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Ms. Watterson, a 75 year old female with a history of CHF/CAD, A-fib, lung CA s/p R wedge resection, basal cell CA on lip s/p resection, and uterine CA s/p TAH, was admitted to the hospital with increasing SOB, weight gain, orthopnea, fever, chills, decreased UOP x1-2 days, L leg swelling, and a T98.6, P72, BP121/65, RR18. In the ED she was given O2 and 40mg of Lasix IV, and her daily meds included Acetylsalicylic Acid 325mg PO daily, Allopurinol 100mg PO daily, Docusate Sodium 100mg PO BID, Esomeprazole 20mg PO daily, Ferrous Sulfate 325mg PO TID, Glipizide 5mg PO BID, KCL Slow Release 20MEQ PO BID, Levothyroxine Sodium 100mcg PO daily, Lorazepam 0.5mg PO daily PRN Insomnia/Anxiety, Metolazone 2.5mg PO daily, Metoprolol Succinate Extended Release 100mg PO daily, Multivitamins 1tab PO daily, Pravastatin 40mg PO bedtime, Torsemide 20mg PO BID, and Warfarin Sodium 2mg PO QPM. CXR, diuresis with IV medications, EKG, R/O MI, and Abdo CT were performed and the patient improved clinically. Antibiotics such as Azithromycin and Levofloxacin were initiated for PNA, and Cefpodoxime 200mg PO QD x 7 days was added for gram pos coverage. In addition, she was given Tessalon Perels 100mg PO TID PRN cough, Guiatuss 10ml PO Q4H PRN cough, Loperamide 2mg PO Q6H PRN diarrhea, and Metolazone 2.5mg PO daily PRN weight gain. The patient was supertheraputic on Coumadin and it was held throughout her admission, INR remained 3.9 to 4.0 in the setting of hemoptysis, started on 1/2 her home coumadin with VNA/PCP f/u in 2 days, d/ced on Coumadin 1mg qpm, UA and urine CTX were negative, developed diarrhea concerning for c.diff but had only been on azithromycin x1 day, all stool studies were negative, presumed viral gastroenteritis, started on loperamide before discharge to be continued prn diarrhea, pt's po DM rx were held during her admission covered with Lantus and Insulin Asp SS, HgA1c was sent and was in nl range, home po rx were restarted on discharge, kept on her home dose of levoxyl, TSH was rechecked and within nl range, home po rx Allopurinol was also continued, the following antibiotics were added: Levofloxacin 500mg by mouth every 48 hours for 7 days, Cefpodoxime 200mg by mouth once daily for 7 days, Tessalon Perels 100mg by mouth three times daily as needed for cough, Guiatuss 10ml by mouth every 4 hours as needed for cough, Loperamide 2mg by mouth every 6 hours as needed for diarrhea, Coumadin: Were taking 2mg by mouth in the pm, now take 1mg by mouth in the pm, and instructions, pt took Metolazone 2.5mg and Torsamide 40mg x1 which did. During her stay the patient remained in afib with good rate control on her bblocker, rx of betablocker, ASA, statin, was diuresed with IV Lasix in the ED, Metolazone 2.5mg and Torsamide 40mg x1, on 2/22 pt's weight increased to 72.9 kg from 70.6kg, restarted on her home rx of torsemide 20mg po bid, was roughly negative 1.3L, pt's daily weights decreased off diuretics, was found to be supertheraputic on her coumadin which was held throughout admission, PNA was initially treated with azithromycin but as her cough and o2 levels persisted, pt was begun on ceftaz and levo for gram pos coverage (levo) double gram neg coverage, and ceftaz changed to cefpodoxime 200mg po qd x 7 days, however pt had only been on azithromycin x 1 day, all stool studies were negative, presumed viral gastroenteritis

