Rationale This vaccine is formulated to fight against three diseases – tetanus, diphtheria, and pertussis. The purpose of having three vaccines in one vial is convenience. In one sitting the recipient gains protection from all three diseases. Tetanus is a neurological disease which can prove fatal. Diphtheria, on the other hand, produces toxins which could cause myocarditis, polyneuritis, and other systemic effects. Obstruction of the respiratory tract, presenting as tachypnea, dyspnea, stridor, cyanosis; and use of accessory muscles of respiration; can be caused by extensive pseudomembrane formation and swelling during the first few days of the disease. If your larynx or tracheobronchial tree is infected, you can suffer a potentially fatal respiratory obstruction. Pertussis is a respiratory tract infection caused by Bordetella pertussis. Its most common presentation among adolescents and adults is a cough, with or without paroxysms, persisting for 2 weeks or more. Other useful clinical clues are shortness of breath during coughing spells, nocturnal cough, tingling sensation in the back of the throat, vomiting, and a history of exposure to other patients with a prolonged coughing illness. The life-threatening complication of this disease is pneumonia. Generic and brand names The generic name is Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed.

Rationale If you are pregnant and then afflicted with rubella, your child may acquire some deformities and abnormalities. Mumps may lead to orchitis and infertility in the future. Measles could lead to blindness, especially among children. Thus, you need to avail of this vaccination with dispatch. Generic and brand names The generic name is Measles, Mumps, and Rubella Vaccine Live. The brand name is M-M-R II. Composition of the vaccine When reconstituted as directed, the dose for injection is 0.5 ml and contains not less than 1,000 CCID50 (50% cell culture infectious dose) of measles virus; 12,500 CCID50 of mumps virus; and 1,000 CCID50 of rubella virus. Mechanism of action Upon injection, your body responds by producing antibodies against mumps, measles, and rubella. Schedule of administration The dose is given at any time over the age of 12 months. Indications and usage M-M-R is indicated for simultaneous vaccination against measles, mumps, and rubella in individuals 12 months of age or older. This vaccination is also recommended for measles and mumps outbreaks. In addition, this is recommended for non-pregnant adolescent and adult females of childbearing age to serve as protection against subsequently acquiring rubella infection during pregnancy, which, in turn, prevents infection of the fetus and consequent congenital rubella injury.

Bipolar disorder is a type of mental disorder. Bipolar Affective Disorder has two different forms that present with different sets of signs, symptoms, diagnoses and treatments. These are known as Bipolar I Disorder and Bipolar II Disorder. These disorders are diagnosed using criteria developed and updated in the DSM-5. The DSM-5 is an acronym that stands for: Diagnostic and Statistical Manual of Mental Disorders. This updated version of the DSM, provides a complete chapter on diagnosing Bipolar and Bipolar Related Disorders. It even includes Cyclothymic Disorder which is a disorder that does not quite meet all the criteria to be considered Bipolar Disorder. Patients who do experience the signs and symptoms of Bipolar disorder, but do not meet the full criteria for either portion of the mania, hypomania or major depression can be classified as Cyclothymic Disorder. Also included in the DSM-5 manual is “manic-like” phenomena which provide a separate set of diagnostic criteria and guidelines that are unique to other outside stimuli that may contribute to this manic-like behavior. This is not considered to be true Bipolar Disorder. Drugs are an example of outside stimuli that can contribute to “manic-like” behavior. A patient cannot be diagnosed with a psychiatric illness if he or she is altered with drugs.

Bipolar disorder is a type of mental disorder. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) provides a complete chapter on diagnosing Bipolar and Bipolar Related Disorders. In order to meet the DSM-5 criteria under Bipolar I Disorder, the patient must have an episode of mania that lasts at least one week in duration; or the episode of mania results in hospitalization or impairment within their job or social realms. The episode of mania must not occur because of alcohol, drugs or other medical conditions. Therefore, the patient must be cleared medically prior to being evaluated for Bipolar I Disorder. The patient must also experience mood disturbances that result in consequences at work. These patients may even become a threat to themselves or others during these mood disturbance episodes. Patients must have at least 5 signs/symptoms associated with major depression that occur for two weeks. If the patient meets these criteria, then they may be diagnosed with Bipolar I Disorder. Bipolar Disorder I: Manic Episodes and Major Depressive Episodes Mania is characterized by mood disturbances that may be of the following: elation, irritability or expansiveness. In order to be considered a manic episode three of the following signs/symptoms must be present for at least one week or result in severe consequences within the patient’s work, family or social life:

Bipolar disorder is a type of mental disorder. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) provides a complete chapter on diagnosing Bipolar and Bipolar Related Disorders. Bipolar II Disorder: Hypomania Episodes and Major Depressive Episodes Bipolar II Disorder is characterized by episodes of hypomania and episodes of depression. Hypomania is defined as elevated, expansive or irritable mood disturbance that lasts for at least 4 days in a row. It must include at least three of the following symptoms: grandiosity, decreased need for sleep, excessive talking/pressured speech, racing thoughts or flight of ideas, clear evidence of distractibility; increased level of goal-focused activity at home, at work, or sexually; and/or excessive pleasurable activities often with painful consequences. While patients who have Bipolar I and Bipolar II will have these episodes of mania, the difference between the two types of Bipolar is that those who experience hypomania, do not have symptoms so serious that they interfere with their ability to function. Bipolar II Disorder patient’s symptoms do not result in hospitalization, impairment of job, or social functioning. On the other hand, patients who have Bipolar I disorder will have a significant impairment that may result in hospitalization. Patients with Bipolar II Disorder will also experience signs/symptoms associated with a major depressive disorder.