin-dependent, was covered on NPH QAM and QPM with aspartate sliding scale for duration of hospitalization. The patient was restarted on Celexa per PCP for likely depressive mood response to recent bilateral knee amputation, and later started on Remeron 7.5 mg PO daily in place of Celexa. He was initially treated for urinary tract infection with uncomplicated course with ciprofloxacin, and Wound care nurse consulted for BKA wound and small decubitus on his back, was treated with DuoDERM, BKA site healing well. The patient was maintained on subcutaneous heparin and Nexium as DVT and GI prophylaxis during this hospitalization. He was discharged on Enteric-coated aspirin 325 mg p.o. daily, Amiodarone 200 mg p.o. daily, Atrovent one to two puffs inhaled q.i.d. p.r.n. for wheezing, Celexa 20 mg p.o. daily, Coumadin 2.5 mg p.o. daily, Diovan 80 mg p.o. daily, enteric-coated aspirin 325 mg p.o. daily, Lantus 25 units every day subcutaneous, Lasix 160 mg p.o. b.i.d., Lipitor 20 mg p.o. q.h.s., Lopressor 50 mg p.o. b.i.d., therapeutic multivitamin one tablet p.o. daily, solsite topical, and instructed to follow up with psychiatry to assess depressive disorder/adjustment disorder, start beta-blocker at a low-dose in the outpatient setting, and check creatinine and BUN along with electrolytes to make sure patient is doing well on current maintenance diuretic schedule of 100 mg torsemide PO daily and spironolactone. Code status was full code.	Has patient ever been prescribed ipratropium	{ "answer_end": [ 1494 ], "answer_start": [ 1451 ], "text": [ "continued aspirin, and inhaled ipratropium." ] }
Ms. Dozois is a 64-year-old female admitted to MICU on 2/19/2005 for neutropenia, nausea, vomiting, abdominal pain, and shortness of breath, requiring intubation and pressors. Her medical problems included severe COPD (on home O2 2 liters baseline sat below 90s), nonsmall cell lung cancer (diagnosed in 1999, status post multiple chemotherapy regimens, most recently ALIMTA from 1/29/2005 to 09), diabetes, obesity, and chronic renal insufficiency. Her MEDICATIONS ON ADMISSION included Avapro, Lipitor, Decadron, ranitidine, Humalog, allopurinol, Alimta, Flonase, Vitamin D, B12, and Colace. She was initially treated with vancomycin, Levaquin, and aztreonam along with Flagyl empirically, and later changed to Levaquin only on 10/25/2005 to treat an enterococcal UTI and possible nosocomial pneumonia. She had thrombocytopenia and required multiple red blood transfusions to maintain her hematocrit greater than 26, though she was never hemodynamically unstable. She also required multiple platelet transfusions to keep her platelets greater than 30,000. She responded well initially to three units of packed red blood cells over 7/28/2005 and 09. However, in the setting of her GI bleed from a sloughing mucosa secondary to resolving neutropenic enteritis and recent chemo, she required multiple further RBC transfusions to keep her hematocrit greater than 30. Hematology was consulted secondary to suboptimal busted platelet levels status post transfusions, which was felt to be secondary to poor marrow response in the setting of recent chemo (workup was negative for other possible causes refractory thrombocytopenia, nystatin, allopurinol, were held given possible worsening of her thrombocytopenia). Surgery was consulted and she was managed conservatively with antibiotics initially and then with bowel rest. TPN was started on 4/21/2005, given her bowel rest for a neutropenic enteritis. She was changed to standing insulin on 10/25/2005 and her Lantus was up titrated along with sliding scale insulin to maintain blood sugars in the 80s to 120s. She is no longer neutropenic and was off Neupogen for one week and will stay and finish the 14-day course of Levaquin for coverage. On discharge her hematocrit and platelets were stable respectively at 29.8 and 46,000 and she had not required a transfusion in greater than 24 hours prior to discharge. Her DISCHARGE MEDICATIONS included Tylenol 650 to 1000 mg PO q. 6h PRN pain, headache, if fever is greater than 101, Peridex mouth wash 10 mL twice a day, nystatin mouth wash 10 mL swish and swallow 4 x day as needed, oxycodone 5 mg PO q. 6h PRN pain, simethicone 80 mg PO q.i.d. PRN gaseousness, trazodone 25 mg PO at bedtime, miconazole nitrate 2% powder topical BID to areas between skin folds including under the right breast, Nexium 20 mg PO daily, Lantus 30 mg subcutaneous daily, DuoNeb 3/0.5 mg Nebs q. 3 h. PRN shortness of breath, aspart 4 units before each meal subcutaneously, folate 3 mg PO daily, Avapro 150 mg PO daily, meclizine 25 mg PO TID, Combivent 2 puffs inhaled q.i.d., Vitamin D 125 0.25 mcg PO daily. She will follow up with infectious disease and hematology for her neutropenia, which has since resolved, and will stay and finish the 14-day course of Levaquin for UTI coverage.	Has this patient ever tried simethicone	{ "answer_end": [ 2687 ], "answer_start": [ 2612 ], "text": [ "simethicone 80 mg PO q.i.d. PRN gaseousness, trazodone 25 mg PO at bedtime," ] }
This 82-year-old RHM with a history of HTN, DM-2, CAD, and AVR (on Coumadin until 3/29) presented to the WTSMC ER for further work-up after receiving Mannitol. On exam, his VS were T: afebrile, BP: 145/64, P: 60, RR: 18, O2 sat: 97%r.a., HEENT anicteric and MMM without lesions, OP clear, neck supple with no LAD, CV had s1s2 paced, pronounce S2, 3/6 systolic murmur, 2/6 diastolic, resp CTAB, abd +BS Soft/NT/ND, ext no C/C/E, s/p above amputation, MS awake and alert, oriented to date, place, and self, attention DOW backwards, memory registration 3/3, recall 2/3 at 5 min 3/3 with prompting, language fluent, +comprehension, +repetition, +naming intact, nondominant no neglect to DSS, able to salute/brush teeth, CN II, III - pupils 3`2 bilaterally, VFF by confrontation; III, IV, VI - EOMI, no ptosis, no nystagmus; V - sensation intact to LT/PP, corneal reflex intact; VII - mild right facial weakness; VIII - hears finger rub; IX, X - voice dysarthric, palate elevates symmetrically, gag intact; XI - SCM/Trapezii 5/5 B; XII - tongue protrudes midline, motor right pronator drift, no asterixis, normal bulk and tone, no tremor, rigidity or bradykinesia, strength 5/5, DTRs C56, C6, C7, L34, S12, Plantar L2, 2, 2, 1, 0, amputated R1, 1, 1, 1, 0, up, sensory decreased LT, temperature, vibration distally up to knees, coord finger tap rapid & symm, FNF & finger follow intact (for weakness), foot tap rapid & symm, gait deferred. LABS showed Sodium 141 mmol/L, Potassium 4.7 mmol/L, Chloride 103 mmol/L, Total CO2 29 mmol/L, Anion Gap 9 mmol/L, CK 33 U/L, CKMB Quant 1.7 ng/mL, Calcium 9.0 mg/dL, Magnesium 1.6 mg/dL, cTn-I See Result Below ng/mL, and Glucose 130 mg/dL. Medications prescribed were COLACE (Docusate Sodium) 100 mg PO BID, LASIX (Furosemide) 20 mg PO QD, Hydralazine HCl 10 mg IV Q6H PRN SBP>160mmHg, Insulin Regular Human Sliding Scale (subcutaneously) SC qAC, qHS, Lisinopril 20 mg PO QD, Magnesium Gluconate 500 mg PO BID, Milk of Magnesia (Magnesium Hydroxide) 30 mL PO QD PRN Constipation, Metoprolol Tartrate 25 mg PO TID starting in PM on 0/17, Xalatan (Latanoprost) 1 drop OU QPM, Flomax (Tamsulosin) 0.4 mg PO QD, Nexium (Esomeprazole) 20 mg PO QD, Glipizide 10 mg PO QD, Zocor 20 mg QD, Metformin 1000 mg BID, Niferex 150 BID, ASA 81 PO QD, and BRIMONIDINE 0.2% BID. Neurologic exam was stable with persistent dysarthria, right pronator drift, and mild right leg weakness; patient was evaluated by PT/OT and deemed appropriate candidate for acute rehab. Cardiovascular continued to be in atrial fibrillation, pacemaker was firing, but had an episode of HR 30's x few seconds, and HR 40's-50's for rest of night. EKG unchanged from admission, atrial fibrillation, left anterior fascicular block, some PVCs. Plan was to admit to NICU and transfer to the floor, control BP with home regimen and keep SBP<140, hold ASA and Coumadin, and hold Metformin for now and add insulin sliding scale. Medications included COLACE (Docusate Sodium) 100 mg PO BID, LASIX (Furosemide) 20 mg PO QD, Hydralazine HCl 10 mg IV Q6H PRN other: SBP>160	Why was milk of magnesia (magnesium hydroxide) originally prescribed	{ "answer_end": [ 2015 ], "answer_start": [ 1947 ], "text": [ "Milk of Magnesia (Magnesium Hydroxide) 30 mL PO QD PRN Constipation," ] }
The patient is a 37-year-old gentleman with known coronary artery disease who underwent coronary artery bypass grafting times three with bilateral internal mammary arteries and a saphenous vein graft. The patient was found to have extremely pronounced atherosclerosis of his coronary arteries and had an entirely smooth postoperative course. He was maintained on low molecular weight Dextran for 48 hours for his endarterectomy and was started on enteric coated aspirin on the first day of his operation. The patient diuresed very well and was started on beta blockers. On discharge, the patient's medications included Tenormin, 75 mg po q day; enteric coated aspirin, one po q day; Carafate, 1 gram po q.i.d.; iron sulfate, 325 mg po q day; Percocet and Colace.	What medications has the patient been prescribed for his endarterectomy	{ "answer_end": [ 427 ], "answer_start": [ 342 ], "text": [ "He was maintained on low molecular weight Dextran for 48 hours for his endarterectomy" ] }
Ms. Halnon is a 67-year-old female with multiple medical comorbidities and a past medical history significant for cardiac transplant in 1993, and hip replacement in July 2005, complicated by wound infection, and need for prolonged rehabilitation who presented from Port Medical Center to Ephma Mersources Ni Memorial Hospital with three days of progressive worsening shortness of breath. Upon admission, her mental status was borderline, but it improved with discontinuation of standing analgesic and decreasing of her clonazepam. A head CT showed no acute processes. She had a right upper arm cellulitis and urinary tract infection on screening urinalysis. She was anemic and was found to be vancomycin resistant Enterococcus positive, but repeated cultures demonstrated MRSA negative. For her heart failure, she was diuresed with IV and transitioned to oral torsemide and they entered discharge dose of torsemide 200 mg p.o. twice per day. She was given a five-day course of levofloxacin (used to address recurrent UTI) and then a two-day course of Ancef, her cellulitis was initially treated with levofloxacin and transitioned to Bactrim based on antibiogram sensitivities. A long-term Foley was placed for comfort with catheter in place. While on Bactrim for her UTI, her creatinine rose from 1.5 to 1.6, but cleared with this regimen. For her chronic anemia, the patient was continued on iron (which was increased to three times per day) and darbepoetin, folate was added. She was asymptomatic from her chronic anemia. She was given two units of packed red blood cells in March, 2005, and two more units on February, 2006. Her admission weight was 133 kg and her creatinine was 1.6. At discharge, she was hemodynamically stable, afebrile, and breathing comfortably on three liters of oxygen. Her discharge medications included Vitamin C 500 mg twice per day, Imuran 25 mg daily, PhosLo 667 mg three times per day, clonazepam 0.25 mg twice daily, iron sulfate 325 mg three times per day, folate 1 mg daily, Dilaudid 2 mg every six hours as needed for pain, lactulose 30 mL four times per day as needed for constipation, prednisone 5 mg every morning, Sarna topical every day apply to affected areas, multivitamin daily, Coumadin 2.5 mg daily, goal INR 2 to 3, zinc sulfate 220 mg daily, Ambien 5 mg before bed as needed for insomnia, torsemide 200 mg by mouth two times per day, cyclosporine 50 mg twice daily, Colace 100 mg twice daily, insulin NPH 14 units every evening, insulin NPH 46 units every morning, esomeprazole 20 mg once per day, DuoNeb 3/0.5 mg inhaled every six hours as needed for shortness of breath, Aranesp 50 mcg subcutaneously once per week, NovoLog sliding scale before meals, Lexapro 20 mg once per day, Maalox one to two tablets every six hours as needed for upset stomach, and Lipitor 20 mg once per day. Outstanding issues include following INR the goal of 2 to 3, following weight and clinical signs of volume overload, following up on loose stools for possible Clostridium difficile infection, and following clinical signs for evidence of urinary tract infection treating with antibiotics as necessary.	What is her current dose of ambien	{ "answer_end": [ 2337 ], "answer_start": [ 2224 ], "text": [ "Coumadin 2.5 mg daily, goal INR 2 to 3, zinc sulfate 220 mg daily, Ambien 5 mg before bed as needed for insomnia," ] }
Dion Scarberry (926-57-39-3) was admitted on 9/0/2005 with a diagnosis of COPD flare and right heart failure and was discharged on 5/28/05 at 02:00 PM with a disposition of Home w/ services. He had a number of medications including Acetylsalicylic Acid 81mg PO QD Starting in AM (7/17), Elavil (Amitriptyline HCL) 10mg PO QHS, Atenolol 25mg PO QD Starting in AM (7/17), Colace (Docusate Sodium) 100mg PO BID, Furosemide 20mg PO QD Starting Today (6/25), Guaifenesin 10ml PO TID Starting Today (6/25) PRN Other:cough, Oxycodone 5mg PO TID Starting Today (6/25) PRN Pain, Quinine Sulfate 325mg PO HS Starting Today (6/25), Senna Tablets (Sennosides) 2 Tab PO BID, MVI Therapeutic (Therapeutic Multivitamins) 1 Tab PO QD, POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & NIACIN, VIT. B-3 Reason for override: will monitor, Zocor (Simvastatin) 20mg PO QHS, Morphine Controlled Release 15mg PO Q12H, Felodipine 5mg PO QD Food/Drug Interaction Instruction, Flonase (Fluticasone Nasal Spray) 1 Spray INH QD, Advair Diskus 500/50 (Fluticasone Propionate/...) 1 Puff INH BID, Caltrate+D (Calcium Carbonate 1,500mg (600...) 1 Tab PO BID, Novolog Mix 70/30 (Insulin Aspart 70/30) 35 Units QAM; 22 Units QPM SC 35 Units QAM 22 Units QPM, Prednisone Taper PO Give 60mg q 24 h X 5 dose(s), then Give 50mg q 24 h X 3 dose(s), then Give 40mg q 24 h X 3 dose(s), then Give 30mg q 24 h X 3 dose(s), then Give 20mg q 24 h X 3 dose(s), then Give 10mg q 24 h X 3 dose(s), then Give 5mg q 24 h X 3 dose(s), then Starting Today (6/25), Combivent (Ipratropium and Albuterol Sulfate) 2 Puff INH QID. He was also given a diet of 4 gram Sodium, activity to resume regular exercise, and follow up appointment(s) with primary care doctor at the BCCMC early next week. He had allergies to Erythromycins and was given Azithromycin and supplemental O2 and Levofloxacin and admitted with a diagnosis of COPD flare. Home meds include Atenolol 25mg PO qd, HCTZ 25mg PO qd, Felodipine 5mg PO qd, Zocor 20mg PO qhs, ASA 81mg PO qd, Advair 1 puff bid, Combivent 2 puffs qid, Loratidine 10mg PO qd, Guqifenesin 600mg PO q12h, Morphine 15mg PO q8-12h, Percocet 1-2 tab PO q6h, Quinine Sulfate 325mg PO qhs, Colace 100mg PO bid, Senna 2 tab PO qd, Calcium+Vim D 125 units PO qd, Elavil 10mg PO qhs. He was treated for COPD flare with supplemental O2, DuoNebs, and steroids and received a V/Q scan which reported a low probability of PE, as well as a cardiac MRI which demonstrated normal cardiac anatomy and function, with an LVEF of 73% and no valvular dysfunction. His diabetes was managed with his home regimen of Novolog and chronic pain and insomnia were managed with his out-pt regimen of morphine and oxycodone, and he was given Elavil for sleep. Because of his history of cancer, he was placed on Lovenox for anticoagulation. Additional Comments include the instruction to use his home oxygen when sleeping at night, the addition of Combivent inhalers and a steroid taper to his medicines, and to stop the hydrochlorathiazide (HCTZ) 25mg and take Lasix 20mg once a day. His discharge condition was stable, and he was instructed to continue Lasix 40mg PO QD at home and D/C home HCTZ, to do a slow prednisone	What does the patient take o2 for	{ "answer_end": [ 2329 ], "answer_start": [ 2256 ], "text": [ "He was treated for COPD flare with supplemental O2, DuoNebs, and steroids" ] }
This is a 72 year old black female with a history of hypertension, angina, adult onset diabetes, and recurrent syncopal events who was treated with Dilantin for less than a year in 1970 and her last episode was in 1989. She was given Nitro Paste and 1 amp of D50 when she experienced a syncopal event on the morning of admission and her fingerstick glucose was checked. Her medications on admission include aspirin one tablet q d, Questran one pack q d, Micronase 5 mg po q d, Betaxolol eye drops bid to each eye, Pilocarpine eye drops tid to each eye, and eye drops bid to each eye. She also receives monthly Vitamin B12 injections and takes nitroglycerin with chest pain. Physical examination revealed pinpoint constriction of her pupils secondary to her glaucoma eyedrops, bibasilar, coarse crackles in the chest, no jugular venous distention, and nonfocal neurologic exam. Laboratory data includes sodium of 143, potassium of 4.3, chloride of 109, bicarbonate of 20, BUN of 21, creatinine of 1.0, glucose of 160, hematocrit of 43.4, white count of 6.45, and normal coagulation factors. Chest X ray showed a calcific aorta, C spine X ray and head CT were negative, and EKG showed no changes from her baseline. The patient was started on Isordil and Lopressor empirically but these were discontinued and her chest pain is relieved with nitroglycerin. She was discharged to home with plans for a repeat 24 hour Holter as an outpatient with diagnoses of syncope, borderline type II diabetes, stable exertional angina, and glaucoma. Discharge medications include aspirin one tablet po q d, Questran one package po q d, Pilocarpine eye drops tid per eye, Betaxolol eye drops bid per eye, eye drops bid per eye, sublingual nitroglycerin prn chest pain, and Naprosyn 375 mg tid prn.	Has the patient had previous nitroglycerin	{ "answer_end": [ 673 ], "answer_start": [ 633 ], "text": [ "and takes nitroglycerin with chest pain." ] }