Has this patient ever been on lasix

This 75-year-old female vasculopath was admitted for further evaluation of her peripheral vascular disease which was suspected to be contributing to her new ulcerations and progressively worsening bilateral foot pain, foot mottling and wrist pain as an exacerbating factor to likely atheroembolic phenomenon, status post coronary catheterizations earlier in the year. She was placed on broad-spectrum antibiotics and plan was made for an MRA to evaluate her anatomy, unfortunately, the patient was unable to tolerate the MR and did experience some mental status changes that prevented further noninvasive imaging when she received some narcotic following her hemodialysis round. Over the ensuing days she required rather significant doses of Zyprexa and Haldol to contain agitation and delirium, as the patient would also get physical and violent. This appeared to sedate her sufficiently and over the following days, she did manage to calm significantly and returned to her baseline mental status. Cardiology was consulted during this time to optimize her prior to the OR and her primary cardiologist, Dr. Fugle, did make some recommendations including an echocardiogram that showed preserved ejection fraction and no wall motion abnormalities. Her beta blockade was titrated up and she was instructed to follow up with cardiology. She did tolerate hemodialysis throughout this time without undue difficulty and they offered an angiogram to delineate aortic and bilateral lower extremity runoff anatomy. After extensive discussions with the patient and the patient's family, the patient did agree to a left femoral to dorsalis pedis bypass graft which was performed on 0/25/2006 without complication. By time of discharge, she was tolerating a regular diet and ambulating at baseline with her rolling walker. The pain was well controlled with minimal analgesics that were not narcotic based. Medications on admission included Aspirin 325 mg p.o. daily, Plavix 75 mg p.o. daily, Cardizem 60 mg p.o. t.i.d., Lipitor 80 mg daily, Atrovent 2 puffs four times a day, Albuterol 2 puffs b.i.d., Renagel 806 mg p.o. every meal, Allopurinol 100 mg p.o. daily, Zaroxylyn 2.5 mg p.o. daily p.r.n. overload, Lantus 10 units subcutaneous nightly, Regular insulin sliding scale, Valium 5 mg p.o. b.i.d. p.r.n., Isordil 40 mg p.o. t.i.d., Hydralazine 20 mg p.o. t.i.d., Lopressor 75 mg p.o. t.i.d., Zantac 150 mg p.o. b.i.d., Aciphex 20 mg p.o. daily, Neurontin 300 mg p.o. post-dialysis, Metamucil, Nitroglycerine p.r.n., Procrit 40,000 units subcutaneously every week, Lilly insulin pen, unknown dosage 20 units every morning and 10 units every evening, Loperamide 2 tabs p.o. four times a day, Ambien 10 mg p.o. nightly p.r.n., Tylenol 325 mg p.o. every four hours p.r.n. pain, Albuterol inhaler 2 puffs b.i.d., Calcitriol 1.5 mcg p.o. every Monday and every Friday, Darbepoetin alfa 100 mcg subcutaneous every week, Ferrous sulfate 325 mg p.o. t.i.d., Prozac 40 mg p.o. daily, Motrin 400 mg p.o. every eight hours p.r.n. pain, Insulin regular sliding scale, and Sevelamer 800 mg p.o. t.i.d. Discharge instructions included touchdown weightbearing on the left heel, legs are to be elevated as much as possible while sitting or lying down, all home medications were to be resumed except for Lopressor, VNA was ordered to assist with wound care including Betadine paint to incisions daily, showering only, no bathing or immersion in water for prolonged periods of time, and follow-up visits with Dr. Amorose in one to two weeks and Dr. Morici primary care physician in one week.

Has this patient ever tried aciphex

The patient is a 50 year old man with unstable angina who was referred to the Rhalca Medical Center for cardiac catheterization and coronary artery bypass grafting. He had a four-year history of coronary artery disease and described episodes of chest pain occurring approximately q. two months as well as evidence of shortness of breath due to chronic obstructive pulmonary disease. On admission, he was taking NTG on a twice daily basis for exertional angina and was given intravenous NTG, heparin, and Diltiazem by an EMT. His cardiac risk factors included an 80-pack year smoking history, family history of heart disease, hypercholesterolemia, and non-insulin-dependent diabetes mellitus. His past medical history was notable for interstitial lung disease, hyperlipidemia, GERD, chronic bronchitis, and obstructive sleep apnea. Medications on admission included Cardizem 120mg p.o.b.i.d., Mevacor 20mg p.o.b.i.d., Pepcid 40mg p.o.q.d., Ventolin and Seldane taken on a prn basis. Allergies were NKDA. An ETT Thallium demonstrated reperfusion abnormalities in the inferior and anterior walls. He underwent cardiac catheterization demonstrating 80% distal stenosis of the left main as well as the origin of the LAD with additional occlusion of the midportion of the LAD and distal carotid, 80% stenosis of midportion of left circumflex and proximal occlusion of the right coronary. On the 26th of May, he received double coronary artery bypass graft including pedicle LIMA bypass to the LAD and LAD patch angioplasty with a single aortocoronary saphenous vein bypass graft to the obtuse marginal. He had a low-grade fever and leukocytosis up to 20,000 for which he was started on an empiric course of cefuroxime and clindamycin 300mg p.o.q.i.d. He was evaluated by the Dental Service and prescribed a course of penicillin for a possible periodontal abscess of tooth #32. He was encouraged to see his cardiologist for follow-up and return to Dr. Donnie Daidone office for completion of his antibiotics. Discharge medications included Aspirin 325mg q.d., Diltiazem 120mg p.o.t.i.d., Colace 100mg t.i.d., iron sulfate 300mg t.i.d., Lasix 80mg p.o.b.i.d., Mevacor 20mg p.o.b.i.d., MVI one p.o.q.d., Percocet one to two tabs. q. 4 prn, KCl 40mil/eq p.o.b.i.d., and ciprofloxacin 500mg p.o.b.i.d. X 10 days taken with clindamycin 300mg p.o.q.i.d.

