app.py

import streamlit as st
import anthropic

# --- Page Config ---
st.set_page_config(
    page_title="Pre-Op Medication Guide",
    page_icon="💊",
    layout="centered",
)

# --- Force custom theme (clear localStorage cache that overrides config.toml) ---
st.markdown("""
<script>
    // Streamlit caches theme choice in localStorage which overrides config.toml
    // Remove cached theme so our config.toml [theme] / [theme.dark] takes effect
    const keys = Object.keys(localStorage);
    keys.forEach(k => {
        if (k.includes('stActiveTheme') || k.includes('theme')) {
            localStorage.removeItem(k);
        }
    });
</script>
""", unsafe_allow_html=True)

# --- Custom Dark Theme CSS ---
st.markdown("""
<style>
    /* Force background on all containers */
    .stApp {
        background-color: #0f1117 !important;
    }
    [data-testid="stAppViewContainer"],
    [data-testid="stAppViewContainer"] > .main,
    [data-testid="stAppViewContainer"] > .main > div,
    .block-container {
        background-color: #0f1117 !important;
        color: #e8eaf0 !important;
    }
    header[data-testid="stHeader"] {
        background-color: #0f1117 !important;
    }
    [data-testid="stBottom"] {
        background-color: #0f1117 !important;
    }
    [data-testid="stBottomBlockContainer"] {
        background-color: #0f1117 !important;
    }

    /* Sidebar */
    section[data-testid="stSidebar"],
    section[data-testid="stSidebar"] > div {
        background-color: #181c26 !important;
    }
    section[data-testid="stSidebar"] p,
    section[data-testid="stSidebar"] li,
    section[data-testid="stSidebar"] span {
        color: #8b92a5 !important;
    }
    section[data-testid="stSidebar"] h1,
    section[data-testid="stSidebar"] h2,
    section[data-testid="stSidebar"] h3,
    section[data-testid="stSidebar"] strong {
        color: #e8eaf0 !important;
    }

    /* Chat messages */
    .stChatMessage,
    [data-testid="stChatMessage"] {
        background-color: #181c26 !important;
        border: 1px solid #252a38 !important;
        border-radius: 12px !important;
    }

    /* Chat input area */
    .stChatInput,
    [data-testid="stChatInput"] {
        background-color: #0f1117 !important;
    }
    .stChatInput textarea,
    [data-testid="stChatInput"] textarea {
        background-color: #181c26 !important;
        border: 1px solid #252a38 !important;
        color: #e8eaf0 !important;
        border-radius: 12px !important;
    }
    .stChatInput textarea:focus,
    [data-testid="stChatInput"] textarea:focus {
        border-color: #3dffc0 !important;
        box-shadow: 0 0 0 1px #3dffc0 !important;
    }

    /* Send button accent */
    .stChatInput button,
    [data-testid="stChatInput"] button {
        color: #3dffc0 !important;
        background-color: transparent !important;
    }
    .stChatInput button:hover,
    [data-testid="stChatInput"] button:hover {
        color: #2de6a8 !important;
    }

    /* All headings */
    h1, h2, h3, h4, h5, h6 {
        color: #e8eaf0 !important;
    }

    /* Body text and paragraphs */
    p, li, span, div {
        color: #e8eaf0;
    }

    /* Captions / muted text */
    .stCaption p,
    [data-testid="stCaption"] p,
    [data-testid="stMarkdownContainer"] small,
    .stCaption {
        color: #8b92a5 !important;
    }

    /* Links */
    a {
        color: #3dffc0 !important;
    }
    a:hover {
        color: #2de6a8 !important;
    }

    /* Dividers */
    hr {
        border-color: #252a38 !important;
    }

    /* Alerts/errors */
    .stAlert {
        background-color: #181c26 !important;
        border-radius: 8px !important;
    }

    /* Spinner */
    .stSpinner > div {
        border-top-color: #3dffc0 !important;
    }

    /* Deploy button area */
    [data-testid="stToolbar"] {
        background-color: #0f1117 !important;
    }

    /* Scrollbar */
    ::-webkit-scrollbar { width: 6px; }
    ::-webkit-scrollbar-track { background: #0f1117; }
    ::-webkit-scrollbar-thumb { background: #252a38; border-radius: 3px; }
    ::-webkit-scrollbar-thumb:hover { background: #8b92a5; }
</style>
""", unsafe_allow_html=True)