Mr. Forde has recovered very well following his elective coronary artery bypass graft procedure and is hemodynamically stable with left lower extremity erythema and tenderness significantly improved 24 hours following initiation of Keflex course. White blood cell count was within normal limits and patient continued to remain afebrile. A course of Keflex was administered on postoperative day seven for sinus rhythm in the high 90s with blood pressure mildly hypertensive, additionally with frequent PVCs noted on telemetry. Mr. Notarnicola continued to remain afebrile and his knee pain has significantly improved. Additionally, of note, Mr. Hovenga's Toprol was increased to 150 mg p.o. daily with an extra 2 mg of magnesium. Mr. Neth is discharged to rehabilitation today having recovered well following his elective CABG procedure. Mr. Marcusen is discharged to rehabilitation today, postoperative day eight, hemodynamically stable, to continue a course of Keflex for left lower extremity erythema and additionally to continue one week of diuresis in the form of low dose Lasix for mild persistent postoperative pulmonary effusions. Mr. Brannigan has been instructed to shower and monitor incisions for signs of increasing infection such as fever, drainage, worsening pain or increase in redness. He is to follow up with his primary care physician for continued evaluation and management of hypertension, dyslipidemia, obesity, obstructive sleep apnea, and uncontrolled Type II diabetes mellitus. Additionally, the patient will follow up with his cardiologist for continued evaluation and management of blood pressure, heart rate, heart rhythm, lipid levels, and for possible future adjustment in medication. Mr. Connin will follow up with his cardiac surgeon, Dr. Quinn Dalio, in six to eight weeks. Additionally, he will follow up with his cardiologist, Dr. Octavio Wulffraat, in two to four weeks and with his primary care physician, Dr. Barrett Mittleman, in one to two weeks. The patient is discharged with medications including Tylenol 325 mg p.o. q.6h. p.r.n. pain for temperature greater than 101 degrees Fahrenheit, amlodipine 5 mg p.o. daily, atorvastatin 10 mg p.o. daily, captopril 6.25 mg p.o. t.i.d., Keflex 500 mg p.o. q.i.d. times total of seven days, last dose on 9/15/06, Colace 100 mg p.o. b.i.d. p.r.n. constipation, enteric-coated aspirin 325 mg p.o. daily, Lasix 40 mg p.o. daily x7 days, hydrochlorothiazide 12.5 mg p.o. daily, NovoLog 3 units subcu AC, Lantus 24 units subcu q. 10 p.m., hold if n.p.o., potassium slow release 20 mEq p.o. daily x7 days, Toprol-XL 150 mg p.o. daily, Niferex 150 mg p.o. b.i.d., oxycodone 5 to 10 mg p.o. q.4h. p.r.n. pain, Ambien 5 mg p.o. nightly p.r.n. insomnia, NovoLog 6 units subcu with breakfast, hold if n.p.o., NovoLog 4 units subcu with lunch, hold if n.p.o., NovoLog 4 units subcu with dinner, hold if n.p.o., NovoLog sliding scale subcu AC, blood sugar less than 125, give 0 units subcu, blood sugar 125 to 150, give 2 units subcu, blood sugar 151 to 200, give 3 units subcu, blood sugar 201 to 250, give 4 units subcu, blood sugar 251 to 300, give 6 units subcu, blood sugar 301 to 350, give 8 units subcu, if blood sugar 351 to 400, NovoLog sliding scale subcu q.h.s. Please recheck blood sugar less than 200, give 0 units subcu, if blood sugar 201 to 250, give 2 units subcu, blood sugar 251 to 300, give 3 units subcu, blood sugar 301 to 350, give 4 units subcu, blood sugar 351 to 400, give 10 units subcu, call physician if blood sugar greater than 400.	Did the patient ever take any medication for her mild persistent postoperative pulmonary effusions in the past	{ "answer_end": [ 1102 ], "answer_start": [ 1036 ], "text": [ "week of diuresis in the form of low dose Lasix for mild persistent" ] }
Ms. Halnon is a 67-year-old female with multiple medical comorbidities and a past medical history significant for cardiac transplant in 1993, and hip replacement in July 2005, complicated by wound infection, and need for prolonged rehabilitation who presented from Port Medical Center to Ephma Mersources Ni Memorial Hospital with three days of progressive worsening shortness of breath. Upon admission, her mental status was borderline, but it improved with discontinuation of standing analgesic and decreasing of her clonazepam. A head CT showed no acute processes. She had a right upper arm cellulitis and urinary tract infection on screening urinalysis. She was anemic and was found to be vancomycin resistant Enterococcus positive, but repeated cultures demonstrated MRSA negative. For her heart failure, she was diuresed with IV and transitioned to oral torsemide and they entered discharge dose of torsemide 200 mg p.o. twice per day. She was given a five-day course of levofloxacin (used to address recurrent UTI) and then a two-day course of Ancef, her cellulitis was initially treated with levofloxacin and transitioned to Bactrim based on antibiogram sensitivities. A long-term Foley was placed for comfort with catheter in place. While on Bactrim for her UTI, her creatinine rose from 1.5 to 1.6, but cleared with this regimen. For her chronic anemia, the patient was continued on iron (which was increased to three times per day) and darbepoetin, folate was added. She was asymptomatic from her chronic anemia. She was given two units of packed red blood cells in March, 2005, and two more units on February, 2006. Her admission weight was 133 kg and her creatinine was 1.6. At discharge, she was hemodynamically stable, afebrile, and breathing comfortably on three liters of oxygen. Her discharge medications included Vitamin C 500 mg twice per day, Imuran 25 mg daily, PhosLo 667 mg three times per day, clonazepam 0.25 mg twice daily, iron sulfate 325 mg three times per day, folate 1 mg daily, Dilaudid 2 mg every six hours as needed for pain, lactulose 30 mL four times per day as needed for constipation, prednisone 5 mg every morning, Sarna topical every day apply to affected areas, multivitamin daily, Coumadin 2.5 mg daily, goal INR 2 to 3, zinc sulfate 220 mg daily, Ambien 5 mg before bed as needed for insomnia, torsemide 200 mg by mouth two times per day, cyclosporine 50 mg twice daily, Colace 100 mg twice daily, insulin NPH 14 units every evening, insulin NPH 46 units every morning, esomeprazole 20 mg once per day, DuoNeb 3/0.5 mg inhaled every six hours as needed for shortness of breath, Aranesp 50 mcg subcutaneously once per week, NovoLog sliding scale before meals, Lexapro 20 mg once per day, Maalox one to two tablets every six hours as needed for upset stomach, and Lipitor 20 mg once per day. Outstanding issues include following INR the goal of 2 to 3, following weight and clinical signs of volume overload, following up on loose stools for possible Clostridium difficile infection, and following clinical signs for evidence of urinary tract infection treating with antibiotics as necessary.	What treatments if any has the patient tried for insomnia in the past	{ "answer_end": [ 2337 ], "answer_start": [ 2224 ], "text": [ "Coumadin 2.5 mg daily, goal INR 2 to 3, zinc sulfate 220 mg daily, Ambien 5 mg before bed as needed for insomnia," ] }
Mr. Raffo is a 59-year-old male with a history of coronary artery disease status post small non-ST elevation myocardial infarction in March of 2000 and also status post cardiac catheterization with 2 vessel disease, small left PICA cerebrovascular accident, congestive heart failure with an echocardiogram in March revealing an ejection fraction of 30%, diabetes mellitus type II complicated by retinopathy, nephropathy and question neuropathy, and hypertension and hypercholesterolemia. On admission, he was on medications including Aspirin daily, Lasix 80 mg p.o. q day, Zaroxolyn 2.5 mg p.o. q day, toprol XL 50 mg p.o. q day, insulin 70/30 65/45, Actos 45 q p.m, Avapro 300 mg p.o. q day, Lipitor 10 mg p.o. q.h.s., and sublingual nitroglycerin p.r.n. For his cardiovascular issues, he was diuresed with doses of Lasix 200 mg b.i.d. IV, as well as Zaroxolyn, with a weight on admission of 135 kg and on discharge of 132 kg. A repeat echocardiogram at Ethool Hospital showed an ejection fraction of 30-35, left ventricular dimensions of 47 mm, 1 plus mitral regurgitation and global hypokinesis, as well as moderate right ventricular dysfunction. His chronic renal insufficiency is likely secondary to poor diabetic control, with a creatinine of 2.5 on March, 2001 and 3.3 at the time of admission. Acute renal failure with increasing creatinine of 6 after aggressive diuresis with a mean of 0.8 percent was treated with Dopamine started on November, 2001 to aid with renal perfusion and diuresis, which was then weaned off on August, 2001. He was discharged home with services and medications including Aspirin 325 mg p.o. q day, Lasix 80 mg p.o. q day, Zocor 20 mg p.o. q.h.s., insulin 70/30 65 units q a.m., insulin 70/30 45 units q p.m., Toprol XL 50 mg p.o. q day, Levaquin 250 mg p.o. q day for a duration of 7 days, and Actos 45 mg p.o. q p.m. He was in stable condition on discharge.	What is the dosage of aspirin	{ "answer_end": [ 1657 ], "answer_start": [ 1607 ], "text": [ "Aspirin 325 mg p.o. q day, Lasix 80 mg p.o. q day," ] }
RECORD #159637 was a 45-year-old male with multiple cardiac risk factors, including known CAD s/p MI (4/14 with PCI to LAD, complicated by instent thrombosis 1 week post-cath->successfully restented), HTN, dyslipidemia, obesity, and positive FHx who was admitted on 4/22/2003 with non-ischemic chest pain. He had an ETT-MIBI in 5/12 which showed large fixed defect in anterior, anteroseptal, anterolateral, inferior, LV apex with EF of 35%. On this occasion, he noted sudden onset of 8/10 chest pain while at rest at 6:30 pm on the evening of admission and was transported to Greena Hospital where his vitals were 98.2, 73, 92/62, 15. He was given IV TNG, heparin, MSO4, ASA with pain down to 4/10 and transferred to ITH. Ruling out ischemia by ensymes and ETT, the patient was discharged on 5/4/2003 with ECASA (Aspirin Enteric Coated) 325 MG PO QD, Folic Acid 1 MG PO QD, Ativan (Lorazepam) 1 MG PO QHS, Nitroglycerin 1/150 (0.4 MG) 1 TAB SL q5min x 3 PRN chest pain, Darvocet N 100 (Propoxyphene Nap./Acetaminophen) 1 TAB PO Q4H PRN Pain, Zocor (Simvastatin) 80 MG PO QHS, Norvasc (Amlodipine) 2.5 MG PO BID, Toprol XL (Metoprolol (Sust. Rel.)) 50 MG PO QD, Altace (Ramipril) 2.5 MG PO QD, Potassium Chloride IV (ref # 68076838) and Immed. Rel. PO (ref #) with Potentially Serious Interaction: Ramipril & Potassium Chloride, Clopidogrel 75 MG PO QD, Vioxx (Rofecoxib) 25 MG PO BID, Protonex (Pantoprazole) 40 MG PO QD, Diet: House/Low Chol/Low Sat. Fat, Activity: Resume Regular Exercise, Follow Up Appointments with Dr. Damon Krzeczkowski and Dr. Lon Willims, Allergy: Atarax (Hydroxyzine Hcl), Sulfa, Number of Doses Required (approximate): 3, and instructions to consider increasing CCB as patient seems to feel it helps his LH, dizziness and to adjust HTN meds as he was relatively hypotensive (SBP 90-110) in hospital (although asymptomatic) and outpatient cardiac rehabillitation.	Has this patient ever been on toprol xl ( metoprolol ( sust. rel. ) )	{ "answer_end": [ 1163 ], "answer_start": [ 1115 ], "text": [ "Toprol XL (Metoprolol (Sust. Rel.)) 50 MG PO QD," ] }
Patient Mariano Librizzi was admitted on 4/21/2005 with a viral infection and severe pulmonary hypertension, and discharged on 9/22/2005 to go home. The discharge medications included ECASA (Aspirin Enteric Coated) 81 MG PO QD, with a potentially serious interaction with Warfarin & Aspirin, COLACE (Docusate Sodium) 100 MG PO BID, LASIX (Furosemide) 160 MG PO BID, GLIPIZIDE 10 MG PO BID, OCEAN SPRAY (Sodium Chloride 0.65%) 2 SPRAY NA QID, COUMADIN (Warfarin Sodium) 5 MG PO QPM, JERICH, JOSPEH, M.D. on order for ECASA PO (ref #91585860), ZOLOFT (Sertraline) 150 MG PO QD, AMBIEN (Zolpidem Tartrate) 10 MG PO QHS, KCL SLOW RELEASE 20 MEQ PO BID, ATROVENT NASAL 0.06% (Ipratropium Nasal 0.06%) 2 SPRAY NA TID, NEXIUM (Esomeprazole) 20 MG PO QD, TRACLEER (Bosentan) 125 MG PO BID, VENTAVIS 1 neb NEB Q3H Instructions: during wake hours, ALBUTEROL INHALER 2 PUFF INH Q4H PRN Shortness of Breath, Wheezing, home O2 (8L NC). The patient was also prescribed K-Dur 20 BID, Nexium 20, Lasix 160 BID, Tracleer 125 BID, Glipizide 80 BID, Coumadin 5/7.5, ECASA 81, Zoloft 100, MVI, Oceanspray 2 Spray NA QID, Ambien 10 QHS, Ventavis nebs Q3H, Albuterol Inhaler 2 puff INH Q4H, KCl Slow Release 20 MEQ PO BID, Colace 100 MG PO BID, Atrovent Nasal 0.06%. The diet was House/Low chol/low sat. fat and 4 gram Sodium and they were advised to do walking as tolerated, with serial enzymes/EKG to be continued and Lasix, KCl, ASA 81 also advised. The patient had a history of depression which had been worse of late and was advised to continue Zoloft and Ambien, and to avoid high Vitamin-K containing foods and to give on an empty stomach (give 1hr before or 2hr after food). The patient was followed by the AH service with ACEi, cephalopsporins, GERD nexium prophylaxis and Coumadin for pulmonary microclots on Bx in tracleer 125 BID, Glipizide 80 BID, Coumadin 5/7.5, ECASA 81, Zoloft. The discharge condition was satisfactory.	Has this patient ever been on cephalopsporins	{ "answer_end": [ 1731 ], "answer_start": [ 1715 ], "text": [ "cephalopsporins," ] }
Arron Umbaugh was admitted on 4/30/2001 and discharged on 7/10/2001 with a code status of full code and disposition of home w/ services. The discharge medications included ASA (Acetylsalicylic Acid) 325 mg PO QD, Atenolol 25 mg PO QD Starting Today (1/24) HOLD IF, Colace (Docusate Sodium) 100 mg PO BID, Lasix (Furosemide) 60 mg PO QD Starting Today (1/24) Instructions: Take 60mg per day for 3 days and then change, Zestril (Lisinopril) 7.5 mg PO QD, on order for KCL IMMEDIATE REL. PO (ref # 85723815) POTENTIALLY SERIOUS INTERACTION: LISINOPRIL & POTASSIUM CHLORIDE Reason for override: will follow, on order for KCL SLOW REL. PO (ref # 68279429), COUMADIN (Warfarin Sodium) 6 mg PO QD, on order for ZOCOR PO (ref # 88249805) POTENTIALLY SERIOUS INTERACTION: WARFARIN & SIMVASTATIN, ZOCOR (Simvastatin) 20 mg PO QHS, on order for ERYTHROMYCIN TP (ref # 53201344) POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & ERYTHROMYCIN, TOPICAL OR OPHTHALMIC, Metformin 1,000 mg PO BID Starting Today (1/24), Prilosec (Omeprazole) 20 mg PO QD, with instructions to take consistently with meals or on empty stomach, and a warning for a potentially serious interaction: Furosemide & Omeprazole, Valacyclovir 1,000 mg PO Q8H X 7 Days, with Tylenol. Please page Dr. Blouir about your eye pain and come to the ED, lasix qd and see Dr. boeshore on wed. as well as daily weights, and to call Dr. Pradel if they can't control their pain due to zoster on your back. The patient was admitted with CHF exacerbation, increased SOB over past few days, orthopnea and PND, with left sided failure and diastolic dysfunction, and IV lasix 40 in ED, which decreased SOB. The patient was also prescribed Metformin 1000 mg PO BID, Prilosec (Omeprazole) 20 mg PO QD, and Valacyclovir 1000 mg PO Q8H X 7 Days with instructions to take consistently with meals or on empty stomach, and a warning for a potentially serious interaction: Furosemide & Omeprazole. Override Notices were added for COUMADIN PO (ref # 29560859), KCL IMMEDIATE REL. PO (ref # 85723815), KCL SLOW REL. PO (ref # 68279429), and ZOCOR PO (ref # 88249805) due to potentially serious interactions: Aspirin & Warfarin, Lisinopril & Potassium Chloride, Warfarin & Simvastatin, respectively. The patient was also instructed to take lasix qd and see Dr. boeshore on wed. as well as daily weights, and to call Dr. Pradel if they can't control their pain due to zoster on their back. The patient was discharged with discharge medications including ASA (Acetylsalicylic Acid) 325 mg PO QD, Atenolol 25 mg PO QD Starting Today (1/24) HOLD IF, Colace (Docusate Sodium) 100 mg PO BID, Lasix (Furosemide) 60 mg PO QD Starting Today (1/24) Instructions: Take 60mg per day for 3 days and then change, Zestril (Lisinopril) 7.5 mg PO QD, COUMADIN (Warfarin Sodium) 6 mg PO QD with instructions to avoid high Vitamin-K containing foods, and ZOCOR (Simvastatin) 20 mg PO QHS with instructions to avoid grapefruit unless MD instructs otherwise.	What was the dosage prescribed of lasix	{ "answer_end": [ 1622 ], "answer_start": [ 1554 ], "text": [ "left sided failure and diastolic dysfunction, and IV lasix 40 in ED," ] }