What is the current dose of the patient's colace

Ms. Lofstrom is a 57-year-old female with a past medical history of hypertension, diabetes mellitus, multinodular goiter, arthritis and questionable recurrent bouts of generalized weakness who was admitted for new onset of right sided weakness, right leg numbness and weakness, right arm clumsiness followed by dysarthria. Laboratory tests showed glucose of 353, sodium 138, potassium 4.9, chloride 98, CO2 28, BUN 33, creatinine 1.1, calcium 10.3, magnesium 2.0, troponin 0.09, white count 8.4, hematocrit 39.8, platelet count 367,000, PT 12.1, PTT 19.5, INR 1.0. An echocardiogram revealed evidence of concentric LVH with preserved systolic function, calculated ejection fraction of 55%, one plus tricuspid regurgitation and normal peak doppler flow velocity across the tricuspid valve. Carotid noninvasive studies showed no evidence of hemodynamically significant disease in either carotid artery. MRI showed a focal area of increased T2 signal in the posterior limb of the left internal capsule, close the genu and a similar smaller area of signal abnormality in the left globus pallidus adjacent to the left internal capsule abnormality. The patient had not taken her insulin for several days prior to admission, and was placed on her regular insulin schedule as well as a sliding scale with blood sugar between 150 and high 200s. Her medications included Hydrochlorothiazide 12.5 milligrams once a day, Norvasc 5 milligrams once a day, Taxol 28 milligrams once a day, Premarin 0.625 milligrams once a day, Trazodone, insulin 12 units of regular and 50 units of NPH in the morning and Ansaid 100 milligrams p.o. b.i.d. p.r.n. joint pain. She was also reportedly taking a baby aspirin 81 milligrams once a day, and was placed on subcu heparin and started on full dose aspirin 325 milligrams p.o. q.d. while her antihypertensives were held in order to maintain a systolic blood pressure between 140-160 with a diastolic blood pressure of 85-90. The patient was rehydrated with IV fluids, and close observation was paid to her electrolytes including her potassium. Rheumatology was consulted and recommended checking a urinalysis to check for red blood cells and casts, which showed no protein, no blood, 0-2 red blood cells, and no casts. He therefore suggested to continue aspirin, but in higher doses to alleviate her left shoulder pain. The patient's Norvasc continued to be held with excellent control of her blood pressure between systolic of 140-160, and should not be reinitiated until roughly ten days after her stroke. Social work was consulted due to a history of abuse by her husband, but no further abuse history was elicited since his death. The patient was considered stable and ready for discharge to a rehabilitation facility.

Has the patient ever had nph

The patient is an 83-year-old man with a history of CAD, s/p MI in 1973, s/p CABG x3, T2DM, and hypertension who was admitted with chest pressure and feeling numb in his arms and legs and around his head. He took some SL nitro but does not remember if it helped and denies shortness of breath. His EKG was A-paced and unchanged from March, his CXR had no acute process, and his cardiac enzymes were negative. His stress test from March 2005 revealed a small to medium sized region of myocardial scar/hibernation in the distribution of the PDA coronary artery and no evidence of stress induced ischemia at a low cardiac workload. He went into V-paced rhythm when given dobutamine and the test was submaximal with max HR 98 (77% predicted). No reversible ischemia was seen. He was continued on B-blocker, statin, and persantine, with no aspirin since history of GIB with it, and monitored on telemetry without any events. He also had an adenosine MIBI on 2/8/05 with results as above. Held oral hypoglycemic while in house. Covered with SSI regular qac. His PM was evaluated by EP to r/o pAF and EP interrogation revealed no mode shifts. He was weaned O2 to sat>93%, his creatinine remained at baseline, he avoided aspirin and was continued on PPI, was covered with SSI regular qac, and was given a PT consult. He was discharged with a full code status, home with services, and on a House/Low chol/low sat. fat and House/ADA 1800 cals/dy diet, and instructed to take medication consistently with meals or on an empty stomach, and to avoid grapefruit unless instructed otherwise and to walk as tolerated. Follow up appointments were scheduled with Dr. Widowski March at 3:30 PM and Dr. Caris 11/10/06. Allergies included Penicillins, Aspirin, DILTIAZEM, and ATORVASTATIN. The discharge medications included TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Headache, PERSANTINE (DIPYRIDAMOLE) 50 MG PO BID, LASIX (FUROSEMIDE) 10 MG PO QD, ATIVAN (LORAZEPAM) 3.5 MG PO QHS, NTG 1/150 (NITROGLYCERIN 1/150 (0.4 MG)), NITROGLYCERIN PASTE 2% 1 INCHES TP BID, INDERAL (PROPRANOLOL HCL) 10 MG PO QID, SUCRALFATE 1 GM PO QID Food/Drug Interaction Instruction, PAXIL (PAROXETINE) 10 MG PO QD, NORVASC (AMLODIPINE) 2.5 MG PO QD, on order for NORVASC PO 5 MG QD (ref #913242331), IMDUR ER (ISOSORBIDE MONONITRATE (SR)) 30 MG PO BID, COZAAR (LOSARTAN) 50 MG PO QD, PROTONIX (PANTOPRAZOLE) 40 MG PO QD, GLYBURIDE 2.5 MG PO QD, ZETIA (EZETIMIBE) 10 MG PO QD, ATIVAN (LORAZEPAM) 2 MG PO QID PRN Anxiety, Lescol 20 mg po qd, and 1 TAB SL Q5MIN X 3 doses PRN Chest Pain. Number of Doses Required (approximate): 3. He was also given instructions to take medication consistently with meals or on an empty stomach, and to avoid grapefruit unless instructed otherwise and to walk as tolerated. Follow up appointments were scheduled with Dr. Widowski March at 3:30 PM and Dr. Caris 11/10/06. Allergies included Penicillins, Aspirin, DILTIAZEM, and ATORVASTATIN. The discharge medications included TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Headache, PERSANTINE (DIPYRIDAMOLE) 50 MG PO BID, LASIX (FUROSEMIDE) 10 MG PO QD, ATIVAN (LORAZEPAM) 3.5 MG PO QHS, NTG 1/150 (NITROGLYCERIN 1/150 (0.4 MG)), NITROGLYCERIN