# --- Knowledge Base (extracted from Preop_Med_Guidance.docx) ---
KNOWLEDGE_BASE = """
Pre-Op Medication Safety Guidance
(Sources: ASA 2022, ACC/AHA 2024, Johns Hopkins Pre-op Roadmap, Delray Anesthesia Guidelines)

⚠️ Patients must follow surgeon/physician instructions. The times below reflect usual practice and are for awareness only. Final decision is always at the discretion of anesthesia/surgeon.

---
SGLT2 Inhibitors
• Empagliflozin – Jardiance®
• Dapagliflozin – Farxiga®
• Canagliflozin – Invokana®
• Ertugliflozin – Steglatro®
Combination products:
- Empagliflozin + Metformin – Synjardy®
- Dapagliflozin + Metformin – Xigduo XR®
- Canagliflozin + Metformin – Invokamet®
- Ertugliflozin + Metformin – Segluromet®
- Empagliflozin + Linagliptin – Glyxambi®
- Dapagliflozin + Saxagliptin – Qtern®
- Dapagliflozin + Saxagliptin + Metformin – Qternmet XR®
→ Hold 3 days before surgery (risk: euglycemic DKA)
→ If urgent surgery: alert anesthesia, monitor ketones/acid-base

---
GLP-1 Receptor Agonists — Injectables
• Weekly agents — HOLD 7 days before surgery
  – Semaglutide (Ozempic®, Wegovy®)
  – Tirzepatide (Mounjaro®, Zepbound®)
  – Dulaglutide (Trulicity®)
  – Exenatide ER (Bydureon® BCise)
• Combo products (treat per GLP-1 component; coordinate insulin plan)
  – Insulin degludec + liraglutide (Xultophy®)
  – Insulin glargine + lixisenatide (Soliqua®)
→ If urgent surgery or significant GI symptoms → alert anesthesia; manage as full stomach

---
ACE Inhibitors / ARBs
• ACE Inhibitors: lisinopril, enalapril, captopril, ramipril, benazepril, quinapril, perindopril
• ARBs: losartan, valsartan, irbesartan, candesartan, olmesartan, telmisartan, eprosartan
→ Usual practice: HOLD morning of surgery (reduce risk of refractory hypotension with anesthesia)

---
Antiplatelets / Aspirin / NSAIDs
• Aspirin (low-dose 81 mg) – may sometimes be continued; often stopped 5–7 days before surgery if required
• Aspirin (regular dose ≥325 mg) – usually stop ~7 days before surgery
• NSAIDs (ibuprofen, naproxen, meloxicam, diclofenac, etc.) – often managed like aspirin (5–7 days)
• Clopidogrel (Plavix®) – stop 5 days before surgery
• Prasugrel (Effient®) – stop 7 days before surgery
• Ticagrelor (Brilinta®) – stop 5 days before surgery
• Dipyridamole (Persantine®) – stop 5 days before surgery
• Cilostazol (Pletal®) – stop 5 days before surgery
⚠️ Important Caveat:
Patients with coronary stents must usually continue antiplatelet therapy.
Many vascular surgery patients (e.g., TCAR, TAVR, EVAR/TEVAR) are specifically instructed to remain on antiplatelets. Always confirm with cardiology/vascular surgery.

---
Diuretics
• Loop diuretics: furosemide, bumetanide, torsemide, ethacrynic acid
• Thiazides: HCTZ, chlorthalidone, indapamide, metolazone
• Potassium-sparing: spironolactone, eplerenone, amiloride, triamterene
→ Usual practice: HOLD morning of surgery (avoid hypovolemia/electrolyte imbalance)
→ May continue if specifically needed for CHF or volume control (confirm with physician)

---
Beta Blockers
• Common: metoprolol, atenolol, carvedilol, bisoprolol, propranolol, nadolol, labetalol, nebivolol
→ Usual practice: CONTINUE morning of surgery
→ Beta blockers are cardioprotective and should not be withheld