The patient is a 74-year-old male with a history of acute inferior myocardial infarction in February of 1998 and total occlusion of the mid circumflex with fresh thrombus, complicated by postmyocardial infarction atrial fibrillation with Mobitz type I block, now admitted following syncopal episode. At admission, the laboratory data was significant for a creatinine of 1.6 and a potassium of 5.1. Blood count was normal, CK 39, and cardiac Troponin I 0.02. The patient was loaded on procainamide and MEDICATIONS ON ADMISSION included Aspirin 325 mg q.d., Captopril 75 mg t.i.d., NPH insulin 18 q.a.m. and 8 q.p.m., Procainamide 500 mg t.i.d., and Simvastatin 20 mg once a day. The patient underwent evaluation for possible ischemic causes of an arrhythmia and was initially ruled out for myocardial infarction by serial enzymes and electrocardiograms. On standard Bruce protocol exercise tolerance test mibi, the patient went four minutes and thirty seconds, with maximum heart rate 121 and maximum blood pressure 210/85. He had typical chest pain for angina and chest tightness at peak exercise which was relieved with rest. The mibi images showed a mixed MI in basilar half of the inferior wall and mild peri-infarct ischemia in 3/20 segments in the right coronary artery territory. PAST MEDICAL HISTORY included Coronary artery disease, Diabetes mellitus on insulin, Hypertension, Status post bilateral knee replacements, asbestos exposure, and chronic renal insufficiency. The patient underwent cardiac catheterization which revealed a normal left main, left anterior descending artery with minor irregularities, left circumflex with 90 percent in-stent restenosis in proximal segment with a dominant left circumflex, and right coronary artery with a mid 50 percent lesion. He underwent successful percutaneous transluminal coronary angioplasty of the in-stent restenosis and was subsequently continued on aspirin. After the procainamide was held, the patient underwent electrophysiology study revealing normal sinus node recovery time, impaired AV nodal conduction, no inducible sustained ventricular tachycardia, and no inducible supraventricular tachycardia or atrial fibrillation. The patient was discharged to home with plans to follow-up with his primary cardiologist, perhaps with a Holter or event monitor and was prescribed Aspirin 325 mg q.d., Captopril 75 mg t.i.d., NPH Humulin insulin 18 units q.a.m. and 8 units q.p.m., nitroglycerin sublingual tablets, Vitamin E, and Simvastatin 20 mg q.h.s. The patient will be followed up by his primary care doctor, in particular the posterior cervical single lymph node should be followed up by his primary care physician.	nph humulin insulin	{ "answer_end": [ 615 ], "answer_start": [ 556 ], "text": [ "Captopril 75 mg t.i.d., NPH insulin 18 q.a.m. and 8 q.p.m.," ] }
Mr. Kanaan is a 68-year-old gentleman with stage IV esophageal cancer who presented with progressive shortness of breath over the three days prior to admission and had a known ejection fraction of 20%. His medical regimen was maximized with an ACE inhibitor or statin and baby aspirin was started on him. He was admitted with diarrhea related to chemotherapy, pulmonary edema secondary to decompensated heart failure, and gout in his right great toe. He was diuresed with Lasix and torsemide in addition to his spironolactone dose with a goal of 1.5 liters a day and received Atrovent nebulizers to help with his shortness of breath, with the combination of dopamine, nesiritide, and Lasix drips being most effective. His medications included amiodarone, digoxin, colchicine, Atrovent, lisinopril, spironolactone, torsemide, Ativan, Zocor, and Prilosec, with instructions to follow up with his primary care doctor with DVT prophylaxis with Lovenox. He also received ferrous sulfate 325 mg daily, trazodone 50 mg at night, multivitamins one tablet daily, and simvastatin 80 mg at night. He was discharged home with oxygen to use overnight and when symptomatic.	Was the patient ever given medication for his diuresis	{ "answer_end": [ 717 ], "answer_start": [ 639 ], "text": [ "the combination of dopamine, nesiritide, and Lasix drips being most effective." ] }
This is a 51 year-old female with fibromyalgia, hypertension, and migraine headaches who presented to the Emergency Room with two months of dyspnea at night, paroxysmal nocturnal dyspnea, and orthopnea, and an episode of severe substernal chest pressure associated with shortness of breath after carrying water bottles from her car. In the Emergency Department, V/Q scan was very low probability and lower extremity noninvasive studies were also unremarkable. Her medications on admission included Nortriptyline, methyldopa, hydrochlorothiazide, Zantac, estrogen, Advil, ALternaGEL. She smokes one and one-half packs per day for 30 years. Physical examination showed temperature 97.4, respiratory rate 22, heart rate 100, blood pressure 150/90, anicteric, bibasilar crackles about one-quarter of the way up, regular rate and rhythm with II/VI systolic murmur and no rubs or gallops, benign abdomen, guaiac negative in the Emergency Department, 1+ pedal edema bilaterally, right greater than left, and nonfocal neurological. Laboratory data on admission showed hematocrit 41.6, BUN 13, creatinine 0.6, chest x-ray showed mild pulmonary edema, and electrocardiogram showed normal sinus rhythm at 91, no ischemic changes. She had serial CPKs which were all negative, and was treated with two doses of intravenous Lasix (20 milligrams each) resulting in a moderate diuresis and resolution of her shortness of breath symptoms. An exercise test was done with arm ergometry (30 watts) and her heart rate went from 100 to 129, blood pressure went from 130 systolic to 172, and electrocardiogram showed no ischemic changes. An echocardiogram showed vigorous systolic function of 86%, no valvular lesions, no wall motion abnormalities, and evidence of thickening in her ventricular walls. Given the fact that the patient had an elevated diastolic pressure and did show some early evidence of thickening in her ventricular walls, the decision was then made to begin her on a calcium channel blocker (Verapamil 240 milligrams p.o. q.d.) in addition to her usual medications. She was discharged to home in good condition with discharge medications including Verapamil SR 240 milligrams p.o. q.d., Zantac 300 milligrams q.d., estrogen 1.25 milligrams q.d., Advil 800 milligrams p.o. b.i.d. p.r.n., hydrochlorothiazide 25 milligrams p.o. q.d., methyldopa 250 milligrams q.d., and Nortriptyline 125 milligrams p.o. q.h.s., and an appointment to see a new primary physician at Dowsna Medical Center scheduled for May 1996.	Has the patient had advil in the past	{ "answer_end": [ 582 ], "answer_start": [ 554 ], "text": [ "estrogen, Advil, ALternaGEL." ] }
Patient Scotty P. Orpen, a 76 year-old female with a history of MI (1984), PVD, CVA, DVT, and supraglottic laryngeal SCC who underwent XRT in 2002, presented to the ED with "stabbing pins" CP which initially started next to the L breast in the midaxillary line that radiated to her breast, sternum, neck, and back around to the L midaxillary line. The patient was given ASA, NTG (partial relief, but dropped BP), heparin bolus & cont infusion, FAMOTIDINE 20 MG PO BID, LASIX (FUROSEMIDE) 80 MG PO QD, MOTRIN (IBUPROFEN) 300 MG PO Q6H, ZOCOR (SIMVASTATIN) 20 MG PO QHS, ECASA (ASPIRIN ENTERIC COATED) 325 MG PO QD, and MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach. The patient was also instructed to take the syrup form of MOTRIN with food, and to avoid grapefruit with ZOCOR unless otherwise instructed by the MD. The patient was given a low cholesterol/low saturated fat diet and a 2 gram sodium diet, and instructed to resume regular exercise. The rib film preliminary read was without fracture but did have some loss of height of vertebral bodies suggestive of compression fractures which she was treated with Motrin for muscular pain. The suspicion for CHF and PE was low and no anticoagulation was given, and she was ruled out for MI while in the house. Her pain was thought to be musculoskeletal in origin and was treated with NSAIDS. The patient was discharged with instructions to follow up with Dr. Haddow within 1 week of discharge, to call for an appointment, and to continue to take all of her medications as directed.	Has the patient had previous ecasa (aspirin enteric coated)	{ "answer_end": [ 617 ], "answer_start": [ 573 ], "text": [ "ECASA (ASPIRIN ENTERIC COATED) 325 MG PO QD," ] }
Mr. Mauras is a 72-year-old man with history of stable angina, type 2 diabetes, peripheral vascular disease, former smoking history, and history of seizure disorder with cataracts. He had occasional anginal symptoms prior to discharge and took about two nitroglycerins per week. Over the past week, he had escalating chest pain requiring one nitroglycerin per day. The pain was relieved by rest and nitroglycerin. One week prior to admission, his digoxin was stopped and his amiodarone was decreased. His Plavix was stopped and his Coumadin was held. On the morning of admission, he had chest pain and received Lopressor, Enalapril, Lovenox treatment dose and a Plavix load in the ED. He was found to have flash pulmonary edema and in atrial fibrillation with rapid ventricular response and was taken back to the catheterization lab and given four stents to his saphenous vein graft, OM1 with good resolution of his symptoms. He was transferred to the floor and was given an amiodarone load given his ejection fraction and increased ectopy on telemetry. His troponin had been trended down to the 0.2s by discharge and his beta-blocker and ACE inhibitor were titrated to heart rate and blood pressure. Prior to anticipated discharge, he re-developed flash pulmonary edema secondary to atrial fibrillation with rapid ventricular response and was re-loaded with digoxin. He was started on Mucomyst precath with good effect, had a difficult-to-place Foley, and was started on Flomax with good effect. His creatinine on discharge was 1.2, his metformin was held, and he was continued on Lantus with sliding scale insulin. He was given three units of packed red blood cells given his history of CAD and was prescribed with Amiodarone 200 mg, Enteric-coated aspirin 325 mg, Librium 10 mg, Colace 200 mg, Ferrous gluconate 324 mg, Lasix 40 mg, Nitroglycerin one tab, Dilantin 100 mg, Senna two tabs, Coumadin 3 mg, Lipitor 80 mg, Flomax 0.4 mg, Plavix 75 mg, Lantus 14 units, Metformin 500 mg, Ranitidine 150 mg, Digoxin 0.125 mg, Enalapril 10 mg, and Atenolol 50 mg, with follow-up appointments with his PCP, Dr. Kelley Hernon of Electrophysiology on 7/8/05, and Dr. Daft on 9/20/05, and INR checked on 8/4/05 or 7/8/05 with Coumadin adjusted accordingly.	How often does the patient take senna	{ "answer_end": [ 1891 ], "answer_start": [ 1876 ], "text": [ "Senna two tabs," ] }
This is a 72 year old black female with a history of hypertension, angina, adult onset diabetes, and recurrent syncopal events who was treated with Dilantin for less than a year in 1970 and her last episode was in 1989. She was given Nitro Paste and 1 amp of D50 when she experienced a syncopal event on the morning of admission and her fingerstick glucose was checked. Her medications on admission include aspirin one tablet q d, Questran one pack q d, Micronase 5 mg po q d, Betaxolol eye drops bid to each eye, Pilocarpine eye drops tid to each eye, and eye drops bid to each eye. She also receives monthly Vitamin B12 injections and takes nitroglycerin with chest pain. Physical examination revealed pinpoint constriction of her pupils secondary to her glaucoma eyedrops, bibasilar, coarse crackles in the chest, no jugular venous distention, and nonfocal neurologic exam. Laboratory data includes sodium of 143, potassium of 4.3, chloride of 109, bicarbonate of 20, BUN of 21, creatinine of 1.0, glucose of 160, hematocrit of 43.4, white count of 6.45, and normal coagulation factors. Chest X ray showed a calcific aorta, C spine X ray and head CT were negative, and EKG showed no changes from her baseline. The patient was started on Isordil and Lopressor empirically but these were discontinued and her chest pain is relieved with nitroglycerin. She was discharged to home with plans for a repeat 24 hour Holter as an outpatient with diagnoses of syncope, borderline type II diabetes, stable exertional angina, and glaucoma. Discharge medications include aspirin one tablet po q d, Questran one package po q d, Pilocarpine eye drops tid per eye, Betaxolol eye drops bid per eye, eye drops bid per eye, sublingual nitroglycerin prn chest pain, and Naprosyn 375 mg tid prn.	has there been a prior dilantin	{ "answer_end": [ 185 ], "answer_start": [ 131 ], "text": [ "was treated with Dilantin for less than a year in 1970" ] }
This 54-year-old female with end-stage renal disease on hemodialysis had an apparent VFib arrest at hemodialysis and was admitted to the CCU after being intubated in the Vibay General Hospital ED. She was intubated, received amiodarone and dopamine, as her BP was low. An x-ray revealed diffuse bilateral opacities, possible pulmonary edema versus aspiration pneumonia, and an EKG showed normal sinus rhythm 100 beats per minute with no acute ST changes. Her first set of cardiac enzyme revealed a creatinine kinase of 116 and the MB fraction of 0.7 and troponin T of less than assay and lactate of 1.8. A fistulogram and angioplasty of her right AV fistula was performed on 9/14/06 with prednisone premedication but it was unsuccessful and therefore a left IJ tunneled dialysis catheter was inserted on 10/18/06 with the tip ending in the right atrium. HOME MEDICATIONS at the time of admission included amitriptyline 25 mg p.o. bedtime, enteric-coated aspirin 325 mg p.o. daily, enalapril 20 mg p.o. b.i.d., Lasix 200 mg p.o. b.i.d., Losartan 50 mg p.o. daily, Toprol-XL 200 mg p.o. b.i.d., Advair Diskus 250/50 one puff inhaler b.i.d., insulin NPH 50 units q.a.m. subcu and 25 units q.p.m. subcu, insulin lispro 18 units subcu at dinner time, Protonix 40 mg p.o. daily, sevelamer 1200 mg p.o. t.i.d., tramadol 25 mg p.o. q.6 h. p.r.n. pain. A bronchoscopy was performed on 9/14/06 with prednisone premedication but it was negative for aspiration. The patient had difficulty weaning from vent and was finally extubated on 0/22/06. She had a single set of coag-negative Staph positive blood cultures from Quinton catheter on 8/8/06 and was treated with vancomycin dose by renal levels. An Echo on 8/1/06 showed an EF of 60 to 65% with mild concentric left ventricular hypertrophy and no wall motion abnormalities. The patient was continued on telemetry and treated with her home dose of beta-blocker with good response and was gradually advanced to an oral diet with no signs of aspiration status post extubation. She was also given heparin subcutaneously and Nexium as prophylaxis. The patient is full code and will likely need rehab and is being screened by PT and OT and will likely be discharged to rehab when bed is available.	Has this patient ever been treated with protonix	{ "answer_end": [ 1303 ], "answer_start": [ 1246 ], "text": [ "Protonix 40 mg p.o. daily, sevelamer 1200 mg p.o. t.i.d.," ] }
This 70-year-old woman with a complex medical history, including cerebrovascular accident x two in 1980s without deficits, seizure history probably secondary to ETOH withdrawal, hypertension x 30 years, asthma, gout, and status post repair of subclavian artery stenosis in 1993, presented to the Dagha Medical Center with severe chest pain. A chest CT revealed a 2.3 x 2.8 cm lobulated mass in the right lower lobe involving the pleura, with extensive hilar and mediastinal constitutions consistent with prior granulomatous disease, and tests were positive for multiple precarinal and right peritracheal areas of adenopathy recent from metastatic disease. The patient was admitted to the Thoracic Surgery Service on 3/27/99 and taken to the Operating Room for a video assisted thorascopic right lower lobe lobectomy by Dr. Minick. Postoperatively, the patient did well, with no complications, and was followed by the Internal Medicine Service. The patient went into rapid atrial fibrillation postoperatively, and was successfully converted into a normal sinus rhythm using Diltiazem IV, which was converted to p.o. Diltiazem. The patient's postoperative course was largely unremarkable but for dysrhythmia, and the patient's pain was well controlled with p.o. pain medications, Percocet. Final pathology was read as squamous cell carcinoma, 4.0 cm., moderately differentiated with focal characterization with extensive necrosis. The patient was discharged to home with medications including Adalat 200 mg p.o. b.i.d., Zantac 150 mg p.o. b.i.d., Magnesium Oxide 40 mg t.i.d., Ultram 300 mg q.d., Trazodone 100 mg q.h.s., Azmacort 80 mg p.r.n., aspirin 81 mg q.d., Dyazide 25 mg q.d., nose spray b.i.d., calcium chloride pills q.d., Colchicine 600 mg q.d., cyproheptadine hydrochloride 4 mg b.i.d. q.h.s., anticholesterol med., Albuterol nebulizers 250 mg q.4h., Allopurinol 300 mg q.d., Colchicine 0.6 mg q.d., cyproheptadine hydrochloride by mouth 400 mg q.d., Digoxin 0.125 mg q.d., Diltiazem 30 mg t.i.d., Colace 100 mg t.i.d., Lasix 40 mg p.o. q.d., Percocet 1-2 tablets p.o. q.4h. p.r.n., Dilantin 200 mg p.o. b.i.d., and Trazodone 100 mg p.o. q.h.s., with follow-up with Thoracic Surgery Service as well as with primary care physician and Cardiology as needed.	has the patient used allopurinol in the past	{ "answer_end": [ 1909 ], "answer_start": [ 1861 ], "text": [ "Allopurinol 300 mg q.d., Colchicine 0.6 mg q.d.," ] }