Has a patient had ativan ( lorazepam )

The 68-year-old female patient presented with lower extremity swelling and erythema at the lower pole of her sternal wound, and her past medical history includes hypertension, diabetes, hypothyroidism, hypercholesterolemia, COPD, GERD, depression, history of GI bleed on Coumadin therapy, and pulmonary hypertension. On admission, the patient was started on 1. Toprol 25 p.o. daily., 2. Valsartan 40 mg p.o. daily., 3. Aspirin 81 mg p.o. daily., 4. Plavix 75 mg p.o. daily., 6. Lasix 40 mg p.o. b.i.d., 7. Spironolactone 25 mg p.o. daily., 8. Simvastatin 20 mg p.o. daily., 9. Nortriptyline 50 mg p.o. daily., 10. Fluoxetine 20 mg p.o. daily., 11. Synthroid 88 mcg p.o. daily., and a Lasix drip and Diuril with antibiotics for coverage of possible lower extremity cellulitis. After transthoracic echocardiogram revealed an ejection fraction of 40% to 45% and a stable mitral valve, the patient was started on a Lasix drip and Diuril with improvement of symptoms, and the Pulmonary team was consulted and recommended regimen of Advair and steroid taper for her COPD, and she was empirically covered for pneumonia with levofloxacin and Flagyl and continued to diurese well on a Lasix drip. Her preadmission cardiac meds, as well as her Coumadin for atrial fibrillation, were restarted, and the patient required ongoing aggressive diuresis to eventually achieve a fluid balance of is negative 1 liter daily. Liver function tests, as well as amylase and lipase, were checked and noted to be normal, and the patient's nausea and vomiting resolved when her bowels began to move. The patient was discharged to home in good condition on hospital day #8 with medications including Enteric-coated aspirin 81 mg p.o. daily, Zetia 10 mg p.o. daily, Fluoxetine 20 mg p.o. daily, Advair Diskus one puff nebulized b.i.d., Lasix 60 mg p.o. b.i.d., NPH insulin 30 units subcutaneously q.p.m., NPH insulin 20 units subcutaneously q.a.m., Potassium slow release 30 mEq p.o. daily, Levofloxacin 500 mg p.o. q.24 h. x4 doses, Levothyroxine 88 mcg p.o. daily, Toprol-XL 100 mg p.o. daily, Nortriptyline 50 mg p.o. nightly, Prednisone taper 30 mg q.24 h. x3 doses, 20 mg q.24 h. x3 doses followed by a 10 mg q.24 h. x3 doses, then 5 mg q.24 h. x3 doses, Simvastatin 40 mg p.o. nightly, Diovan 20 mg p.o. daily, and Coumadin to be taken as directed to maintain INR 2 to 2.5 for atrial fibrillation, with followup appointments with her cardiologist, Dr. Schwarzkopf in one to two weeks with her cardiac surgeon, Dr. Carlough in four to six weeks, and VNA will monitor her vital signs, weight, and wounds, and the patient's INR and Coumadin dosing will be followed by S Community Hospital Anticoagulation Service at 300-135-5841.

