| Medication Log | | | | | | | | | | | | | |
| Name | | | | Date | | | | | |
| Name of Medication | Date Started | Date Stopped | Dosage, Dosage Times | Special Instructions | Purpose | Size, Shape, Color | Prescribing Physician | Physician Phone Number | Side Effects? | Refill Number | Pharmacy Phone Number | | |
| Norvasc 5mg Norvasc 5mg | Feb. 22/09 Feb. 22/09 | | 1 tablet daily 1 tablet daily | Morning(Breakfast) Morning(Breakfast) | | white oblong white oblong | Dr. Oswauld Dr. Oswauld | | | 935089 935089 | 519-586-3983 519-586-3983 | | |
| Novo-Pantoprazole 40mg Novo-Pantoprazole 40mg | Feb.22/09 Feb.22/09 | | 1 tablet daily 1 tablet daily | Morning(Breakfast) Morning(Breakfast) | | Yellow oval tab. Yellow oval tab. | Dr. Oswauld Dr. Oswauld | | | 749227 749227 | | | |
| Lipitor 80mg Lipitor 80mg | | | 1 tablet daily 1 tablet daily | Evening(Bedtime) Evening(Bedtime) | Cholesterol Cholesterol | White ellipitcal White ellipitcal | Dr. Bard/Dr. Mead Dr. Bard/Dr. Mead | Dr. Bard-519-428-9992/Dr. Mead 905-779-3436 Dr. Bard-519-428-9992/Dr. Mead 905-779-3436 | | 749225 749225 | | | |
| PS Enteric Coated ASA 81mg PS Enteric Coated ASA 81mg | | | 1 tablet daily 1 tablet daily | Morning(Breakfast) Morning(Breakfast) | | round white round white | Dr. Bard/Dr. Mead Dr. Bard/Dr. Mead | | | 740807 740807 | | | |
| APO Furosemide 40mg APO Furosemide 40mg | | | 1 tablet daily 1 tablet daily | Morning(Breakfast) Morning(Breakfast) | | Yellow round tablet Yellow round tablet | Dr. Bard/Dr. Mead Dr. Bard/Dr. Mead | | | 740806 740806 | | | |
| Metformin 500mg Metformin 500mg | | | 2 tablets once daily 2 tablets once daily | Morning(Breakfast) Morning(Breakfast) | | Big white round tablet Big white round tablet | Dr. Bard/Dr. Mead Dr. Bard/Dr. Mead | | | 740313 740313 | | | |
| Atacand 16mg Atacand 16mg | | | 1 Tablet TWICE daily 1 Tablet TWICE daily | Morning(Breakfast) Evening(Bedtime) Morning(Breakfast) Evening(Bedtime) | | rose round tablet rose round tablet | Dr. Bard/Dr. Mead Dr. Bard/Dr. Mead | | | 736720 736720 | | | |
| Ezetrol 10mg Ezetrol 10mg | | | 1 Tablet daily 1 Tablet daily | Evening(Bedtime) Evening(Bedtime) | | Small white oval tablet Small white oval tablet | Dr. Bard/Dr. Mead Dr. Bard/Dr. Mead | | | 732905 732905 | | | |
| Quinine 300 mg Quinine 300 mg | | | 1 Tablet daily 1 Tablet daily | Evening(Bedtime) Evening(Bedtime) | | White capsule black lettering White capsule black lettering | Dr. Bard/ Dr. Mead Dr. Bard/ Dr. Mead | | | 687852 687852 | | | |
| Nitro Derm 0.4mg Nitro Derm 0.4mg | | | 1 patch daily 1 patch daily | Put on patch Morning/Remove at bedtime Put on patch Morning/Remove at bedtime | | Patch Patch | Dr. Oswauld Dr. Oswauld | | | | | | |
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| Humalin insulin Humalin insulin | | | 15 units 15 units | Breakfast/Lunch/Dinner Breakfast/Lunch/Dinner | | Insulin Insulin | | | | | | | |
| Humalog insulin Humalog insulin | | | 50 units 50 units | Bedtime Bedtime | | Insulin Insulin | | | | | | | |
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| Prochlorazine 10mg Prochlorazine 10mg | March 6/09 March 6/09 | | 1 tablet 3 times per day 1 tablet 3 times per day | ONLY WHEN NEEDED ONLY WHEN NEEDED | | | Dr. Mead Dr. Mead | | | | | | |
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| Dr. Mead - Family Doctor Dr. Mead - Family Doctor | | | | | | | | | | | | | |
| Lions Medical Clinic Lions Medical Clinic | | | | | | | | | | | | | |
| Fisherville Ontario Fisherville Ontario | | | | | | | | | | | | | |
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| 905-779-3436 905-779-3436 | | | | | | | | | | | | | |
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| Dr. Timothy Bard-Specialist Dr. Timothy Bard-Specialist | | | | | | | | | | | | | |
| 216 West St. 216 West St. | | | | | | | | | | | | | |
| suite 204 suite 204 | | | | | | | | | | | | | |
| Simcoe, Ontario Simcoe, Ontario | | | | | | | | | | | | | |
| 519-428-9992 519-428-9992 | | | | | | | | | | | | | |
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