| 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 | |||||||||
| 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 | ||||||||||
| 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 | |||||||||
| Dr. Mead - Family Doctor Dr. Mead - Family Doctor | |||||||||||||
| Lions Medical Clinic Lions Medical Clinic | |||||||||||||
| Fisherville Ontario Fisherville Ontario | |||||||||||||
| 905-779-3436 905-779-3436 | |||||||||||||
| 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 | |||||||||||||