has there been a prior simvastatin

This is a 67-year-old male with a history of tremor, hypertension, diabetes, atrial fibrillation, coronary artery disease, benign prostatic hypertrophy, gastroesophageal reflux disease, hiatal hernia, degenerative joint disease, polymyalgia rheumatica, diverticulitis, and osteomyelitis. He was admitted to the hospital with r/o MI and discharged with a diet of House/Low chol/low sat. fat, and instructed to follow up with his primary care doctor one week after d/c from rehab. His medications on admission included Lasix 20 qod, Isordil 40 bid, Prednisone 2 qd, Primidone 50 bid, Norvasc 5 qd, Coreg 25 bid, Flomax 0.4 qd, Prilosec OTC 20 qd, Lipitor 20 qd, ISS, Lantus 7 qd, Novolog 17 qac, Lovenox 30 qd, Vancomycin 1 gm qod, Ceftriaxone 2 gm qd, Digoxin 0.25 qod, Colace 100 bid, and Medications in ED: NS 500 cc, Aspirin. He was anticoagulated with Lovenox and given aspirin. He had a PICC line placed and was discharged with IV abx. At the tail end of his antibiotic regimen he spiked a fever and was admitted to VOWH. His course of antibiotics was extended and he was discharged to rehab on CEFTRIAXONE 2,000 MG IV QD and Vanc. In the ED, his temperature was normal, EKG demonstrated new ST depressions, and his first set of enzymes were negative. For Neuro, he has a history of tremor and is treated with Primidone and for ID, he was continued on his outpatient regimen of Lantus, standing insulin qAC and insulin SS. For GU, he was continued on Flomax for his BPH. He was discharged to rehab on his admission regimen with no dictated summary and advised to follow up with his PCP within 2 weeks.

What is the current dose of ceftriaxone

The patient is an 83-year-old man with a history of CAD, s/p MI in 1973, s/p CABG x3, T2DM, and hypertension who was admitted with chest pressure and feeling numb in his arms and legs and around his head. He took some SL nitro but does not remember if it helped and denies shortness of breath. His EKG was A-paced and unchanged from March, his CXR had no acute process, and his cardiac enzymes were negative. His stress test from March 2005 revealed a small to medium sized region of myocardial scar/hibernation in the distribution of the PDA coronary artery and no evidence of stress induced ischemia at a low cardiac workload. He went into V-paced rhythm when given dobutamine and the test was submaximal with max HR 98 (77% predicted). No reversible ischemia was seen. He was continued on B-blocker, statin, and persantine, with no aspirin since history of GIB with it, and monitored on telemetry without any events. He also had an adenosine MIBI on 2/8/05 with results as above. Held oral hypoglycemic while in house. Covered with SSI regular qac. His PM was evaluated by EP to r/o pAF and EP interrogation revealed no mode shifts. He was weaned O2 to sat>93%, his creatinine remained at baseline, he avoided aspirin and was continued on PPI, was covered with SSI regular qac, and was given a PT consult. He was discharged with a full code status, home with services, and on a House/Low chol/low sat. fat and House/ADA 1800 cals/dy diet, and instructed to take medication consistently with meals or on an empty stomach, and to avoid grapefruit unless instructed otherwise and to walk as tolerated. Follow up appointments were scheduled with Dr. Widowski March at 3:30 PM and Dr. Caris 11/10/06. Allergies included Penicillins, Aspirin, DILTIAZEM, and ATORVASTATIN. The discharge medications included TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Headache, PERSANTINE (DIPYRIDAMOLE) 50 MG PO BID, LASIX (FUROSEMIDE) 10 MG PO QD, ATIVAN (LORAZEPAM) 3.5 MG PO QHS, NTG 1/150 (NITROGLYCERIN 1/150 (0.4 MG)), NITROGLYCERIN PASTE 2% 1 INCHES TP BID, INDERAL (PROPRANOLOL HCL) 10 MG PO QID, SUCRALFATE 1 GM PO QID Food/Drug Interaction Instruction, PAXIL (PAROXETINE) 10 MG PO QD, NORVASC (AMLODIPINE) 2.5 MG PO QD, on order for NORVASC PO 5 MG QD (ref #913242331), IMDUR ER (ISOSORBIDE MONONITRATE (SR)) 30 MG PO BID, COZAAR (LOSARTAN) 50 MG PO QD, PROTONIX (PANTOPRAZOLE) 40 MG PO QD, GLYBURIDE 2.5 MG PO QD, ZETIA (EZETIMIBE) 10 MG PO QD, ATIVAN (LORAZEPAM) 2 MG PO QID PRN Anxiety, Lescol 20 mg po qd, and 1 TAB SL Q5MIN X 3 doses PRN Chest Pain. Number of Doses Required (approximate): 3. He was also given instructions to take medication consistently with meals or on an empty stomach, and to avoid grapefruit unless instructed otherwise and to walk as tolerated. Follow up appointments were scheduled with Dr. Widowski March at 3:30 PM and Dr. Caris 11/10/06. Allergies included Penicillins, Aspirin, DILTIAZEM, and ATORVASTATIN. The discharge medications included TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Headache, PERSANTINE (DIPYRIDAMOLE) 50 MG PO BID, LASIX (FUROSEMIDE) 10 MG PO QD, ATIVAN (LORAZEPAM) 3.5 MG PO QHS, NTG 1/150 (NITROGLYCERIN 1/150 (0.4 MG)), NITROGLYCERIN