Mr. Lumadue is a 68-year-old man with significant cardiac history and vascular disease who came in with a chief complaint of hip pain after a mechanical fall. At that time, his hospital course was complicated by a non-Q wave MI, and Cardiology recommended medical management with Lopressor. An echocardiogram revealed an ejection fraction of 45%, and Dobutamine MIBI revealed a severe fixed perfusion defect in the inferoposterior and inferoseptal left ventricle with an ejection fraction of 26%. His medications included HCTZ 50 mg PO q.d., enteric-coated aspirin 325 mg PO q.d., Zestril 20 mg PO q.d., glyburide 5 mg PO q.d., multivitamins, and cough medicine PRN. Upon admission, his vital signs were afebrile, temperature 97.3, tachycardia, heart rate 106, blood pressure 162/77, oxygenation 94% on room air. X-rays of his left pelvis and femur revealed fracture of the left intertrochanter and subtrochanteric fracture with lesser trochanteric fracture intact by 3 cm, less than five degrees angulation. His femoral head was reduced. During his hospital course, the patient was started on a beta blocker, Ace inhibitor, and continued on an aspirin. He was aggressively diuresed with Lasix for diuresis and was treated with vancomycin, Flagyl, and levofloxacin for presumed aspiration pneumonia. He was continued on Lovenox 60 mg subcu. b.i.d. for prophylaxis against DVT post-hip surgery to continue for six months minimal followed by orthopedic surgery, and restarted on oral hypoglycemics prior to discharge in addition to sliding scale insulin. He was discharged on standing 20 mEq of K-Dur q.d., lisinopril 5 mg PO q.d., hold for systolic blood pressure less than 100, Lasix 100 mg PO q.d., Lovenox 60 mg subcu. b.i.d. x6 months, glipizide 2.5 mg PO q.d., sliding scale insulin, Nexium 20 mg PO q.d., Silvadene wet-to-dry dressing, DuoDerm to left lower leg wound and change q.3 days, and Lopressor 12.5 mg PO t.i.d., hold for systolic blood pressure less than 100. He was maintained on Nexium prophylaxis in the setting of his anticoagulation and on two liters of nasal cannula oxygen at the time of transfer to rehab. Upon discharge, he was instructed to follow up with his primary care physician, orthopedic surgery, cardiology, and pulmonary medicine within two weeks, with labs for a metabolic panel, magnesium, and calcium q.o.d. and physical therapy as needed, with a weightbearing status of non-weightbearing on the left lower extremity and weightbearing as tolerated on the right lower extremity.	Has the patient ever had k-dur	{ "answer_end": [ 1604 ], "answer_start": [ 1553 ], "text": [ "He was discharged on standing 20 mEq of K-Dur q.d.," ] }
This 64-year-old male with a history of coronary artery disease, CHF, EF of 15%, status post AVR, and NSTEMI initially presented to outside hospital with chief complaint of shortness of breath and was found to have a BNP of 747 as well as a troponin I of 0.43. He was diuresed, started on Carvedilol and improved, and placed on a heparin drip. His medications on admission included Aspirin 81, Lisinopril 20, Plavix 75, Verapamil 240 sustained release, Gemfibrozil 600 b.i.d., Nystatin 500 b.i.d., Paxil 20 daily, Glipizide 10 daily, Coumadin 4 prior to admission to outside hospital, Carvedilol 6.25 daily, heparin drip and Spironolactone. During his hospital stay, he was continued on Aspirin, Plavix, beta-blocker and ACE inhibitor, which were titrated to effect, started on a statin and continued on Niaspan, and maintained on a nicotine patch. He was also prescribed Spironolactone 25 mg p.o. daily, Atorvastatin 80 mg daily, Niaspan 0.5 gm p.o. twice daily, and Coumadin 5 mg p.o. at night. The patient's diabetes was controlled with regular insulin and placed back on his oral hypoglycemics, which were discontinued on admission and was encouraged to stop smoking. He had runs of ectopy and SVT, so was placed on a heparin drip. Left heart cath revealed wall defect consistent with a right coronary artery infarct and the patient was continued on Spironolactone. He was discharged in a stable condition on Aspirin 325 p.o. daily, Lisinopril 4 mg p.o. daily, Nicotine patch 14 mg per day topical, Spironolactone 25 mg p.o. daily, Paxil 25 mg p.o. daily, Atorvastatin 80 mg daily, Niaspan 0.5 gm p.o. twice daily, Carvedilol 12.5 mg p.o. twice daily, Plavix 75 mg daily, Gemfibrozil 900 mg p.o. twice daily and Coumadin 5 mg p.o. at night, with instructions to follow up with PCP and Cardiology as well as EP, to check his daily weights and report any increases to his PCP, and to arrange to have his INR drawn on 6/21/06 and follow-up INRs to be drawn every seven days.	Is there a mention of of plavix usage/prescription in the record	{ "answer_end": [ 476 ], "answer_start": [ 409 ], "text": [ "Plavix 75, Verapamil 240 sustained release, Gemfibrozil 600 b.i.d.," ] }
A 58 year old female smoker with a history of Coronary Artery Disease (CAD), Cirrhosis, Diabetes Mellitus Type II (DMII), Hypertension (HTN), and Hyperlipidemia was admitted to the CCU after an elective cardiac catheterization following an abnormal stress test. The cath showed impaired flow in the inferior and posterolateral zones due to obstructive degenerative disease in the SVGs to the RCA and LCF-OM, and a stent was placed in the RCA graft though there was extensive calcification and difficulty obtaining full stent expansion. After the stent deployment there was poor reflow accompanied by mild chest pain and EKG changes, without hemodynamic embarrassment. The patient experienced jaw and chest pain post-procedure which she described as different from previous episodes of angina. The pump-function was preserved, BP low-normal, and rhythm was NSR on telemetry. For pulmonary issues, the patient had a chronic cough due to post nasal drip which was taken off of her antihistamine on admission and CXR was normal with no acute changes. There were no renal issues during the hospital course and the patient was on Lantus, Novolog SS, and FS Glu monitored while in the hospital. Heme-wise, the patient had a cath and subsequent oozing from the site in the groin and was discharged on home meds including Plavix and ASA. Medications prescribed include ENTERIC COATED ASA 325 MG PO DAILY, TESSALON PERLES ( BENZONATATE ) 100 MG PO TID, PLAVIX ( CLOPIDOGREL ) 75 MG PO DAILY, CODEINE PHOSPHATE 15 MG PO Q3H PRN Pain, DEXTROMETHORPHAN HBR 10 MG PO Q6H PRN Other:cough, ZETIA ( EZETIMIBE ) 10 MG PO DAILY, LANTUS ( INSULIN GLARGINE ) 20 UNITS SC BEDTIME, POTASSIUM CHLORIDE IMMED. REL. ( KCL IMMEDIATE... ) 1.Only KCL Immediate Release products may be used for KCL, 4.As per SMH Potassium Chloride Policy: each 20 mEq dose, on order for DIOVAN PO ( ref # 032637277 ), VALSARTAN Reason for override: aware, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach, MAGNESIUM GLUCONATE Sliding Scale PO ( orally ) DAILY: -> Mg-scales cannot be used and magnesium doses must be, If Mg level is less than 1 , then give 3 gm Mg Gluconate, NITROGLYCERIN 1/150 ( 0.4 MG ) 1 TAB SL q5min x 3, OXYCODONE 5-10 MG PO Q6H PRN Pain, PINDOLOL 5 MG PO BID HOLD IF: sbp<90 , HR<50, ZOCOR ( SIMVASTATIN ) 80 MG PO BEDTIME, DIOVAN ( VALSARTAN ) 160 MG PO DAILY, Lantus 40u qd Estradiol 0.05, Diltiazem 180 mg qd HCTZ 25 mg qd, Zetia 10mg qd, Plavix 75 mg qd, Zocor 80 mg qd, ASA 325 mg qd, Famotidine 20 mg BID, Lovenox 40 sc qd, nicotine patch MgSO4 qd, Novolog SS Pt as outpt and heparin and Integrelin have been discontinued, insulin, and was stable post cath, with anticoagulation stopped. The patient was prescribed ENTERIC COATED ASA 325 MG PO DAILY, TESSALON PERLES ( BENZONATATE ) 100 MG PO TID, PLAVIX ( CLOPIDOGREL ) 75 MG PO DAILY, CODEINE PHOSPHATE 15 MG PO Q3H PRN Pain, DEXTROMETHORPHAN HBR 10 MG PO Q6H PRN Other:cough, ZETIA ( EZETIMIBE ) 10 MG PO DAILY, LANTUS ( INSULIN GLARGINE ) 20 UNITS SC BEDTIME, POTASSIUM CHLORIDE IMMED. REL. ( KCL IMMEDIATE... ), 1.Only KCL Immediate Release products may be used for KCL, 4.As per SMH Potassium Chloride Policy: each 20 mE	What medications if any has the patient tried for other:cough in the past	{ "answer_end": [ 1573 ], "answer_start": [ 1523 ], "text": [ "DEXTROMETHORPHAN HBR 10 MG PO Q6H PRN Other:cough," ] }
Mr. Royce Meidlinger is a 78-year-old male who was admitted on 11/12/05 with ADMISSION MEDICATIONS including Atenolol 25 mg daily, allopurinol 300 mg daily, and Flomax 0.8 mg daily. Cardiovascularly, he was on aspirin and had a pacemaker for sick sinus and was saturating well on 2 liters of oxygen delivered by Dobbhoff. Respiratorily, white count at preop baseline was afebrile completing 21 day course of linezolid for EC bacteremia and chest x-ray improved after adding low-dose Lasix. Renally, there was a postoperative increase in creatinine requiring dopamine 2 mcg, continued high chest tube output and an official echo report showed moderate TR, with no changes from prior echos. Hematology was treated with aspirin and anticoagulation and he had left upper extremity DVT as well, was started on argatroban, PTT to be therapeutic, with argatroban dose increased from 0.1 to 0.2, bridging to Coumadin, and argatroban dose reduced to maintain PTT of 50. He had profuse GI bleeding requiring 3 units of packed red blood cells, 2 units packed red blood cells with improvement in hematocrit, NG-tube aspiration with melena, and was HIT positive with worsening clinical syndrome. Foley was put in place with Lasix for reduced urine output and left hand demarcated with argatroban dose increased from 0.1 to 0.2, bridging to Coumadin, restarting Coumadin, postop day #51, patient went to OR with plastics for toe finger amputations/left hand debridement, holding tube feeds, was on triple antibiotic therapy for sputum/blood culture, and rehabilitation when restarting Coumadin. Postop day #54	Has the patient ever been on dopamine.	{ "answer_end": [ 573 ], "answer_start": [ 500 ], "text": [ "here was a postoperative increase in creatinine requiring dopamine 2 mcg," ] }
Mr. Kanaan is a 68-year-old gentleman with stage IV esophageal cancer who presented with progressive shortness of breath over the three days prior to admission and had a known ejection fraction of 20%. His medical regimen was maximized with an ACE inhibitor or statin and baby aspirin was started on him. He was admitted with diarrhea related to chemotherapy, pulmonary edema secondary to decompensated heart failure, and gout in his right great toe. He was diuresed with Lasix and torsemide in addition to his spironolactone dose with a goal of 1.5 liters a day and received Atrovent nebulizers to help with his shortness of breath, with the combination of dopamine, nesiritide, and Lasix drips being most effective. His medications included amiodarone, digoxin, colchicine, Atrovent, lisinopril, spironolactone, torsemide, Ativan, Zocor, and Prilosec, with instructions to follow up with his primary care doctor with DVT prophylaxis with Lovenox. He also received ferrous sulfate 325 mg daily, trazodone 50 mg at night, multivitamins one tablet daily, and simvastatin 80 mg at night. He was discharged home with oxygen to use overnight and when symptomatic.	What is the patient's current dose does the patient take of her ativan	{ "answer_end": [ 832 ], "answer_start": [ 825 ], "text": [ "Ativan," ] }
A 74-year-old female with pulmonary sarcoid, CHF, and CRI presented with SOB after stopping Lasix several weeks ago. On admission, she was in mildly decompensated CHF and was started on more aggressive diuresis with Lasix 40 IV BID increased to 80 BID on HD2, with Cardiology Service consulting, then increased to Lasix drip at 15/hr on HD3 with I/O goal 1-2 l neg. She did well on this and by HD5 was near her dry weight of 49kg and her drip was transitioned back to PO Lasix. She was continued on Hydralazine, Lopressol and Isordil on HD3, titrated up to 20 TID. She has history of MI with stents and was continued on ASA, Plavix, Zocor, Coumadin (ref#960263524) PO, MVI Therapeutic 1 TAB PO QD, Iron Sulfate 325 MG PO TID, Folate 1 MG PO QD, Calcium Carbonate 500 MG PO TID, Acetylsalicylic Acid 81 MG PO QD, Colace 100 MG PO BID, Prednisone 10 MG PO QAM, Sodium Bicarbonate 325 MG PO TID, Flovent 220 MCG INH BID, Bactrim DS, Plavix 75 MG PO QD, Esomeprazole 40 MG PO QD, Duoneb, Glipizide XL 2.5 MG PO QD, Vit. B-3, Lipitor 40 MG PO QD, Atorvastatin Calcium, Lovenox 50 MG SC QD, and Insulin Regular Human (Sliding Scale subcutaneously SC AC: if BS is 125-150, then give 2 units; if BS is 151-200, then give 3 units; if BS is 201-250, then give 4 units; if BS is 251-300, then give 6 units; if BS is 301-350, then give 8 units; if BS is 351-400, then give 10 units). She was discharged to Wadesdi Ckgart Community Hospital at a euvolemic state with a dry weight of 49kg, continuing on Lasix 80 PO BID unless Cr rises above new baseline of 3.5 or if she gains weight or shows signs of new overload, and Lovenox should be stopped once her INR is >2. Coumadin dose should be adjusted according to INR goal 2-3, and she should be on a renal diet with low potassium and low glucose but with diabetic caloric supplements like GLUCERNA. She should receive a HOT PACK to her neck 2-3x per day and to her vein before blood draw for comfort, physical therapy daily with the goal of gait stability, home safety, and good O2 sats on 2L O2, and VNA services for meds. She should follow up with PCP, renal, and cardiology, and return to the hospital or call doctor if she experiences worsening SOB, fever over 100.5, chest pain, decreased urine output, weight gain over 5 pounds, or any other concerning symptoms. The patient was prescribed ACETYLSALICYLIC ACID 81 MG PO QD, CALCIUM CARBONATE (500 MG ELEMENTAL CA++) 500 MG PO TID, COLACE (DOCUSATE SODIUM) 100 MG PO BID, IRON SULFATE (FERROUS SULFATE) 325 MG PO TID, FOLATE (FOLIC ACID) 1 MG PO QD, LASIX (FUROSEMIDE) 80 MG PO BID, HYDRALAZINE HCL 25 MG PO TID HOLD IF: SBP<90, INSULIN REGULAR HUMAN Sliding Scale (subcutaneously) SC AC, ISORDIL (ISOSORBIDE DINITRATE) 20 MG PO TID, LOPRESSOR (METOPROLOL TARTRATE) 12.5 MG PO TID, DILANTIN (PHENYTOIN) 100 MG PO QID, POTENTIALLY SERIOUS INTERACTION: PHENYTOIN & WARFARIN, PREDNISONE 10 MG PO QAM, SODIUM BICARBONATE 325 MG PO TID, COUMADIN (WARFARIN SODIUM) 5 MG PO QPM, POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & WARFARIN, SERIOUS INTERACTION: SULFAMETHOXAZOLE & WARFARIN, MVI THERAPEUTIC (THERAPE	Has patient ever been prescribed glipizide xl	{ "answer_end": [ 1010 ], "answer_start": [ 984 ], "text": [ "Glipizide XL 2.5 MG PO QD," ] }
Mr. Gramby is a 43-year-old man with morbid obesity, type II diabetes, hypertension, hyperlipidemia, chronic renal insufficiency, and severe peripheral arterial disease status post femoral popliteal bypass in July which was complicated by repeated return of cellulitis x 2 who was admitted with cellulitis and volume overload. He was initially treated with courses of intravenous nafcillin and vancomycin for four weeks, having been seen by Vascular Surgery five days prior to admission and had been started on dicloxacillin for a third episode of cellulitis. He had also presented with fluid overload and spironolactone was added to his diuretic regimen. The patient was prescribed Atenolol 100 mg q.d., spironolactone, torsemide 160 mg b.i.d., Hyzaar 50/12.5 q. day, lisinopril 60 mg q. day, Neurontin 1200 mg t.i.d., Norvasc 10 mg q.a.m. and 5 mg q.p.m., Coumadin 8 mg, aspirin, Humalog sliding scale, Percocet, Pletal 100 mg b.i.d., Procrit, Zantac, nitroglycerin p.r.n., and NPH 80 q.a.m. and q.p.m. His torsemide was changed to IV and metolazone was added on the first day of admission and his electrolytes were replaced as needed. He was hypertensive on arrival, which was treated with Hydralazine initially and transitioned to his p.o. home medicines, with Hydralazine p.o. added on hospital day #9 to lower his systolic blood pressure to the range of the 120s-130s. His Coumadin was restarted when his INR was 2.2 and he his now in the therapeutic range and will need to be followed. The patient is on NPH and Humalog, with NPH doses increased to 90 units in the morning and 85 units at night, and the goal for this patient is below 150 particularly given the need for wound healing. Additional antibiotic coverage was added specifically of fluoroquinolone for anti-psuedomonal coverage for his diabetic foot ulcers, with surgical debridement done in the operating room with drainage of pus, but the metal showed could not be located even with fluoroscopy. The patient will complete a 14-day course of levofloxacin and clindamycin for these foot ulcers, and will be discharged home with visiting nursing care for b.i.d. wet-to-dry dressing changes. He will follow up with Jerold Cristopher Blazon, M.D. in one to two weeks, go home with visiting nurse care, and will need to see his nephrologist, vascular surgeons, primary care provider, and Bariatric Surgery following discharge.	Has the patient taken any medications for cellulitis. management	{ "answer_end": [ 524 ], "answer_start": [ 421 ], "text": [ "having been seen by Vascular Surgery five days prior to admission and had been started on dicloxacillin" ] }
