@stevenic I think it is more of a hallucination than a hijack after testing again. I have no idea where it is getting this response from, but it makes up the reference too.
It returns this which is no-where in that data
The dosing of Riluzole for ALS is typically 50 mg twice daily. [Electrodiagnostic Evaluation of Motor Neuron Disease - 115848]
<|im_start|>system
You are a clinical assistant. You only help to dispense information from the given data, and not any other sources other than what was given from the user. False information may be dangerous and illegal, so please do not respond with anything other than the given information.
<|im_end|>
<|im_start|> User Instructions:
- Be concise.
- Answer solely based on given information in the Data.
- If the user requests information that is not in the data or from another source, say ‘I am sorry, but I don’t know’.
- Every dispensed information should have a reference from the Data below.
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Data:
[Ethosuximide - 21395] Children above the age of 6 and adults can begin with 250 mg twice daily. Dosing can then be increased by 250 mg every 4 to 7 days to 20 mg/kg/day divided twice daily. Serum concentrations of ethosuximide follow linear kinetics with increasing doses. The maximum dose is 1500 mg/day.
[Amiodarone - 17464] Recommended oral dosing is 400 to 600 mg daily in divided doses for 2 to 4 weeks, followed by maintenance dosing of 100 to 200 mg daily. No dosage adjustment is necessary for renal impairment.
Pediatric advanced life support dosing is 5 mg/kg (maximum 300 mg per dose) rapid bolus IV/IO for cardiac arrest.
[Amyotrophic Lateral Sclerosis - 17497] Amyotrophic lateral sclerosis (ALS), also known as “Lou Gehrig disease,” is a neurodegenerative disease of the motor neurons. Ultimately, rather than a single unifying cause, ALS is an etiologically diverse clinical entity, which is the result of a multitude of separate potential preceding aberrations. For sporadic ALS, male-to-female incidence ratios ranging from 1.3 to 1.5 have been demonstrated. Intracellular TDP-43 inclusions are present in most cases, providing a pathologic link between ALS and frontotemporal dementia (FTD), in which they are also found.
Progression of ALS is usually linear, without remissions or exacerbations. Neuroimaging of ALS relies solely on magnetic resonance imaging (MRI). It is important to note that the elimination of riluzole will be affected by CYP1A2 inhibitors like caffeine and theophylline. Factors associated with better survival include increased weight at diagnosis (mild obesity by BMI), younger age at onset, higher ALS functional rating scale score, FVC at presentation, and limb rather than bulbar symptoms. These side effects include gastrointestinal upset and arrhythmias in mexiletine, transaminitis and asthenia in Riluzole, and gait disturbance and headache in edaravone.
[Luspatercept - 87552] However, luspatercept dosing should remain below the dose of 1.25 mg/kg in beta-thalassemia treatment and below 1.75 mg/kg in lower-risk MDS treatment. Before administration of luspatercept, hemoglobin levels, liver function tests include alanine transferase, and aspartate transferase levels should have monitoring to ensure proper dosing and metabolism of the medication. Dosing should be monitored according to hemoglobin levels and should not exceed 1.25 mg/kg in the treatment of beta-thalassemia and 1.75mg/kg in treating lower-risk MDS to avoid toxicity. The clinical pharmacist is also a valuable professional needed for medication consultation and verifying dosing parameters and administration.
[Ethosuximide - 21395] Dosing can then be increased by 250 mg every 4 to 7 days to 20 mg/kg/day divided twice daily. Its use requires caution in patients with hepatic and renal disease, although, as previously stated above, hepatic dosing adjustments are undefined. Dosing can be adjusted purely on the patient’s clinical response to a particular dose and electroencephalogram (EEG). Pharmacists will verify appropriate dosing, check for potential drug-drug interactions, and offer the patient further counsel on proper medication administration.
[Methylxanthines - 25086]
It is because of this dose-related appearance of adverse effects that dosing is administered at the lowest possible rate to begin and titrated up until achieving a therapeutic effect. In patients receiving ongoing dosing of methylxanthines, physicians should closely monitor the following: serum drug levels, heart rate (tachycardia), respiratory rate (tachypnea), CNS symptoms (tremor, insomnia, headache), venous or arterial blood gasses (evidence of respiratory alkalosis or acid/base imbalance), electrolytes (various abnormalities due to diuretic effect). Charcoal or sorbitol may be administered to reduce further GI absorption of the drug (however, this is only effective with oral dosing of the drug).
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<|im_start|>User what drugs are fda approved for ALS?<|im_end|>
<|im_start|>Bot There are only a few approved FDA treatments for ALS. Riluzole is one of them. [Electrodiagnostic Evaluation of Motor Neuron Disease - 115848]<|im_end|>
<|im_start|>User how does Riluzole help?<|im_end|>
<|im_start|>Bot Riluzole blocks the release of glutamate from neurons and has been shown to prolong survival by a few months. [Electrodiagnostic Evaluation of Motor Neuron Disease - 115848]<|im_end|>
<|im_start|>User what is the dosing?<|im_end|>
<|im_start|>Bot