Did the patient ever take any medication for her headache in the past

Mr. Gerache is a 59 yo man with poorly controlled diabetes and asthma who presented with chest pain. He had intermittent chest pain with activity lasting 5 minutes, relieved with rest, as well as shortness of breath when climbing stairs. Cardiac catheterization showed LAD prox 40%, no LCX lesions, no RCA lesions, and R PDA mid 30% lesion. Beta blocker was started, cholesterol was checked (elevated triglycerides 308, total cholesterol 146, HDL 29), statin was started and aspirin was held because of the patient's stated allergy to aspirin (causing asthma type symptoms). He was started on low-dose lisinopril and no prior echo was considered as outpatient. Patient was continued on home regimen of NPH insulin but clearly needs better control of his sugars as outpatient. Hemoglobin A1c is 10.7 and he will need better control of his sugars as outpatient. He has had asthma as a child and no record of PFTs but should obtain as outpatient, with home inhalers continued. Mr. Gaulding currently has good renal function but needs to have his Cr checked after starting the lisinopril. The patient was advised to consider carefully his lifestyle, including diet and exercise plans, and to take medications including VENTOLIN NEBULIZER (ALBUTEROL NEBULIZER) 2.5 MG NEB Q4H PRN Shortness of Breath, ATENOLOL 12.5 MG PO QD Starting IN AM (8/7), NPH HUMULIN INSULIN (INSULIN NPH HUMAN) 60 UNITS QAM; 70 UNITS QPM SC 60 UNITS QAM 70 UNITS QPM, LISINOPRIL 5 MG PO QD, ZOCOR (SIMVASTATIN) 20 MG PO QHS, FLOVENT (FLUTICASONE PROPIONATE) 44 MCG INH BID, COMBIVENT (IPRATROPIUM AND ALBUTEROL SULFATE) 2 PUFF INH QID, and make an appointment with his primary care doctor, take his medications as instructed, and follow up with his cardiologist within 4-6 weeks. He was also placed on a House / Low chol/low sat. fat diet, ADA 2100 cals/dy diet, 2 gram Sodium diet. He was discharged with Full code status and disposition to Home.

Has patient ever been prescribed -statin

The 68-year-old female patient presented with lower extremity swelling and erythema at the lower pole of her sternal wound, and her past medical history includes hypertension, diabetes, hypothyroidism, hypercholesterolemia, COPD, GERD, depression, history of GI bleed on Coumadin therapy, and pulmonary hypertension. On admission, the patient was started on 1. Toprol 25 p.o. daily., 2. Valsartan 40 mg p.o. daily., 3. Aspirin 81 mg p.o. daily., 4. Plavix 75 mg p.o. daily., 6. Lasix 40 mg p.o. b.i.d., 7. Spironolactone 25 mg p.o. daily., 8. Simvastatin 20 mg p.o. daily., 9. Nortriptyline 50 mg p.o. daily., 10. Fluoxetine 20 mg p.o. daily., 11. Synthroid 88 mcg p.o. daily., and a Lasix drip and Diuril with antibiotics for coverage of possible lower extremity cellulitis. After transthoracic echocardiogram revealed an ejection fraction of 40% to 45% and a stable mitral valve, the patient was started on a Lasix drip and Diuril with improvement of symptoms, and the Pulmonary team was consulted and recommended regimen of Advair and steroid taper for her COPD, and she was empirically covered for pneumonia with levofloxacin and Flagyl and continued to diurese well on a Lasix drip. Her preadmission cardiac meds, as well as her Coumadin for atrial fibrillation, were restarted, and the patient required ongoing aggressive diuresis to eventually achieve a fluid balance of is negative 1 liter daily. Liver function tests, as well as amylase and lipase, were checked and noted to be normal, and the patient's nausea and vomiting resolved when her bowels began to move. The patient was discharged to home in good condition on hospital day #8 with medications including Enteric-coated aspirin 81 mg p.o. daily, Zetia 10 mg p.o. daily, Fluoxetine 20 mg p.o. daily, Advair Diskus one puff nebulized b.i.d., Lasix 60 mg p.o. b.i.d., NPH insulin 30 units subcutaneously q.p.m., NPH insulin 20 units subcutaneously q.a.m., Potassium slow release 30 mEq p.o. daily, Levofloxacin 500 mg p.o. q.24 h. x4 doses, Levothyroxine 88 mcg p.o. daily, Toprol-XL 100 mg p.o. daily, Nortriptyline 50 mg p.o. nightly, Prednisone taper 30 mg q.24 h. x3 doses, 20 mg q.24 h. x3 doses followed by a 10 mg q.24 h. x3 doses, then 5 mg q.24 h. x3 doses, Simvastatin 40 mg p.o. nightly, Diovan 20 mg p.o. daily, and Coumadin to be taken as directed to maintain INR 2 to 2.5 for atrial fibrillation, with followup appointments with her cardiologist, Dr. Schwarzkopf in one to two weeks with her cardiac surgeon, Dr. Carlough in four to six weeks, and VNA will monitor her vital signs, weight, and wounds, and the patient's INR and Coumadin dosing will be followed by S Community Hospital Anticoagulation Service at 300-135-5841.