The patient is a 26-year-old female with a past medical history significant for Hodgkin's lymphoma, splenectomy, asthma, and history of tobacco use, who presented to our service with symptoms of congestive heart failure. She underwent an elective mitral valvuloplasty on November, 2003, with size 26 Cosgrove-Edwards ring and vegectomy, where epinephrine was used to maintain proper pressure and subsequently weaned off. On postoperative day #1, diuresis was increased and a low dose beta blocker was started, which she tolerated well. Baby aspirin and Neurontin 300 mg q.d. were also begun. The patient was discharged to home with VNA assistance with follow up recommendations and medications including enteric-coated aspirin 81 mg p.o. q.d., Colace 100 mg p.o. b.i.d. x 7 days, Lasix 60 mg p.o. q.d., ibuprofen 800 mg p.o. q.8h. p.r.n. pain, Lopressor 25 mg p.o. t.i.d., Niferex 150 mg p.o. b.i.d., Atrovent nebulizer 0.5 mg nebulized q.i.d., Neurontin 300 mg p.o. q.d., K-Dur 30 mEq p.o. q.d. to be discontinued or decreased if Lasix dose is changed, and Flovent 44 mcg/inh b.i.d. The patient was also consulted with the Department of Neurology for persistent numbness and tingling of the left lower extremity, for which Neurontin 300 mg q.d. was prescribed. With aggressive diuresis, the patient was able to regain her postoperative weight and by the day of discharge was 1.7 kilograms below her preoperative weight. The patient is anticipated to return to her full preoperative level of independent functioning with continued cardiovascular rehabilitation and VNA assistance.	Why has the patient been prescribed epinephrine	{ "answer_end": [ 391 ], "answer_start": [ 343 ], "text": [ "epinephrine was used to maintain proper pressure" ] }
A 83 year old female with hereditary angioedema was admitted to the hospital with abdominal pain which was not relieved by Stanazolol, and she had diarrhea, nausea/vomiting, sweats, and decreased PO intake. She was given 6 units FFP with premedication of IV Benadryl on the first night of her hospitalization, Stanazolol 4 mg q4h overnight, which was changed to bid on second hospital day, Zantac, and Lovenox. The patient was maintained on Acetylsalicylic Acid 81 mg PO qd, Vit C 500 mg PO bid, Atenolol 75 mg PO qd, hold if sbp <100 or hr <60, Digoxin 0.125 mg PO qod (Sun, Tues, Thurs), Potentially serious interaction: Digoxin & Levothyroxine Sodium, Vit E 400 units PO qd, Pepcid 20 mg PO qd, Colace 100 mg PO bid PRN constipation, Senna Tablets 2 tab PO bid PRN constipation, Lasix 20 mg PO qd, Keflex 500 mg PO qid x 28 doses, and on order for Synthroid PO (ref. #66804792), Lasix PO (ref. #91042032), and Keflex PO (ref. #63524947). She was also continued on her home dose of Synthroid, Rhinocort (Budesonide Nasal Inhaler) 2 spray na bid, and Allegra (Fexofenadine HCl) 60 mg PO bid. She was discharged with instructions to follow up with allergy and to call her doctor if she develops fevers, worsening of her abdominal pain, or other concerning symptoms. Follow up appointments were made with Dr. Morrell and Dr. Guadagnolo or Dr. Yoes for 1-2 weeks.	Is the patient currently or have they ever taken stanazolol	{ "answer_end": [ 340 ], "answer_start": [ 267 ], "text": [ "on the first night of her hospitalization, Stanazolol 4 mg q4h overnight," ] }
The patient is a 54 year old white male with cardiac risk factors of diabetes, borderline hypertension, male gender, and a positive family history, who presented to Leyson Memorial Hospital complaining of substernal chest pain. On arrival to Icoson Hospital, the patient's blood pressure was 126/80 and heart rate was 80, and the electrocardiogram showed new ST depressions in V2-V5, T wave inversions in AVL, and flat T's in 1 and V6. The patient was treated with two sublingual nitroglycerins and sent to the Mendwood Hospital. On route to Icoson Hospital, the patient received an aspirin, a sublingual nitroglycerin, nitro paste, Lopressor 5 mg x 1 intravenously, and intravenous heparin. Upon transfer to the CCU, the patient was pain free and was maintained on heparin and intravenous nitroglycerin for 72 hours after admission. The patient was started on Lopressor and Glucotrol 5 mg p.o. q.d., as well as enteric-coated aspirin at admission, and was maintained on his glipizide and atenolol, 50 mg p.o. q.d., and enteric-coated aspirin, as well as nitroglycerins p.r.n. chest pain. Two days after the cardiac catheterization, the patient was pain free and was maintained on heparin overnight. The patient's condition at the time of discharge was stable, and was discharged with diabetic teaching as an outpatient with CH, follow-up with Dr. Kalert, atenolol 50 mg PO q.d., sublingual nitroglycerins PRN chest pain, and Glucotrol 5 mg PO q.d.	lopressor	{ "answer_end": [ 691 ], "answer_start": [ 620 ], "text": [ "nitro paste, Lopressor 5 mg x 1 intravenously, and intravenous heparin." ] }
This 90+-year-old male with a complex past medical history including CAD, CHF, AF and diabetes mellitus presented to the SICU for removal of chronically MRSA-infected mesh from prior abdominal surgery. He was intubated with etomidate, succinylcholine and kept sedated with Versed and fentanyl. He received intraoperative vancomycin and levofloxacin as well as 2200 mL of lactated Ringer's. In an attempt to reverse anticoagulation, one unit of FFP was begun but then aborted due to hypotension, which resolved with epinephrine injection, likely due to transfusion reaction. Another unit of FFP was administered, with platelets also given at the request of the Plastic Surgery Team in light of aspirin and Plavix, which were continued due to the patient's cardiac stents. Despite bolus Lasix, the patient did develop CHF with symptomatic pulmonary edema and increased oxygen requirement, concomitantly becoming delirious. He developed hypertension refractory to beta-blockade, calcium channel blockers and IV ACE inhibitors, and was thus placed on a nitroglycerin drip, a furosemide drip with ginger blood product resuscitation to address bleeding and an elevated INR, responding well to this regimen and aggressive pulmonary toilet. The patient was advanced to clear liquids, on medications including Amiodarone 200 mg p.o. daily, Calcium, Colace 100 mg by mouth t.i.d., Coumadin alternating doses of 4 mg and 3 mg, Diltiazem CD 360 mg p.o. daily, Aspirin 81 mg p.o. daily, Folate 1 mg p.o. daily, Lisinopril 10 mg p.o. daily, Metamucil p.r.n., Clopidogrel 75 mg p.o. daily, Potassium, Protonix 40 mg p.o. daily, Simvastatin 80 mg p.o. daily, Synthroid 25 mcg p.o. daily, Thiamine 100 mg p.o. daily, Metoprolol SR 100 mg p.o. b.i.d., Zyprexa 2.5 mg at bedtime p.r.n., and Vancomycin for MRSA-infected mesh. He does experience more significant delirium with morphine and less so with sparing Dilaudid p.r.n., and Haldol is written p.r.n. as needed. Weaning off nitroglycerin drip, nitro paste added, hematocrit 25%, one unit of packed red blood cells with Lasix and potassium to be given, RISS, and PICC line consult ordered for anticipated long-term vancomycin. Services following the patient include Medicine, Dr. Harcar, patient's PCP, Cardiology, Dr. Pagliari, and Plastic Surgery, Dr. Dunshie. Patient anticipated to be transferred to the floor on 9/28/06.	Previous simvastatin	{ "answer_end": [ 1642 ], "answer_start": [ 1613 ], "text": [ "Simvastatin 80 mg p.o. daily," ] }
Mr. Zack Nieman is a 62-year-old white man with ischemic cardiomyopathy, status post coronary artery bypass graft in 1985 with left internal mammary artery to left anterior descending, saphenous vein graft to posterior descending artery, saphenous vein graft to obtuse marginal branch, and a repeat coronary artery bypass graft done in 1995 with saphenous vein graft to first diagonal, saphenous vein graft to obtuse marginal, and saphenous vein graft to posterior descending artery. He had multiple episodes of pulmonary congestion and was admitted to Rorea Valley Health for IV diuresis. EKG revealed atrial flutter with variable block (2:1 versus 3:1), rate around 120, left bundle branche block, and echocardiogram revealed ejection fraction about 25% with 2+ mitral regurgitation. On admission, his temperature was 97.1, pulse 103, blood pressure 148/94, respirations 18, and O2 saturation 97% on two liters. Because of his rapid ventricular response, Digoxin was started with a loading dose of 0.5 mg, then 0.25 mg times two q. six hours, and the patient was then on a maintenance dose of Digoxin at 0.125 mg p.o. q. day, and his Digoxin level has been maintained around 0.9. For his rate control, the amiodarone was also increased to 400 mg q. day, and the patient was started on anticoagulation with heparin. The patient underwent cardioversion through his AICD by the Electrophysiological Service with successful conversion to normal sinus rhythm, and was loaded with Coumadin and meanwhile on heparin until INR between 2-3. The patient developed hyperthyroidism secondary to amiodarone, treated with PTU, then developed hypothyroidism, treated with Levothyroxine. He was discharged on Amiodarone 400 mg p.o. q.d., Captopril 25 mg p.o. t.i.d., clonazepam 1 mg p.o., Lasix 80 mg p.o. b.i.d., glipizide 5 mg p.o. q.d., levothyroxine sodium 100 mcg p.o. q.d., magnesium oxide 420 mg p.o. q.d., Lopressor 25 mg p.o. b.i.d., nitroglycerin 1/150 (0.4 mg) one tab sublingual q. five minutes times three, Coumadin 5 mg p.o. q. day until INR between 2-3 then the dose needs to be adjusted accordingly to maintain INR between 2-3, Simvastatin 20 mg p.o. q. h.s., Klonopin 0.5 mg p.o. q. a.m., Digoxin 0.125 mg p.o. q.d., isosorbide, mononitrate-SR 30 mg p.o. q.d., and troglipazone 400 mg p.o. q. day.	Has a patient had amiodarone.	{ "answer_end": [ 1255 ], "answer_start": [ 1204 ], "text": [ "the amiodarone was also increased to 400 mg q. day," ] }
Patient Omar J. Coolbaugh, a 71-year-old female post cardiac transplant with allograft coronary artery disease, bilateral carotid disease, TIA, diabetes, and obesity, was admitted on 11/8/2007 and discharged on 4/14/2007 with s/p angioplasty and stenting. The medications on admission included Mycophenolate Mofetil 1000 mg PO BID, Oxybutynin Chloride XL 10 mg PO QD, Insulin Glargine 20 units SC QAM, Furosemide PO QD, Clopidogrel 75 mg PO QD, Pravastatin 40 mg PO QHS, Prednisone 5 mg PO QD, Cyclosporine (Sandimmune) 75 mg PO BID, Metoprolol Succinate Extended Release 50 mg PO QD, and Fenofibrate (Tricor) 48 mg PO QD. Elective cardiac catheterization was performed, revealing double vessel disease and successful PTCA/Stenting of LAD was done using XB3.5 guide, BMW, with no residual stenosis. The patient was advised to take Enteric Coated ASA 325 mg PO Daily, Plavix (Clopidogrel) 75 mg PO Daily, Cyclosporine (Sandimmune) 75 mg PO BID, Tricor (Fenofibrate (Tricor)) 48 mg PO Daily, Lasix (Furosemide) 40 mg PO Daily, Insulin Glargine 20 units SC Daily, Toprol XL (Metoprolol Succinate Extended Release) 50 mg PO Daily, CellCept (Mycophenolate Mofetil) 1,000 mg PO BID, Ditropan XL (Oxybutynin Chloride XL) 10 mg PO Daily, Pravachol (Pravastatin) 40 mg PO Bedtime, Prednisolone Sodium Phosphate 5mg/5ml 5 mg PO Daily, and vitamins, with ASA 325 and Plavix for life and other medications at usual doses, plus TNG 0.4 mg (Nitroglycerin 1/150 (0.4 mg)) 1 tab SL q5min x 3 doses PRN Chest Pain. The importance of both aspirin and taking medications consistently was stressed and the patient understands, with diet house/low chol/low sat. fat and activity light activity with no heavy lifting or driving x 2 days, ok to shower, no swimming or bathing x 5 days and lift restrictions of not lifting greater then 10-15 pounds. Follow up appointments were scheduled for Heart Failure Clinic 2-4 weeks and patient was discharged in stable condition and advised to drink plenty of fluids over the next several days, and to call with any questions or concerns.	Has the patient ever been on pravachol ( pravastatin )	{ "answer_end": [ 1271 ], "answer_start": [ 1230 ], "text": [ "Pravachol (Pravastatin) 40 mg PO Bedtime," ] }
A 45-year-old man with a history of familial cardiomyopathy and status post cardiac transplant in 2002, and chronic renal insufficiency presented with greater than two weeks of polyuria, polydipsia, blurry vision, muscle cramps, and myalgias and reported approximately a 15-pound weight loss over three weeks with decrease in usual lower extremity edema. On admission, notable for a blood glucose of 1064, creatinine 2.2 from a baseline of 1.8, sodium 130, potassium 4.9. Endocrine service was consulted and the patient was controlled with a combination regimen of Lantus, Novolog q. a.c., combined with a Novolog sliding scale. The patient was discharged with followup with Napoleon Mettee, the diabetic teaching nurse and with Dr. Jonson in the diabetes clinic and with VNA services to assist with home medications. The patient had mild acute gout flare during admission for which he was started on colchicine. The patient was discharged with medications including Calcium carbonate 1250 mg t.i.d., Cartia XT 300 mg daily, CellCept 1500 mg b.i.d., colchicine 0.6 mg daily p.r.n., Neoral 150 mg b.i.d., folate 1 mg daily, K-dur 20 mg daily, magnesium oxide 400 mg b.i.d., methotrexate 2.5 mg daily, Pravastatin 20 mg daily, prednisone 7 mg daily, Rocaltrol 0.25 mg daily, Synthroid 150 mcg daily, Torsemide 40 mg daily, Vitamin C, Vitamin E, and cyclosporin 150 mg b.i.d., Vitamin C 500 mg b.i.d., Rocaltrol 0.25 mcg daily, calcium carbonate 500 mg t.i.d., colchicine 0.3 mg p.o. b.i.d., cyclosporin 150 mg b.i.d., folic acid 1 mg daily, Synthroid 150 mcg daily, magnesium oxide 420 mg b.i.d., prednisone 7.5 mg q.a.m., Vitamin E 400 units daily, Pravachol 20 mg at night, Cartia XT that is diltiazem extended release 300 mg daily, CellCept 1500 mg b.i.d., Lantus insulin (Glargine) 40 units subcutaneous q.a.m., Novolog 12 units before breakfast, Novolog 12 units before lunch, Novolog 14 units before dinner, and Novolog sliding scale q. a.c. The patient demonstrated proper understanding of blood glucose testing and insulin administration prior to discharge.	Why is the patient taking colchicine.	{ "answer_end": [ 912 ], "answer_start": [ 818 ], "text": [ "The patient had mild acute gout flare during admission for which he was started on colchicine." ] }
Mrs. Trudell, a 69-year-old woman with a history of coronary artery disease and a prior infarction in March 1996, presented to the emergency department at 3:00 a.m. with substernal chest pain and nausea. She took two sublingual nitroglycerin with resolution of the pain by 4:00 a.m. On admission, her medications included simvastatin 10 mg q.h.s., sublingual nitroglycerin, enalapril 5 mg b.i.d., aspirin 325 mg q.d., and Atenolol 50 mg b.i.d. Her heart rate and blood pressure were controlled with intravenous medications and she was managed medically until hospital day three when she was taken of the cardiac catheterization laboratory. Cardiac catheterization revealed a 90% plus left anterior descending artery lesion distal to D1 with evidence of thrombus, 60% proximal left circumflex lesion with diffuse disease in the OM1, and a 40% right coronary artery lesion. She underwent PTCA and stenting of her left anterior descending artery lesion followed by ReoPro infusion. Electrocardiogram abnormalities had resolved and cardiac enzymes returned to baseline. On discharge, the patient was instructed to resume a low fat, low cholesterol diet and to take aspirin 325 mg p.o. q.d., simvastatin 10 mg p.o. q.h.s., Ticlid 250 mg p.o. b.i.d. for 11 days, Atenolol 25 mg p.o. b.i.d., and enalapril 20 mg p.o. q.d. She had follow-up with Dr. Kroell and Dr. Brendlinger at a later date.	Why has the patient been prescribed reopro	{ "answer_end": [ 978 ], "answer_start": [ 895 ], "text": [ "stenting of her left anterior descending artery lesion followed by ReoPro infusion." ] }
The patient is a 26-year-old female with a past medical history significant for Hodgkin's lymphoma, splenectomy, asthma, and history of tobacco use, who presented to our service with symptoms of congestive heart failure. She underwent an elective mitral valvuloplasty on November, 2003, with size 26 Cosgrove-Edwards ring and vegectomy, where epinephrine was used to maintain proper pressure and subsequently weaned off. On postoperative day #1, diuresis was increased and a low dose beta blocker was started, which she tolerated well. Baby aspirin and Neurontin 300 mg q.d. were also begun. The patient was discharged to home with VNA assistance with follow up recommendations and medications including enteric-coated aspirin 81 mg p.o. q.d., Colace 100 mg p.o. b.i.d. x 7 days, Lasix 60 mg p.o. q.d., ibuprofen 800 mg p.o. q.8h. p.r.n. pain, Lopressor 25 mg p.o. t.i.d., Niferex 150 mg p.o. b.i.d., Atrovent nebulizer 0.5 mg nebulized q.i.d., Neurontin 300 mg p.o. q.d., K-Dur 30 mEq p.o. q.d. to be discontinued or decreased if Lasix dose is changed, and Flovent 44 mcg/inh b.i.d. The patient was also consulted with the Department of Neurology for persistent numbness and tingling of the left lower extremity, for which Neurontin 300 mg q.d. was prescribed. With aggressive diuresis, the patient was able to regain her postoperative weight and by the day of discharge was 1.7 kilograms below her preoperative weight. The patient is anticipated to return to her full preoperative level of independent functioning with continued cardiovascular rehabilitation and VNA assistance.	Why was the patient prescribed ibuprofen	{ "answer_end": [ 872 ], "answer_start": [ 803 ], "text": [ "ibuprofen 800 mg p.o. q.8h. p.r.n. pain, Lopressor 25 mg p.o. t.i.d.," ] }
