| 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 | ||
| Kadian Kadian | Sept.4,2008 Sept.4,2008 | 9:45 pm 9:45 pm | 2 daily 2 daily | pain pain | green cap green cap | Dr. Baldi Dr. Baldi | Refill Line 515-282-5701 Refill Line 515-282-5701 | Not related | |||||
| Endocet Endocet | Sept.4,2008 Sept.4,2008 | 10:30 PM 10:30 PM | 2 every 4 hours 2 every 4 hours | Pain Pain | white tabs white tabs | Dr. Baldi Dr. Baldi | Dr. Baldi 515-282-5710 Dr. Baldi 515-282-5710 | not related not related | 318-5378 318-5378 | not related | |||