Previous enteric-coated aspirin

This 57-year-old female with a distant history of ovarian cancer, rheumatoid arthritis with systemic lupus erythematosus features, and history of TTP, status post splenectomy, was admitted with fever, shortness of breath, and pleuritic chest pain. She was initially given cefuroxime and levofloxacin in the emergency department for a presumed community acquired pneumonia, as well as Lasix. Her medications included diltiazem 240 mg a day, lisinopril 40 mg a day, Naprosyn 500 mg b.i.d., NPH insulin 24 units subcutaneously q.a.m., Entex-LA, and Cardizem-CD 240 mg p.o. q.d. She underwent thoracentesis and multiple bilateral therapeutic pleuracentesis, and was diuresed aggressively with Lasix, with her oxygen requirement being down from initially 5 to 6 liters per nasal cannula prior to discharge. A continuous Doppler wave form was found and she underwent abdominal CT scan, which did not show any evidence of venous or lymphatic obstruction. Initially, she was started on cefuroxime and azithromycin by the General Medicine team, and her Legionella urine antigen became positive and levofloxacin was added given recommendations from the Infectious Disease Service. She was off of O2 except that she had desaturations to 86% with ambulation, therefore, she was discharged home with p.r.n. oxygen, on Lasix 80 mg b.i.d., insulin sliding scale, lisinopril 40 mg a day, and Cardizem-CD 240 mg p.o. q.d. and levofloxacin 500 mg times 14 days. An elevated platelet count up to 800 and an elevated CA-125 level was discussed with her GYN oncologist, and she was to follow-up with her doctor in one week.

Has the patient had cefuroxime in the past

Logan Czaplinski, an 833-08-42-8 patient, was admitted on 1/27/2001 and discharged on 5/18/2001 to his home with a prescription of ASA (Acetylsalicylic Acid) 81 MG PO QD, Allopurinol 300 MG PO QD, Digoxin 0.25 MG PO QD, Folic Acid 1 MG PO QD, Lasix (Furosemide) 80 MG PO BID, Ativan (Lorazepam) 1 MG PO BID PRN anxiety or insomnia, Lopressor (Metoprolol Tartrate) 12.5 MG PO BID, Thiamine (Thiamine HCl) 100 MG PO QD, Coumadin (Warfarin Sodium) 5 MG PO QHS, Simvastatin and Warfarin, Levofloxacin 250 MG PO QD starting in AM (7/21), Insulin 70/30 (Human) 30 units SC BID, Imdur (Isosorbide Mononit.(SR)) 60 MG PO QD, KCL Slow Rel. 20 mEq x 1 PO BID, Allegra (Fexofenadine HCl) 60 MG PO QD, and Levofloxacin 250 MG PO QD Starting in AM (7/21). An override was added on 10/10/01 by Kent R. Kazee, MD with Potentially Serious Interactions: Aspirin & Warfarin, Simvastatin & Warfarin, and Levofloxacin & Warfarin. Food/Drug Interaction Instructions were also given. This 60-year-old male patient with ischemic CMP and AFib was started on Coumadin 5 weeks ago and was cardioverted via the AICD last Tuesday. He then developed SOB and fever, so he went to the local ED and was given Lasix and Rocephin. His WBC was elevated at 12.2 and he was sent to LMH where he had a low grade fever and required FM O2. He was treated empirically with Levofloxacin, diuresed, and assessed for underlying rhythm. His CXR showed interval improvement and his BCXs from LWMH were negative at 3 days. He was discharged on PO diuretics and a 14-day course of Levofloxacin, with ASA 81 MG PO QD, Allopurinol 300 MG PO QD, Digoxin 0.25 MG PO QD, Folic Acid 1 MG PO QD, Lopressor 12.5 MG PO BID, Thiamine 100 MG PO QD, Coumadin 5 MG PO QHS, Simvastatin and Warfarin, Levofloxacin 250 MG PO QD starting in AM (7/21), and Ativan 1 MG PO BID PRN anxiety or insomnia. He should seek immediate medical attention if he develops chest pain, SOB, lightheadedness, fever, chills, palpitations, or falls.