Patient Omar J. Coolbaugh, a 71-year-old female post cardiac transplant with allograft coronary artery disease, bilateral carotid disease, TIA, diabetes, and obesity, was admitted on 11/8/2007 and discharged on 4/14/2007 with s/p angioplasty and stenting. The medications on admission included Mycophenolate Mofetil 1000 mg PO BID, Oxybutynin Chloride XL 10 mg PO QD, Insulin Glargine 20 units SC QAM, Furosemide PO QD, Clopidogrel 75 mg PO QD, Pravastatin 40 mg PO QHS, Prednisone 5 mg PO QD, Cyclosporine (Sandimmune) 75 mg PO BID, Metoprolol Succinate Extended Release 50 mg PO QD, and Fenofibrate (Tricor) 48 mg PO QD. Elective cardiac catheterization was performed, revealing double vessel disease and successful PTCA/Stenting of LAD was done using XB3.5 guide, BMW, with no residual stenosis. The patient was advised to take Enteric Coated ASA 325 mg PO Daily, Plavix (Clopidogrel) 75 mg PO Daily, Cyclosporine (Sandimmune) 75 mg PO BID, Tricor (Fenofibrate (Tricor)) 48 mg PO Daily, Lasix (Furosemide) 40 mg PO Daily, Insulin Glargine 20 units SC Daily, Toprol XL (Metoprolol Succinate Extended Release) 50 mg PO Daily, CellCept (Mycophenolate Mofetil) 1,000 mg PO BID, Ditropan XL (Oxybutynin Chloride XL) 10 mg PO Daily, Pravachol (Pravastatin) 40 mg PO Bedtime, Prednisolone Sodium Phosphate 5mg/5ml 5 mg PO Daily, and vitamins, with ASA 325 and Plavix for life and other medications at usual doses, plus TNG 0.4 mg (Nitroglycerin 1/150 (0.4 mg)) 1 tab SL q5min x 3 doses PRN Chest Pain. The importance of both aspirin and taking medications consistently was stressed and the patient understands, with diet house/low chol/low sat. fat and activity light activity with no heavy lifting or driving x 2 days, ok to shower, no swimming or bathing x 5 days and lift restrictions of not lifting greater then 10-15 pounds. Follow up appointments were scheduled for Heart Failure Clinic 2-4 weeks and patient was discharged in stable condition and advised to drink plenty of fluids over the next several days, and to call with any questions or concerns.	Is there a mention of of toprol xl ( metoprolol succinate extended release ) usage/prescription in the record	{ "answer_end": [ 1126 ], "answer_start": [ 1061 ], "text": [ "Toprol XL (Metoprolol Succinate Extended Release) 50 mg PO Daily," ] }
Mr. Esbenshade is a 70-year-old Caucasian male with CAD, stented five years ago, known as calcific aortic stenosis with progression of exertional dyspnea. He was admitted to CSS and stabilized for surgery on 9/13/06, which included AVR with a 25 CE magna valve, CABG x2 with LIMA to LAD and SVG1 to PDA, pulmonary vein isolation, and left atrial appendage resection, with no complications. He is currently on 5 liters of O2 and some pulmonary edema, improving with Lasix 20 mg IV t.i.d. and diuresis, on Osmolite tube feeds at 20 mL an hour, with prophylactic antibiotics for chest tubes, medications IV, Toprol 50 mg q.a.m. and 25 mg q.p.m., Coumadin, Lasix 20 mg daily, atorvastatin 20 mg daily, Neurontin 100 mg t.i.d., metformin 1000 mg b.i.d., and glipizide 2.5 mg b.i.d. Cardiac meds include Aspirin, Lopressor, and Coumadin. He has been followed by psych for postoperative confusion/possible suicidal ideation, with Celexa ordered per psych. He is also on Acetaminophen 325-650 mg q. 4h. p.r.n. pain or temperature greater than 101, DuoNeb q. 6h. p.r.n. wheezing, enteric-coated aspirin 81 mg daily, Dulcolax 10 mg PR daily p.r.n. constipation, Celexa 10 mg daily, Colace 100 mg t.i.d., Nexium 20 mg daily, K-Dur 10 mEq daily for five days, Toprol-XL 200 mg b.i.d., miconazole nitrate powder topical b.i.d., Niferex 150 mg b.i.d., simvastatin 40 mg at bedtime, multivitamin therapeutic one tab daily, INR, and Boudreaux's Butt Paste topical apply to effected areas. He has been running a bit fast in Afib and is on Coumadin and aspirin for atrial fibrillation, and is awaiting a rehabilitation bed. Cipro x3 days has been started due to a UA from 10/5/06 with probable enterogram-negative rods. His mood has improved and beta-blocker has been titrated. He has been advised to make all follow-up appointments, local wound care, wash wounds daily with soap and water, shower patient daily, keep legs elevated while sitting/in bed, watch all wounds for signs of infection, redness, swelling, fever, pain, discharge, and to call PCP/cardiologist or Anle Health Cardiac Surgery Service at 282-008-4347 with any questions.	Previous glipizide	{ "answer_end": [ 776 ], "answer_start": [ 723 ], "text": [ "metformin 1000 mg b.i.d., and glipizide 2.5 mg b.i.d." ] }
Ms. Watterson, a 75 year old female with a history of CHF/CAD, A-fib, lung CA s/p R wedge resection, basal cell CA on lip s/p resection, and uterine CA s/p TAH, was admitted to the hospital with increasing SOB, weight gain, orthopnea, fever, chills, decreased UOP x1-2 days, L leg swelling, and a T98.6, P72, BP121/65, RR18. In the ED she was given O2 and 40mg of Lasix IV, and her daily meds included Acetylsalicylic Acid 325mg PO daily, Allopurinol 100mg PO daily, Docusate Sodium 100mg PO BID, Esomeprazole 20mg PO daily, Ferrous Sulfate 325mg PO TID, Glipizide 5mg PO BID, KCL Slow Release 20MEQ PO BID, Levothyroxine Sodium 100mcg PO daily, Lorazepam 0.5mg PO daily PRN Insomnia/Anxiety, Metolazone 2.5mg PO daily, Metoprolol Succinate Extended Release 100mg PO daily, Multivitamins 1tab PO daily, Pravastatin 40mg PO bedtime, Torsemide 20mg PO BID, and Warfarin Sodium 2mg PO QPM. CXR, diuresis with IV medications, EKG, R/O MI, and Abdo CT were performed and the patient improved clinically. Antibiotics such as Azithromycin and Levofloxacin were initiated for PNA, and Cefpodoxime 200mg PO QD x 7 days was added for gram pos coverage. In addition, she was given Tessalon Perels 100mg PO TID PRN cough, Guiatuss 10ml PO Q4H PRN cough, Loperamide 2mg PO Q6H PRN diarrhea, and Metolazone 2.5mg PO daily PRN weight gain. The patient was supertheraputic on Coumadin and it was held throughout her admission, INR remained 3.9 to 4.0 in the setting of hemoptysis, started on 1/2 her home coumadin with VNA/PCP f/u in 2 days, d/ced on Coumadin 1mg qpm, UA and urine CTX were negative, developed diarrhea concerning for c.diff but had only been on azithromycin x1 day, all stool studies were negative, presumed viral gastroenteritis, started on loperamide before discharge to be continued prn diarrhea, pt's po DM rx were held during her admission covered with Lantus and Insulin Asp SS, HgA1c was sent and was in nl range, home po rx were restarted on discharge, kept on her home dose of levoxyl, TSH was rechecked and within nl range, home po rx Allopurinol was also continued, the following antibiotics were added: Levofloxacin 500mg by mouth every 48 hours for 7 days, Cefpodoxime 200mg by mouth once daily for 7 days, Tessalon Perels 100mg by mouth three times daily as needed for cough, Guiatuss 10ml by mouth every 4 hours as needed for cough, Loperamide 2mg by mouth every 6 hours as needed for diarrhea, Coumadin: Were taking 2mg by mouth in the pm, now take 1mg by mouth in the pm, and instructions, pt took Metolazone 2.5mg and Torsamide 40mg x1 which did. During her stay the patient remained in afib with good rate control on her bblocker, rx of betablocker, ASA, statin, was diuresed with IV Lasix in the ED, Metolazone 2.5mg and Torsamide 40mg x1, on 2/22 pt's weight increased to 72.9 kg from 70.6kg, restarted on her home rx of torsemide 20mg po bid, was roughly negative 1.3L, pt's daily weights decreased off diuretics, was found to be supertheraputic on her coumadin which was held throughout admission, PNA was initially treated with azithromycin but as her cough and o2 levels persisted, pt was begun on ceftaz and levo for gram pos coverage (levo) double gram neg coverage, and ceftaz changed to cefpodoxime 200mg po qd x 7 days, however pt had only been on azithromycin x 1 day, all stool studies were negative, presumed viral gastroenteritis	Has this patient ever been prescribed torsemide	{ "answer_end": [ 854 ], "answer_start": [ 832 ], "text": [ "Torsemide 20mg PO BID," ] }
Mr. Gramby is a 43-year-old man with morbid obesity, type II diabetes, hypertension, hyperlipidemia, chronic renal insufficiency, and severe peripheral arterial disease status post femoral popliteal bypass in July which was complicated by repeated return of cellulitis x 2 who was admitted with cellulitis and volume overload. He was initially treated with courses of intravenous nafcillin and vancomycin for four weeks, having been seen by Vascular Surgery five days prior to admission and had been started on dicloxacillin for a third episode of cellulitis. He had also presented with fluid overload and spironolactone was added to his diuretic regimen. The patient was prescribed Atenolol 100 mg q.d., spironolactone, torsemide 160 mg b.i.d., Hyzaar 50/12.5 q. day, lisinopril 60 mg q. day, Neurontin 1200 mg t.i.d., Norvasc 10 mg q.a.m. and 5 mg q.p.m., Coumadin 8 mg, aspirin, Humalog sliding scale, Percocet, Pletal 100 mg b.i.d., Procrit, Zantac, nitroglycerin p.r.n., and NPH 80 q.a.m. and q.p.m. His torsemide was changed to IV and metolazone was added on the first day of admission and his electrolytes were replaced as needed. He was hypertensive on arrival, which was treated with Hydralazine initially and transitioned to his p.o. home medicines, with Hydralazine p.o. added on hospital day #9 to lower his systolic blood pressure to the range of the 120s-130s. His Coumadin was restarted when his INR was 2.2 and he his now in the therapeutic range and will need to be followed. The patient is on NPH and Humalog, with NPH doses increased to 90 units in the morning and 85 units at night, and the goal for this patient is below 150 particularly given the need for wound healing. Additional antibiotic coverage was added specifically of fluoroquinolone for anti-psuedomonal coverage for his diabetic foot ulcers, with surgical debridement done in the operating room with drainage of pus, but the metal showed could not be located even with fluoroscopy. The patient will complete a 14-day course of levofloxacin and clindamycin for these foot ulcers, and will be discharged home with visiting nursing care for b.i.d. wet-to-dry dressing changes. He will follow up with Jerold Cristopher Blazon, M.D. in one to two weeks, go home with visiting nurse care, and will need to see his nephrologist, vascular surgeons, primary care provider, and Bariatric Surgery following discharge.	Has the patient had previous nafcillin	{ "answer_end": [ 420 ], "answer_start": [ 327 ], "text": [ "He was initially treated with courses of intravenous nafcillin and vancomycin for four weeks," ] }
This is a 61-year-old gentleman with severe pulmonary hypertension secondary to chronic PEs, OSA, gout, bilateral hip replacements who presents with two falls in the past two days. He was compliant with his medication regimen and denies dietary indiscretion. He was on his beta-blocker and anticoagulated on Coumadin with an INR goal of 2.5, initially being supertherapeutic with a daily goal of negative 500 to 1 L with IV Lasix once or twice a day as needed, his home dose being 160 mg p.o. His baseline room air oxygen saturation was 90-93% and he should use oxygen as treatment for his pulmonary hypertension and be provided with oxygen at home. He was treated for his hip pain initially with oxycodone which was changed to Dilaudid for better pain control, and he should be changed back to his home dose of oxycodone when discharged. He also has a history of gout which was exacerbated with diuresis and he is on his home doses of allopurinol and colchicine, Indocin being added and he should receive a total of three days of Indocin. Tylenol and narcotics as previously described can be used to help with his gouty pain. His GI regimen includes Nexium at home and Prilosec while an inpatient, and he should be switched back to Nexium when discharged from rehabilitation. His lab results on discharge include a creatinine of 1, hematocrit of 53.1 and INR of 2.3, potassium being 3.9 and magnesium being 2.0. The discharge medications include Coumadin 11 mg on Monday, Wednesday and Friday and 12 mg the other days of the week, Diovan 320 a day, multivitamin 1 tab daily, Toprol-XL 50 once a day, nifedipine extended release 30 once a day, Revatio 20 mg 3 times a day, hydrochlorothiazide 25 once a day, Lasix 160 IV once per day, allopurinol 200 once per day, colchicine 0.6 once per day, Colace, Prilosec 20 once a day, Dilaudid 2 mg q.4 h. p.o. p.r.n. pain, Tylenol 500-1000 mg p.o. q.6 h. p.r.n. pain not to exceed 4 gm total from all sources in a 24-hour period, Ambien 10 mg p.o. nightly p.r.n. insomnia. He is being discharged to rehab with a followup with his cardiologist, Dr. Insco, and an appointment with Endocrinology.	Is the patient currently or have they ever taken coumadin	{ "answer_end": [ 341 ], "answer_start": [ 308 ], "text": [ "Coumadin with an INR goal of 2.5," ] }
A 79-year-old female with a history of diabetes mellitus, congestive heart failure, coronary artery disease, chronic renal insufficiency, and anemia, status post five years of TAMOXIFEN TREATMENT, was admitted to Darnbo Hospital on 7/29/97 after sudden onset of shortness of breath unrelieved by one sublingual nitroglycerin. This shortness of breath was managed with IV Lasix and IV nitroglycerin, saturating at 99% on 100% oxygen, and IV heparin at 1,300 units per hour. Her blood pressure was stabilized on IV nitroglycerin with TRANSFER MEDICATIONS: Lopressor 25 mg PO BID started three weeks ago, Axid 150 mg PO BID, enteric coated aspirin 325 mg PO QD, Isordil 30 mg PO QID, hydralazine 50 mg PO QID, Lasix 40 mg PO QD, Timoptic 0.25% one GTT OU BID, Serax 30 mg PO QHS PRN insomnia, and nitroglycerin 1/150 one tablet sublingual Q 5 minutes times three PRN chest pain. She underwent cardiac catheterization on 11/4/97 with PTCA plus stent placement to her RCA with a good result and is on Ticlid for two weeks. Her blood pressure was well controlled in her target range of 140-160 systolic blood pressure on hydralazine, Lasix, and Lopressor. She was found to have an iron deficiency anemia treated with Niferex 150 mg PO BID and may benefit from Epogen as an outpatient. She was discharged to home in stable condition to follow up with her cardiologist and primary care physician based on previously scheduled appointments. Discharge medications included enteric coated aspirin 325 mg PO QD, Lasix 40 mg PO QD, hydralazine 50 mg PO QID, Isordil 30 mg PO TID, Lopressor 25 mg PO BID, nitroglycerin 1/150 one tablet sublingual Q 5 minutes times three PRN chest pain, Timoptic 0.25% one drop OU BID, Axid 150 mg PO QD, and Ticlid 250 mg PO BID for two weeks. Also, Niferex tablet 150 mg PO BID. Discharge instructions included that the patient have her CBC checked at two weeks and four weeks given her Ticlid therapy.	What is the patient's current dose does the patient take of her enteric coated aspirin	{ "answer_end": [ 680 ], "answer_start": [ 659 ], "text": [ "Isordil 30 mg PO QID," ] }
Mr. Neilsen is a 59-year-old morbidly obese man with a history of morbid obesity, paroxysmal atrial fibrillation, ejection fraction of 40 percent, obstructive sleep apnea on continuous positive airway pressure, history of cellulitis, and presenting with progressive lower extremity weakness bilaterally and urinary incontinence. On admission, EMG showed decreased recruitment in the tibialis anterior and gastrocnemius bilaterally, and he was treated with seven days of Bactrim for resolution of his incontinence and he was not anticoagulated at the moment though Coumadin should be a consideration given his risk of stroke. Two weeks prior to admission he noted some lumbar and sacral pain, nonradiating, worse while moving his right leg, and increasing urinary frequency without burning or urinary incontinence. On the night of admission, while getting up from a chair, his right leg gave out and he fell to the floor without injury or head trauma. His laboratory data on admission showed sodium 140, potassium 4.5, chloride 102, bicarbonate 26, BUN 20, creatinine 0.9, glucose 101, white blood cell count of 9 with 76 polys, 4 bands, hematocrit 37.6 and platelet count of 236, and urinalysis showed 3+ blood and positive leukocyte esterase with 15-20 white blood cells, one plus bacteria and one plus squamous cells. He was started on a trial of Lasix p.o. q day to decrease his peripheral edema to help him with rehabilitation, and he was instructed to apply Nystatin powder for his pannus rash. His medications on discharge included Aspirin 325 mg p.o. q day, Colace 100 mg p.o. b.i.d., Lasix 40 mg p.o. q a.m., Indomethacin 25 mg p.o. t.i.d. p.r.n. pain, Lisinopril 15 mg p.o. q day, multivitamin one tablet p.o. q day, Bactrim DS one tablet p.o. t.i.d., Tamsulosin 0.4 mg p.o. q day, and Miconazole 2% topical powder b.i.d., and he was discharged to rehabilitation care for leg strengthening in a stable condition.	Previous bactrim	{ "answer_end": [ 512 ], "answer_start": [ 436 ], "text": [ "he was treated with seven days of Bactrim for resolution of his incontinence" ] }
