David medication log book

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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
Lotrel 5 - 20 mg Lotrel 5 - 20 mg			1 capsule at noon 1 capsule at noon		Blood pressure Blood pressure	Pink oblong shape Pink oblong shape	Ghandi or Gagne Ghandi or Gagne			869088 869088	248-8018 248-8018
Magnesium Oxide 400 mg Magnesium Oxide 400 mg			1 tab twice daily 1 tab twice daily			White tablet White tablet	Ghandi or Gunnell Ghandi or Gunnell				952-2108 952-2108
Potassium Cl 20 meq tab tev Potassium Cl 20 meq tab tev			1 tab three times daily 1 tab three times daily	after meals after meals		Large white tab Large white tab	Gunnell or Ghandi Gunnell or Ghandi			869087 869087	248-8018 248-8018
Furosemide (Lasix) 40 mg tablet Furosemide (Lasix) 40 mg tablet	6/20/08 6/20/08		1 tab twice daily 1 tab twice daily		Fluid build up Fluid build up	White round shape White round shape	Lee or Ghandi Lee or Ghandi			869085 869085	248-8018 248-8018
Albuterol INH 90 MCG ARM 17 GM	6/24/08		2 Puffs every 4 hours	As needed	Cough		Wong			443695	952-2108
Combivent Aero Inhaler 14.7 gm Combivent Aero Inhaler 14.7 gm	6/26/08 6/26/08		2 sprays every 4 hours 2 sprays every 4 hours	As needed As needed	Cough (PE) Cough (PE)		Wong Wong			443913 443913	952-2108 952-2108
Alprazol (Xanax) tab .5 mg Alprazol (Xanax) tab .5 mg	6/26/08 6/26/08		1 tab every 4 hours 1 tab every 4 hours	As needed As needed	Anxiety Anxiety		Gunnell Gunnell			443914 443914	952-2108 952-2108
Prednisone 10 mg tab wat Prednisone 10 mg tab wat	6/29/08 6/29/08		3 tab 2 times day for 5 days, then 3 tabs daily for 5 days, then 1 tab daily for 5 days 3 tab 2 times day for 5 days, then 3 tabs daily for 5 days, then 1 tab daily for 5 days		breathing, lung problems breathing, lung problems		Wong Wong			871078 871078	248-8018 248-8018
Theophylline 200 mg tab SA PL1 Theophylline 200 mg tab SA PL1	6/29/08 6/29/08		1 tab twice daily 1 tab twice daily		Wheezing, trouble breathing Wheezing, trouble breathing		Wong Wong			871077 871077	248-8018 248-8018
Glyburide 5 mg tab TEV Glyburide 5 mg tab TEV	6/29/08 6/29/08		1 tab each day 1 tab each day		Control blood sugar Control blood sugar		Wong Wong			871079 871079	248-8018 248-8018
Lovenox 100 mg prefilled syave Lovenox 100 mg prefilled syave	6/20/08 6/20/08		Inject 1 syringe unders skin twice a day (every 12 hours) Inject 1 syringe unders skin twice a day (every 12 hours)		Blood thinner Blood thinner		Ghandi / Gunnell Ghandi / Gunnell			869378 or new order placed with Verdugo Pharm 6/30 869378 or new order placed with Verdugo Pharm 6/30	248-8018 / 952-2108 248-8018 / 952-2108

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Name:	David medication log book by	wwfeldman
Description:	Medication log
Tags:	medication log

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