---
Calcium Channel Blockers (CCBs)
• Dihydropyridines: amlodipine, nifedipine, felodipine, nicardipine, isradipine
• Non-dihydropyridines: diltiazem, verapamil
→ Usual practice: CONTINUE morning of surgery
→ Help maintain blood pressure control perioperatively

---
Anticoagulants
• Warfarin – stop ~5 days before surgery; check INR prior
• DOACs (apixaban, rivaroxaban, edoxaban) – hold 2–3 days; longer if renal impairment/high bleeding risk
• Dabigatran – hold 2–3 days if CrCl ≥50; hold 4–5 days if CrCl <50
• Parenterals (enoxaparin, dalteparin, fondaparinux) – hold ~24 h; longer for high-risk procedures
• Heparin IV infusion – stop 4–6 h before surgery

---
Diabetes Medications (Oral & Insulin)
• Metformin – hold evening before surgery
• Sulfonylureas (glipizide, glyburide, glimepiride) – hold morning of surgery
• DPP-4 inhibitors (sitagliptin, saxagliptin, linagliptin, alogliptin) – hold morning of surgery
• TZDs (pioglitazone, rosiglitazone) – hold morning of surgery
• Meglitinides (repaglinide, nateglinide) – hold morning of surgery
• Insulin (all types: basal, bolus, premixed):
  – Confirm perioperative plan with anesthesia
  – Do NOT adjust dose without anesthesia guidance

---
⚠️ Disclaimer: This content is for preoperative screening/education. Final decisions must always be confirmed with anesthesia, surgeon, or provider.
""".strip()

SYSTEM_PROMPT = f"""This is a DNP student research and education project demo created solely for departmental and academic evaluation purposes. It must never be used for direct patient care, medical advice, or clinical decision-making. All examples provided are illustrative of common pre-operative medication practices in an educational context and are not prescriptive or exhaustive. Responses should remain professional, concise, and relevant to nurse education and research use. Always include educational disclaimers where appropriate. Every answer must end with this reminder:
⚠️ Confirm with anesthesia or the surgeon before making final medication decisions.

You have access to the following pre-operative medication reference guide. Use it to answer questions accurately. If a question falls outside this guide, say so clearly.

--- REFERENCE GUIDE ---
{KNOWLEDGE_BASE}
--- END REFERENCE GUIDE ---"""

# --- Sidebar ---
with st.sidebar:
    st.image("https://img.icons8.com/emoji/96/pill-emoji.png", width=80)
    st.title("About")
    st.markdown("""
    This is a **DNP student research and education project** demo created for departmental and academic evaluation.

    **Not for clinical use.**

    Sources: ASA 2022, ACC/AHA 2024, Johns Hopkins Pre-op Roadmap, Delray Anesthesia Guidelines
    """)
    st.divider()
    st.caption("Powered by Claude AI")

# --- Main Chat UI ---
st.title("💊 Pre-Op Medication Guide")
st.caption("Ask questions about pre-operative medication management for nursing education")

# Initialize chat history
if "messages" not in st.session_state:
    st.session_state.messages = []

# Display chat history
for message in st.session_state.messages:
    with st.chat_message(message["role"]):
        st.markdown(message["content"])

# Chat input
if prompt := st.chat_input("Ask about a medication (e.g., 'Should metoprolol be held before surgery?')"):
    # Add user message
    st.session_state.messages.append({"role": "user", "content": prompt})
    with st.chat_message("user"):
        st.markdown(prompt)

    # Generate response
    with st.chat_message("assistant"):
        try:
            client = anthropic.Anthropic(api_key=st.secrets["ANTHROPIC_API_KEY"])

            with st.spinner("Looking up guidance..."):
                response = client.messages.create(
                    model="claude-haiku-4-5-20251001",
                    max_tokens=1024,
                    system=SYSTEM_PROMPT,
                    messages=[
                        {"role": m["role"], "content": m["content"]}
                        for m in st.session_state.messages
                    ],
                )
                assistant_message = response.content[0].text

            st.markdown(assistant_message)
            st.session_state.messages.append(
                {"role": "assistant", "content": assistant_message}
            )
        except anthropic.AuthenticationError:
            st.error("Invalid API key. Check your Streamlit secrets configuration.")
        except Exception as e:
            st.error(f"Error: {e}")