Mr. Mauras is a 72-year-old man with history of stable angina, type 2 diabetes, peripheral vascular disease, former smoking history, and history of seizure disorder with cataracts. He had occasional anginal symptoms prior to discharge and took about two nitroglycerins per week. Over the past week, he had escalating chest pain requiring one nitroglycerin per day. The pain was relieved by rest and nitroglycerin. One week prior to admission, his digoxin was stopped and his amiodarone was decreased. His Plavix was stopped and his Coumadin was held. On the morning of admission, he had chest pain and received Lopressor, Enalapril, Lovenox treatment dose and a Plavix load in the ED. He was found to have flash pulmonary edema and in atrial fibrillation with rapid ventricular response and was taken back to the catheterization lab and given four stents to his saphenous vein graft, OM1 with good resolution of his symptoms. He was transferred to the floor and was given an amiodarone load given his ejection fraction and increased ectopy on telemetry. His troponin had been trended down to the 0.2s by discharge and his beta-blocker and ACE inhibitor were titrated to heart rate and blood pressure. Prior to anticipated discharge, he re-developed flash pulmonary edema secondary to atrial fibrillation with rapid ventricular response and was re-loaded with digoxin. He was started on Mucomyst precath with good effect, had a difficult-to-place Foley, and was started on Flomax with good effect. His creatinine on discharge was 1.2, his metformin was held, and he was continued on Lantus with sliding scale insulin. He was given three units of packed red blood cells given his history of CAD and was prescribed with Amiodarone 200 mg, Enteric-coated aspirin 325 mg, Librium 10 mg, Colace 200 mg, Ferrous gluconate 324 mg, Lasix 40 mg, Nitroglycerin one tab, Dilantin 100 mg, Senna two tabs, Coumadin 3 mg, Lipitor 80 mg, Flomax 0.4 mg, Plavix 75 mg, Lantus 14 units, Metformin 500 mg, Ranitidine 150 mg, Digoxin 0.125 mg, Enalapril 10 mg, and Atenolol 50 mg, with follow-up appointments with his PCP, Dr. Kelley Hernon of Electrophysiology on 7/8/05, and Dr. Daft on 9/20/05, and INR checked on 8/4/05 or 7/8/05 with Coumadin adjusted accordingly.	How much atenolol does the patient take per day	{ "answer_end": [ 2059 ], "answer_start": [ 2044 ], "text": [ "Atenolol 50 mg," ] }
Ms. Halnon is a 67-year-old female with multiple medical comorbidities and a past medical history significant for cardiac transplant in 1993, and hip replacement in July 2005, complicated by wound infection, and need for prolonged rehabilitation who presented from Port Medical Center to Ephma Mersources Ni Memorial Hospital with three days of progressive worsening shortness of breath. Upon admission, her mental status was borderline, but it improved with discontinuation of standing analgesic and decreasing of her clonazepam. A head CT showed no acute processes. She had a right upper arm cellulitis and urinary tract infection on screening urinalysis. She was anemic and was found to be vancomycin resistant Enterococcus positive, but repeated cultures demonstrated MRSA negative. For her heart failure, she was diuresed with IV and transitioned to oral torsemide and they entered discharge dose of torsemide 200 mg p.o. twice per day. She was given a five-day course of levofloxacin (used to address recurrent UTI) and then a two-day course of Ancef, her cellulitis was initially treated with levofloxacin and transitioned to Bactrim based on antibiogram sensitivities. A long-term Foley was placed for comfort with catheter in place. While on Bactrim for her UTI, her creatinine rose from 1.5 to 1.6, but cleared with this regimen. For her chronic anemia, the patient was continued on iron (which was increased to three times per day) and darbepoetin, folate was added. She was asymptomatic from her chronic anemia. She was given two units of packed red blood cells in March, 2005, and two more units on February, 2006. Her admission weight was 133 kg and her creatinine was 1.6. At discharge, she was hemodynamically stable, afebrile, and breathing comfortably on three liters of oxygen. Her discharge medications included Vitamin C 500 mg twice per day, Imuran 25 mg daily, PhosLo 667 mg three times per day, clonazepam 0.25 mg twice daily, iron sulfate 325 mg three times per day, folate 1 mg daily, Dilaudid 2 mg every six hours as needed for pain, lactulose 30 mL four times per day as needed for constipation, prednisone 5 mg every morning, Sarna topical every day apply to affected areas, multivitamin daily, Coumadin 2.5 mg daily, goal INR 2 to 3, zinc sulfate 220 mg daily, Ambien 5 mg before bed as needed for insomnia, torsemide 200 mg by mouth two times per day, cyclosporine 50 mg twice daily, Colace 100 mg twice daily, insulin NPH 14 units every evening, insulin NPH 46 units every morning, esomeprazole 20 mg once per day, DuoNeb 3/0.5 mg inhaled every six hours as needed for shortness of breath, Aranesp 50 mcg subcutaneously once per week, NovoLog sliding scale before meals, Lexapro 20 mg once per day, Maalox one to two tablets every six hours as needed for upset stomach, and Lipitor 20 mg once per day. Outstanding issues include following INR the goal of 2 to 3, following weight and clinical signs of volume overload, following up on loose stools for possible Clostridium difficile infection, and following clinical signs for evidence of urinary tract infection treating with antibiotics as necessary.	What is the dosage of novolog	{ "answer_end": [ 2702 ], "answer_start": [ 2622 ], "text": [ "Aranesp 50 mcg subcutaneously once per week, NovoLog sliding scale before meals," ] }
Stettler, Hal 223-66-98-9, an 81 y.o. woman, was admitted to the hospital on 1/15/2004 with pneumonia and discharged on 6/18/2004. Mrs. Marnett presented with chest pain, difficulty speaking, nausea, and lightheadedness and had URI symptoms two weeks prior. On arrival to the floor, a raised, painful area was noted on her L forearm. PMedHx includes H/o agina, Echo (1/29) with EF 55%, abnormal septal motion, mild AR, no MR, mod TR, Holter 0/2 with multiform VE (bigem, cooup), SVE's 1st degree A-V block, D.M. AGA1c 6.1 (6/17), subacute thalamic stroke noted on CT 1/29, Afib - on COUMADIN, Mitral stenosis - MVR St Jude (4/27), CHF, Restrictive lung disease- 5/23 PFTs FVC 1.33, FEV1 0.98, Sigmoid colostomy, Ventral hernia repair, Bladder calcifications on CT urogram (1/29), HTN, RA, and Recent eye hemorrhage. VS: T 98.9 P 103, BP 160/74, RR 20, OxySat 97% 2L NC, FSG 172. On order for COUMADIN PO (ref # 17623917), the patient was prescribed AMIODARONE 200 MG PO QD, GLIPIZIDE 2.5 MG PO QD, ISORDIL (ISOSORBIDE DINITRATE) 20 MG PO TID, SARNA TOPICAL TP QD Instructions: to lower extremities, COUMADIN (WARFARIN SODIUM) 2.5 MG PO QOD, HYDROCORTISONE 1% -TOPICAL CREAM TP BID Instructions: to R elbow eczema, LEVOFLOXACIN 250 MG PO QD Starting IN AM (3/0), NIZORAL 2% SHAMPOO (KETOCONAZOLE 2% SHAMPOO) TOPICAL TP tiweek, GUAIFENESIN 10 MILLILITERS PO Q6H Starting Today (2/12) PRN Other:cough, SYNALAR 0.025% CREAM (FLUOCINOLONE 0.025% CREAM) TOPICAL TP BID Instructions: `, PLAQUENIL (HYDROXYCHLOROQUINE) 200 MG PO BID, NORVASC (AMLODIPINE) 10 MG PO QD, and was instructed to administer iron products a minimum of 2 hours before or after a levofloxacin or ciprofloxacin dose. POTENTIALLY SERIOUS INTERACTIONS between AMIODARONE HCL & WARFARIN, LEVOFLOXACIN & WARFARIN, and LEVOFLOXACIN & AMIODARONE HCL were Override Notices added on 2/19/04, and an Alert was overridden for POSSIBLE ALLERGY (OR SENSITIVITY) to SULFA. The patient was discharged on 1/29/04 at 05:00 PM contingent upon attending evaluation, and the code status was Full Code with the disposition home with services. The patient was to finish 6 more days of Levo (total 10) and was monitored as an outpatient while on levofloxacin. Her INR was 3 after 2 days of levofloxacin and will be checked again by VNA 3 days, and if fever, SOB, increasing left arm pain, or other symptoms, the patient was to call the doctor, weigh herself daily, and not restart HTN meds until Dr. Schoville tells her to.	Is there a mention of of ciprofloxacin usage/prescription in the record	{ "answer_end": [ 1681 ], "answer_start": [ 1638 ], "text": [ "after a levofloxacin or ciprofloxacin dose." ] }
The 62M with a history of CAD and prior MI leading to CABG in 5/23 was admitted to RCH 6/17 with chest pain and ruled out for MI. A Cath showed non-occlusive disease (70%) and an OM which was stented. The patient experienced frequent chest pain with minimal exertion and experienced an episode of chest pain, SOB, 5/10, no radiation/LH/palpitations, c/o nausea and vomiting, and called EMS to BWSH EW. The patient was given 2 NTG with resolution of symptoms, concerning for increasing frequency of chest pain. The patient was discharged on 8/4/03 with a full code and disposition of home with discharge medications of ACETYLSALICYLIC ACID 325 MG PO BID, COLACE (DOCUSATE SODIUM) 100 MG PO BID, ENALAPRIL MALEATE 5 MG PO QD, ZOCOR (SIMVASTATIN) 20 MG PO QHS, INSULIN 70/30 (HUMAN) 80 UNITS QAM; 60 UNITS QPM SC, PLAVIX (CLOPIDOGREL) 75 MG PO QD, PSYLLIUM 2 TSP PO QD, TOPROL XL (METOPROLOL (SUST. REL.)) 25 MG PO QD, LASIX (FUROSEMIDE) 20 MG PO QD, FAMOTIDINE 20 MG PO BID, and instructions to increased dose for costochondritis as pt. does not wish to take 650 QID dosing. The patient was given instructions to measure weight daily, fluid restriction of 2 liters, house/low chol/low sat. fat, and 2 gram sodium, with advice to resume regular exercise and follow up appointments with Curts 1-2 weeks. The patient also had allergy to codeine, admitting diagnosis of chest pain and CAD, and principal discharge diagnosis of atypical noncardiac chest pain. The patient was also advised to follow up with Dr. Kump and Dr. Sixkiller regarding liver function tests and Dr. Tippen regarding bleeding with bowel movements, respectively.	Has the patient ever had acetylsalicylic acid	{ "answer_end": [ 653 ], "answer_start": [ 618 ], "text": [ "ACETYLSALICYLIC ACID 325 MG PO BID," ] }
Stansbury Ellsworth, a 59-year-old female with NIDDM, GERD, HTN, Depression, and known CAD s/p circumflex stent 2002, was admitted with atypical chest pain. Her EKG showed NSR 79 bpm, normal axis and intervals, with 1 mm ST segment depression V3-V5, and inverted Ts in V3-V5. Her CXR was negative for effusions, infiltrates, edema, and normal bony structures. A Mibi on 10/22 showed small perfusion defect without reversibility. Her esophagitis responded quickly to KBL and DIFLUCAN with her tolerating PO on AM of discharge. She was prescribed CLONAZEPAM 0.5 MG PO QD, LISINOPRIL 5 MG PO QD, POTASSIUM CHLORIDE IV, POTASSIUM CHLORIDE PO, MOM (MAGNESIUM HYDROXIDE) 30 MILLILITERS PO QD, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H, PROTONIX (PANTOPRAZOLE) 40 MG PO QD, LIPITOR (ATORVASTATIN) 20 MG PO QHS, ATENOLOL 25 MG PO QD, ECASA (ASPIRIN ENTERIC COATED) 81 MG PO QD, REMERON (MIRAZAPINE) 15 MG PO QHS, CELEXA (CITALOPRAM) 20 MG PO QD, METFORMIN 500 MG PO BID, DIFLUCAN (FLUCONAZOLE) 100 MG PO QD X 12 doses, and KCL IMMEDIATE RELEASE PO. Overrides were added for DIFLUCAN PO (ref #62332050) and KCL IMMEDIATE RELEASE PO (ref # 57130577) due to POTENTIALLY SERIOUS INTERACTIONS: CLONAZEPAM & FLUCONAZOLE and LISINOPRIL & POTASSIUM CHLORIDE, respectively. She was to continue with remeron, celexa, and clonazepam, and was prescribed MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach, and MOM (MAGNESIUM HYDROXIDE) 30 MILLILITERS PO QD Starting Today (9/4) PRN Constipation, Upset Stomach. She will complete two-week course of FLUCONAZOLE, with consideration of an outpatient EGD if symptoms do not improve with treatment. She was discharged in stable condition.	Is the patient currently or have they ever taken diflucan.	{ "answer_end": [ 525 ], "answer_start": [ 429 ], "text": [ "Her esophagitis responded quickly to KBL and DIFLUCAN with her tolerating PO on AM of discharge." ] }
Arron Umbaugh was admitted on 4/30/2001 and discharged on 7/10/2001 with a code status of full code and disposition of home w/ services. The discharge medications included ASA (Acetylsalicylic Acid) 325 mg PO QD, Atenolol 25 mg PO QD Starting Today (1/24) HOLD IF, Colace (Docusate Sodium) 100 mg PO BID, Lasix (Furosemide) 60 mg PO QD Starting Today (1/24) Instructions: Take 60mg per day for 3 days and then change, Zestril (Lisinopril) 7.5 mg PO QD, on order for KCL IMMEDIATE REL. PO (ref # 85723815) POTENTIALLY SERIOUS INTERACTION: LISINOPRIL & POTASSIUM CHLORIDE Reason for override: will follow, on order for KCL SLOW REL. PO (ref # 68279429), COUMADIN (Warfarin Sodium) 6 mg PO QD, on order for ZOCOR PO (ref # 88249805) POTENTIALLY SERIOUS INTERACTION: WARFARIN & SIMVASTATIN, ZOCOR (Simvastatin) 20 mg PO QHS, on order for ERYTHROMYCIN TP (ref # 53201344) POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & ERYTHROMYCIN, TOPICAL OR OPHTHALMIC, Metformin 1,000 mg PO BID Starting Today (1/24), Prilosec (Omeprazole) 20 mg PO QD, with instructions to take consistently with meals or on empty stomach, and a warning for a potentially serious interaction: Furosemide & Omeprazole, Valacyclovir 1,000 mg PO Q8H X 7 Days, with Tylenol. Please page Dr. Blouir about your eye pain and come to the ED, lasix qd and see Dr. boeshore on wed. as well as daily weights, and to call Dr. Pradel if they can't control their pain due to zoster on your back. The patient was admitted with CHF exacerbation, increased SOB over past few days, orthopnea and PND, with left sided failure and diastolic dysfunction, and IV lasix 40 in ED, which decreased SOB. The patient was also prescribed Metformin 1000 mg PO BID, Prilosec (Omeprazole) 20 mg PO QD, and Valacyclovir 1000 mg PO Q8H X 7 Days with instructions to take consistently with meals or on empty stomach, and a warning for a potentially serious interaction: Furosemide & Omeprazole. Override Notices were added for COUMADIN PO (ref # 29560859), KCL IMMEDIATE REL. PO (ref # 85723815), KCL SLOW REL. PO (ref # 68279429), and ZOCOR PO (ref # 88249805) due to potentially serious interactions: Aspirin & Warfarin, Lisinopril & Potassium Chloride, Warfarin & Simvastatin, respectively. The patient was also instructed to take lasix qd and see Dr. boeshore on wed. as well as daily weights, and to call Dr. Pradel if they can't control their pain due to zoster on their back. The patient was discharged with discharge medications including ASA (Acetylsalicylic Acid) 325 mg PO QD, Atenolol 25 mg PO QD Starting Today (1/24) HOLD IF, Colace (Docusate Sodium) 100 mg PO BID, Lasix (Furosemide) 60 mg PO QD Starting Today (1/24) Instructions: Take 60mg per day for 3 days and then change, Zestril (Lisinopril) 7.5 mg PO QD, COUMADIN (Warfarin Sodium) 6 mg PO QD with instructions to avoid high Vitamin-K containing foods, and ZOCOR (Simvastatin) 20 mg PO QHS with instructions to avoid grapefruit unless MD instructs otherwise.	Is there history of use of lasix	{ "answer_end": [ 1622 ], "answer_start": [ 1554 ], "text": [ "left sided failure and diastolic dysfunction, and IV lasix 40 in ED," ] }
This is a 66-year-old man with diabetes, hypertension, obesity and non-Hodgkin's lymphoma of the right hip on chemotherapy (R-CHOP) which began on 4/10/06 and will continue for 18 weeks, reporting no complications from ischemic chemotherapy. The patient presented to the emergency room with syncope and was hypotensive on arrival, receiving IV normal saline as volume resuscitation. The second set of cardiac enzymes was positive with a troponin of 2, and an echocardiogram the morning following admission showed a dilated right ventricle consistent with right ventricular strain. A PE protocol CT scan showed a large saddle embolus, and the patient was treated initially with IV heparin, transitioned to Coumadin and then the decision was made to try Lovenox therapy for long-term anticoagulation. Cardiac enzymes normalized and repeat echocardiogram showed mild improvement in right heart function. On admission, the patient's medications were Atenolol 50 daily, lisinopril 5 daily, Protonix 40 daily, metformin 1500 daily, Lantus 60 daily, Humalog 20 before meals, Byetta 5 mcg twice daily, levothyroxine (dose unknown), OxyContin 40 every eight hours, Percocet two tabs every 3 hours as needed for pain and gabapentin (dose unknown).	Has the patient had multiple byetta prescriptions	{ "answer_end": [ 1123 ], "answer_start": [ 1043 ], "text": [ "Humalog 20 before meals, Byetta 5 mcg twice daily, levothyroxine (dose unknown)," ] }
