| 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 | |||||||