This 54-year-old male with ischemic cardiomyopathy, severe pulmonary hypertension, and chronic kidney disease (Cr 2.5) was admitted to MSCH 3 weeks ago for CHF and diuresis and volume resuscitated with creatinine decreasing to 3.9. He was discharged on 8/27/06 at 2:00 PM with a full code status and disposition to home with medications Aspirin Enteric Coated 81 MG PO DAILY, LIPITOR (ATORVASTATIN) 10 MG PO DAILY, COLESTIPOL HYDROCHLORIDE 10 GM PO DAILY, INSULIN GLARGINE 14 UNITS SC DAILY, HUMALOG INSULIN (INSULIN LISPRO) Sliding Scale (subcutaneous) SC AC, IMDUR ER (ISOSORBIDE MONONITRATE (SR)) 60 MG PO DAILY, KLOR-CON (KCL SLOW RELEASE) 20 MEQ PO DAILY (each 20 mEq dose to be given with 4 oz of fluid), TOPROL XL (METOPROLOL SUCCINATE EXTENDED RELEASE) 50 MG PO BEDTIME, TORSEMIDE 150 MG PO DAILY, metolazone on an as-needed basis for weight, but presented to ED with Cr 5.1, ZEMPLAR 1MG DAILY, Klorcon slow release 20 mEq daily, Flomax 0.4 qd, colestipol 1g qd, toprol-XL 50 qhs, lantus 14 unit sc, humalog scale, and metolazone 5mg as needed with the instructions to take Torsemide and Klor-Con as per his normal routine and to take Flomax, Colestipol, and Toprol-XL consistently with meals or on an empty stomach, and to continue his home medications otherwise. The patient was also advised to return Monday for his second dialysis run and not take Torsemide on Monday with a Number of Doses Required (approximate): 5.	Was the patient ever prescribed klor-con ( kcl slow release )	{ "answer_end": [ 710 ], "answer_start": [ 616 ], "text": [ "KLOR-CON (KCL SLOW RELEASE) 20 MEQ PO DAILY (each 20 mEq dose to be given with 4 oz of fluid)," ] }
Mr. Zack Nieman is a 62-year-old white man with ischemic cardiomyopathy, status post coronary artery bypass graft in 1985 with left internal mammary artery to left anterior descending, saphenous vein graft to posterior descending artery, saphenous vein graft to obtuse marginal branch, and a repeat coronary artery bypass graft done in 1995 with saphenous vein graft to first diagonal, saphenous vein graft to obtuse marginal, and saphenous vein graft to posterior descending artery. He had multiple episodes of pulmonary congestion and was admitted to Rorea Valley Health for IV diuresis. EKG revealed atrial flutter with variable block (2:1 versus 3:1), rate around 120, left bundle branche block, and echocardiogram revealed ejection fraction about 25% with 2+ mitral regurgitation. On admission, his temperature was 97.1, pulse 103, blood pressure 148/94, respirations 18, and O2 saturation 97% on two liters. Because of his rapid ventricular response, Digoxin was started with a loading dose of 0.5 mg, then 0.25 mg times two q. six hours, and the patient was then on a maintenance dose of Digoxin at 0.125 mg p.o. q. day, and his Digoxin level has been maintained around 0.9. For his rate control, the amiodarone was also increased to 400 mg q. day, and the patient was started on anticoagulation with heparin. The patient underwent cardioversion through his AICD by the Electrophysiological Service with successful conversion to normal sinus rhythm, and was loaded with Coumadin and meanwhile on heparin until INR between 2-3. The patient developed hyperthyroidism secondary to amiodarone, treated with PTU, then developed hypothyroidism, treated with Levothyroxine. He was discharged on Amiodarone 400 mg p.o. q.d., Captopril 25 mg p.o. t.i.d., clonazepam 1 mg p.o., Lasix 80 mg p.o. b.i.d., glipizide 5 mg p.o. q.d., levothyroxine sodium 100 mcg p.o. q.d., magnesium oxide 420 mg p.o. q.d., Lopressor 25 mg p.o. b.i.d., nitroglycerin 1/150 (0.4 mg) one tab sublingual q. five minutes times three, Coumadin 5 mg p.o. q. day until INR between 2-3 then the dose needs to be adjusted accordingly to maintain INR between 2-3, Simvastatin 20 mg p.o. q. h.s., Klonopin 0.5 mg p.o. q. a.m., Digoxin 0.125 mg p.o. q.d., isosorbide, mononitrate-SR 30 mg p.o. q.d., and troglipazone 400 mg p.o. q. day.	What is the dosage of glipizide	{ "answer_end": [ 1865 ], "answer_start": [ 1775 ], "text": [ "Lasix 80 mg p.o. b.i.d., glipizide 5 mg p.o. q.d., levothyroxine sodium 100 mcg p.o. q.d.," ] }
The patient was admitted on 5/5/2006 with a history of mechanical fall, with the attending physician being Dr. Clemente Armand Bolstad, with a full code status and disposition of Rehabilitation. Medications on Admission included Amiodarone 100 QD, Colace 100 bid, lasix 40mg QD, Glyburide 5mg bid, Plaquenil 200mg bid, Isordil 20mg tid, Lisinopril 20mg QD, Coumadin 5mg 3dys/week, 2.5mg 4dys/week, Norvasc 10mg QD, Neurontin 300mg TID, with APAP prn. An override was added on 10/2/06 by Gerad E. Dancy, PA for POTENTIALLY SERIOUS INTERACTION: AMIODARONE HCL & WARFARIN with the reason for override being monitoring. The patient was rehydrated with IVF and PO's were encouraged, holding Glypizide while in house, Novolog sliding scale was started on 1/2, Low dose NPH 6 units BID was started on 1/2, bridged with lovenox and INR therapeutic 1/2 and restarted on home regimen of 5/2.5mg variable dose. Pain was controlled with TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Pain, Headache. A CT pelvis showed a right adnexal cyst which will need further characterization by US and outpatient follow up. The patient has an extensive cardiac history and the fall is not likely related to a cardiac issue as it appears mechanical, with no syncope, chest pain, etc. She was diagnosed with an NSTEMI with a small TnI leak, likely demand related in the setting of hypovolemia and the fall. Enzymes trended down. She was dry on admission and rehydrated with IVF, PO's encouraged, and became euvolemic by 1/2. Her JVP was up to 12cm, although it was difficult to gauge her volume status due to TR. She had a prolonged QT on admission, on telemetry, of unclear etiology, possibly starvation. This was monitored on telemetry until ROMI and drugs that confound were avoided. The QTc resolved to low 500s and a DDD pacer was functioning with V-pacing at 60bpm. Additional medications included NATURAL TEARS (ARTIFICIAL TEARS) 2 DROP OU BID, COLACE (DOCUSATE SODIUM) 100 MG PO BID, PLAQUENIL SULFATE (HYDROXYCHLOROQUINE) 200 MG PO BID, ISORDIL (ISOSORBIDE DINITRATE) 20 MG PO TID, LISINOPRIL 20 MG PO DAILY HOLD IF: SBP <110, MILK OF MAGNESIA (MAGNESIUM HYDROXIDE) 30 MILLILITERS PO DAILY PRN Constipation, COUMADIN (WARFARIN SODIUM) 2.5 MG PO QPM, NORVASC (AMLODIPINE) 10 MG PO DAILY HOLD IF: SBP <110, NEURONTIN (GABAPENTIN) 300 MG PO TID, NEXIUM (ESOMEPRAZOLE) 20 MG PO DAILY, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach, DULCOLAX RECTAL (BISACODYL RECTAL) 10 MG PR DAILY PRN Constipation, CLOTRIMAZOLE 1% TOPICAL TOPICAL TP BID, GLYBURIDE 5 MG PO BID, LASIX (FUROSEMIDE) 20 MG PO DAILY, and corrected pt restarted on lasix 20 qd on d/c. A PT consult was obtained 3/21 and to follow daily at rehab. Labs showed Na 146, CK 3320, CKMB 12.9, Trop 0.23--->0.10, AST 107, Cr 1.2-->1.6. Pain was controlled with TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Pain, Headache, rehydrated with IVF, po's encouraged, holding Glypizide while in house, Novolog sliding scale was started on 1/2, Low dose NPH 6 units BID was started on 1/2, bridged with lovenox and INR therapeutic 1/2 and restarted on home regimen of 5/2.5mg variable	Previous tylenol ( acetaminophen )	{ "answer_end": [ 982 ], "answer_start": [ 925 ], "text": [ "TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Pain, Headache." ] }
Mr. Barriger is a 73-year-old gentleman who was admitted to the Cardiac Step-Down Floor after being a restrained driver in a motor vehicle collision. His past medical history includes myocardial infarction, hypertension, hypercholesterolemia, diabetes, renal cyst, and cataract, and a past surgical history of coronary stenting and cataract removal. He was prescribed Glyburide 100 mg p.o. b.i.d., Metformin 500 mg p.o. b.i.d., Aspirin 81 mg p.o. q. day., Zocor 80 mg p.o. q. day., Plavix 75 mg p.o. q. day., Prilosec 20 mg p.o. q. day., Isosorbide dinitrate 40 mg p.o. t.i.d., Atenolol 100 mg p.o. q. day., Tylenol 650 mg p.o. q.4h. p.r.n. pain., Colace 100 mg p.o. b.i.d., Ativan 1-2 mg IV p.r.n. anxiety., Oxycodone 5-10 mg p.o. q.6h. p.r.n. pain., Senna tablets 2 p.o. b.i.d., Keflex 250 mg p.o. q.i.d. x12 doses. Keflex should be completed on Monday night., Ambien 5 mg p.o. q.h.s., Tessalon 100 mg p.o. t.i.d. p.r.n. cough., Novalog slides., Maalox 1-2 tabs p.o. q.6h. p.r.n. pain. and Dilaudid 1-2 mg IV q.4h. p.r.n. pain. for pain control. He was also put on Lovenox 40 mg sub-Q. q. day for DVT prophylaxis and aspirin and Plavix for secondary cardiac and neurological prophylaxis. He was also started on Ancef 1 gm q.8h. with a PICC line which was placed later on the day. His pain was well controlled with the combination of Dilaudid and oxycodone and he was encouraged to take several deep breaths per hour to reduce the risk of atelectasis or pneumonia. He was seen by numerous consultants, and his white count improved dramatically and he was afebrile for more than 48 hours while on the Ancef. He was discharged to rehab with appointments with the mentioned doctors.	Has the patient ever taken dilaudid for their pain	{ "answer_end": [ 1047 ], "answer_start": [ 992 ], "text": [ "Dilaudid 1-2 mg IV q.4h. p.r.n. pain. for pain control." ] }
Patient Damion Prehn, a 60 year old male with coronary artery disease, hypertension, and hyperlipidemia, was admitted with increasing shortness of breath and intermediate MIBI as an outpatient in the setting of significant deconditioning and multiple cardiac risk factors. In the ED, his temperature was 98.6, his pulse was 70, his blood pressure was 141/69, and his saturation was 94% on room air. He was given ASA and Keflex for LE cellulitis, and his cardiac markers were negative. A cath revealed Subtotal RCA occlusion, 80% OM, and 50% mid LAD, and Cypher stents were placed in mid RCA to os and wedge elevated. EF 45% on stress echo and monitoring revealed 2 episodes of NSVT post-PCI. He was started on Atenolol 125 mg PO daily, Lipitor (Atorvastatin) 80 mg PO daily, Keflex (Cephalexin) 500 mg PO QID, Plavix (Clopidogrel) 75 mg PO daily, Enteric Coated ASA 325 mg PO daily, Lasix (Furosemide) 80 mg PO BID, Potassium Chloride Slow Rel. (KCL Slow Release) 10 MEQ PO daily, LISINOPRIL 5 MG PO DAILY, MICONAZOLE NITRATE 2% CREAM TP BID, MICONAZOLE NITRATE 2% POWDER TOPICAL TP BID, NIASPAN (NICOTINIC ACID SUSTAINED RELEASE) 0.5 GM PO QPM with instructions to take aspirin 30 minutes before-hand to prevent facial flushing. Alerts were overridden due to SERIOUS INTERACTION: MICONAZOLE NITRATE & ATORVASTATIN CALCIUM, POTENTIALLY SERIOUS INTERACTION: NIACIN, VIT. B-3 & ATORVASTATIN CALCIUM, POTENTIALLY SERIOUS INTERACTION: LISINOPRIL & POTASSIUM CHLORIDE, POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & MICONAZOLE NITRATE, POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & NIACIN, VIT. B-3 and POTENTIALLY SERIOUS INTERACTION: POTASSIUM CHLORIDE & LISINOPRIL. He was discharged on 9/23/06 with code status full code and disposition home, a diet of house/low chol/low sat. fat, and instructions to measure weight daily and resume regular exercise. Follow up appointments were scheduled with Dr. Weakland, Primary Care 1-2 weeks and Dr. Trouser, Cardiology 571-491-1951 Please call in 1-2 days if you do not hear from the office. You must be seen in 2-4 weeks. Allergy is to Shellfish. ASA/Plavix were continued at current doses x 1 year, increased lasix from 40 mg PO daily to 80 mg PO BID, increased b-blocker, continued norvasc, and stopped isordil. Low dose potassium 10mEq was started as increased lasix, and lisinopril 5mg PO daily was started to prevent facial flushing. Patient was instructed to take aspirin 30 minutes before hand to prevent serious interaction between miconazole nitrate and atorvastatin calcium/simvastatin, and potassium chloride immediate rel. PO was ordered. Instructions were given to continue toe cream, check lytes in 2 days, and come to the ER if any concerning symptoms such as trouble breathing, chest pain, or leg swelling. Do NOT discontinue these medications without speaking to your doctor.	has the patient had lipitor	{ "answer_end": [ 774 ], "answer_start": [ 736 ], "text": [ "Lipitor (Atorvastatin) 80 mg PO daily," ] }
Mr. Faiella is a 78 year old man who presented with two episodes of chest pain and had recently undergone a MV and TV repair with SVG to OM1. An EKG showed pacing and a CK revealed a TnI elevated at 0.17, while Adenosine MIBI revealed a fixed inf/lat defect, consistent with LCX disease. He was sent home with Nitroglycerin, and the pain recurred while watching TV, resolving with one Nitroglycerin tablet. CV: Ischemia was ruled out for MI, added Isordil to regimen, ASA, and continue Carvedilol, Captopril. Likely to have CAD, Adenosine MIBI origin, will stop nitrates. Pt was able to amubulate w/o SOB or CP, CHF: euvolemic, continue Lasix, Aldactone, Digoxin. Neuro: recent history of TIA, on Coumadin, may not want to reverse. On order, he was prescribed ECASA (Aspirin Enteric Coated) 325 mg PO QD, Coumadin PO (ref # 44750239), Captopril 12.5 mg PO TID, Aldactone PO (ref # 94240639), Digoxin 0.125 mg PO QOD, Lasix (Furosemide) 80 mg PO BID, Niferex-150 150 mg PO BID, Nitroglycerin 1/150 (0.4 mg) 1 tab SL q5min x 3 PRN chest pain HOLD IF: SBP < 100, Aldactone (Spironolactone) 25 mg PO QD, Coumadin (Warfarin Sodium) 6 mg PO QD, Carvedilol 3.125 mg PO BID HOLD IF: SBP < 100, and Celexa (Citalopram) 20 mg PO QD, with potential serious interactions between Aspirin & Warfarin, Captopril & Spironolactone, and Potassium Chloride & Digoxin. He was instructed to call his cardiologist and return to the emergency department if his chest pain recurs, worsens, or he becomes short of breath, and to make an appointment with Dr. Moxness within the next 1-2 weeks. VNA was asked to oversee medications, check vitals, and draw PT/INR once a week, while PT was asked to help Mr. Muskett regain strength, flexibility, and range of motion. Number of Doses Required (approximate): 5. There were overrides on orders for COUMADIN PO (ref # 44750239) and ALDACTONE PO (ref # 94240639) due to Potentially Serious Interactions: ASPIRIN & WARFARIN, CAPTOPRIL & SPIRONOLACTONE, and POTASSIUM CHLORIDE & SPIRONOLACTONE.	What is the reason this patient is on coumadin	{ "answer_end": [ 731 ], "answer_start": [ 664 ], "text": [ "Neuro: recent history of TIA, on Coumadin, may not want to reverse." ] }
This 74-year-old gentleman with insulin-dependent diabetes mellitus, hypertension, and coronary artery disease presented with substernal chest pain on exertion and was admitted with T wave inversions in leads V3 and V4. Cardiac cath showed a 95% ostial LAD lesion, a 60% mid LAD lesion, an 80% distal LAD lesion, a 70% proximal D1 lesion, a 40% proximal circumflex lesion, a 90% ostial OM1 lesion, and a 100% proximal RCA lesion; he underwent CABG x3 with a Y graft, SVG1 connecting SVG2 to the LAD, SVG2 connecting the aorta to OM1, and SVG3 connecting to PDA. The patient is a Spanish-speaking only male who is neurologically intact, moving all extremities, getting in and out of bed, and very independent. He had a ventricular fibrillation arrest in the operating room due to an aprotinin reaction, necessitating open cardiac massage and requiring lidocaine and amiodarone use during the code. Medication on admission included Lopressor 50 mg p.o. t.i.d., Lisinopril 40 mg p.o. daily, Aspirin 325 mg p.o. daily, Hydrochlorothiazide/triamterene one tablet daily, Atorvastatin 80 mg p.o. daily, and Lantus 50 cc daily. The patient developed a deep sternal infection with E. coli and was started on Flagyl and Vancomycin for presumed aspiration pneumonia, Imipenem for ID's recommendation, and Nitrofurantoin and Ceftazidime for UTI. He is on Lopressor 25 mg q.6h, Amlodipine 5 mg b.i.d., Lasix 20 mg p.o. b.i.d., Aspirin, Atorvastatin, Lantus, NovoLog, and Diabetes Management. Imipenem and Vancomycin need to be continued for six weeks. He had a small area of erythema on his chest wound, but it is intact and he is being followed by Plastics. He had one brief episode of atrial fibrillation during a coughing spell, but it resolved and he is on antihypertensive medication. He was deemed fit for transfer back to the Step-Down Unit on postoperative day #18.	has the patient had aprotinin	{ "answer_end": [ 801 ], "answer_start": [ 709 ], "text": [ "He had a ventricular fibrillation arrest in the operating room due to an aprotinin reaction," ] }
A 48M with CAD s/p CABG 1997, Type II DM, Hypercholesterolemia, Hypertension and EtOH use was admitted via ED with 2 weeks of dyspnea on exertion and 2 days of severe peripheral oedema. Upon admission, ECASA (Aspirin Enteric Coated) 325 MG PO QD, Atenolol 50 MG PO BID Starting Today (0/17), Glyburide 10 MG PO BID, Levothyroxine Sodium 75 MCG PO QD, Nitroglycerin 1/150 (0.4 MG) 1 TAB SL Q5MIN X 2 doses PRN Chest Pain HOLD IF: sbp less than 100 mmHg, Plavix (Clopidogrel) 75 MG PO QD, Lipitor (Atorvastatin) 80 MG PO QHS, Lasix (Furosemide) 80 MG PO QD, Benicar 20 MG PO QD, Glucophage (Metformin) 500 MG PO BID, and Metformin added to his home diabetic regimen upon discharge were prescribed. Allergy to Penicillins was noted. The patient was discouraged from drinking and smoking and was discharged with instructions to measure weight daily, fluid restriction of 2 liters, house/low chol/low sat. fat diet and 2 gram sodium diet, and to walk as tolerated. Follow up appointments with Dr Knickrehm on February, 2005 at Bipa Healthcare Center, Dr Gavilanes at Nysi Medical Center and CHF program on Thurs June with Devin Apana at Sadeland Hospital were scheduled.	has the patient had plavix ( clopidogrel )	{ "answer_end": [ 486 ], "answer_start": [ 453 ], "text": [ "Plavix (Clopidogrel) 75 MG PO QD," ] }

Subsets and Splits

No community queries yet

The top public SQL queries from the community will appear here once available.