has there been a prior digoxin

Shaull Darin was admitted on 8/12/2007 and discharged on 7/17/2007 with a full code status and disposition to home. During his stay, he was prescribed ACETYLSALICYLIC ACID 325 MG PO DAILY, with an Override Notice added on 10/30/07 by LAUB , STERLING B M. , M.D. on order for COUMADIN PO ( ref # 853955570 ) due to a POTENTIALLY SERIOUS INTERACTION: ASPIRIN & WARFARIN, ATENOLOL 37.5 MG PO DAILY, CAPTOPRIL 12.5 MG PO BID, on order for KCL IMMEDIATE RELEASE PO ( ref # 545368405 ) due to a POTENTIALLY SERIOUS INTERACTION: CAPTOPRIL & POTASSIUM CHLORIDE, CELEXA ( CITALOPRAM ) 40 MG PO DAILY, PLAVIX ( CLOPIDOGREL ) 75 MG PO DAILY, DIGOXIN 0.125 MG PO DAILY, EPLERENONE 25 MG PO DAILY, FOLATE ( FOLIC ACID ) 1 MG PO DAILY, LASIX ( FUROSEMIDE ) 60 MG PO BID, Alert overridden: Override added on 10/30/07 by GOODWINE , BUFORD H B. , M.D. on order for LASIX PO ( ref # 145213873 ), NEURONTIN ( GABAPENTIN ) 100 MG PO TID, LORAZEPAM 0.5 MG PO DAILY PRN Anxiety, LOVASTATIN 40 MG PO DAILY, with an Override Notice added on 10/30/07 by PERAULT , SHELBY H M. , M.D. on order for COUMADIN PO ( ref # 853955570 ) due to a POTENTIALLY SERIOUS INTERACTION: LOVASTATIN & WARFARIN, POTENTIALLY SERIOUS INTERACTION: NIACIN , VIT. B-3 & LOVASTATIN, OMEPRAZOLE 20 MG PO DAILY, TEMAZEPAM 15-30 MG PO BEDTIME PRN Insomnia, MULTIVITAMIN THERAPEUTIC ( THERAPEUTIC MULTIVI... ) 1 TAB PO DAILY, COSOPT ( TIMOLOL/DORZOLAMIDE ) 1 DROP OU BID, Alert overridden: Override added on 11/14/07 by LUTHY , LANNY D E. , M.D. on order for COSOPT OU ( ref # 517414331 ), COUMADIN ( WARFARIN SODIUM ) 1 MG PO QPM, TRAVATAN 1 DROP OU BEDTIME Instructions: OU. thanks., amiodarone toxicity, Peripheral neuropathy, restless legs, Spinal, ASA/Plavix, BB. Some concern for ischemia causing his, to 60 bid. Cont Dig/nitrate/BB, ACEi. Checked echo, no change., Rhythym: Tele. Lyte replete78M with significant CAD, iCM EF 15-20%, presenting with SOB, underwent Adenosine MIBI with no focal defects, LHC with no new disease and no interventions, RHC with wedge of 16, PFTs 1992 with no COPD, CR 1.4-1.8, Barrett's on PPI, neuropathy, neurontin, celexa, glaucoma on eye drops, CV, NAS, 2L fluid restrict diet, held coumadin for cath then restarted it with 2mg on 8/1, 1mg on 6/10, INR of 1.7 on d/c, additional comments included measuring daily weights and calling MD if weight increases by more than 5 lbs in one week or 2-3 lbs in one day, continuing coumadin and checking INR on Monday, taking lasix 60 twice a day, and resuming all home medications. Patient discharged in stable condition with instructions to follow up volume status and check INR on 2/21/07. Number of Doses Required ( approximate ): 7. Override Notice: Override added on 10/30/07 by LAUB, STERLING B M. , M.D. on order for COUMADIN PO ( ref # 853955570 ) and Alert overridden: Override added on 11/14/07 by LUTHY , LANNY D E. , M.D. on order for

What is the current dose of coumadin ( warfarin sodium )

A 60 year old Spanish speaking woman with multiple cardiac risk factors and a two to three year history of exertional angina presented complaining of unstable chest pain. Dr. Maximo Bryum in C&O MEDICAL CENTER Clinic initiated an antianginal regimen, however the patient recently stopped taking Aspirin and her symptoms then recurred. The patient was given three sublingual Nitroglycerins after her primary M.D. was called and her pain resolved after approximately 15 minutes. On the 27 of January, 1995, the patient underwent a Dobutamine MIBBE on which she went 6 minutes and 48 seconds reaching a maximal heart rate of 154, a blood pressure of 172/82, with 2 mm ST depressions diffusely and moderate to severe reversible anterior and anteroseptal wall ischemia. Medications on admission included Atenolol 50 mg p.o. q.d., Axid 150 mg p.o. b.i.d., Enteric Coated Aspirin 325 mg p.o. q.d., Coumadin 10 mg p.o. q.h.s., Diltiazem 240 mg p.o. q.d., Lisinopril 10 mg p.o. q.d., Lopipd 600 mg p.o. q.d., Lasix 40 mg p.o. q.d., Insulin NPH 75 units sub-q q.a.m., 50 units q.p.m., Insulin Regular 25 units sub-q q.a.m., Nitroglycerin 1/150th one tablet sublingual q. 5 minutes x 3 p.r.n. chest pain, and Omeprazole 20 mg p.o. q.d. The Cardiology Team was consulted and serial CK, MB and EKG's were done, with Heparin initially started given the possibility that this was unstable angina. The patient's Insulin dosages were adjusted in the manner to keep her blood sugars in the approximately 200 range and she was discharged with medications including Enteric Coated Aspirin 325 mg p.o. q.d., Lasix 40 mg p.o. q.d., Lopid 600 mg p.o. q.d., Insulin NPH 100 units sub-q q.a.m., 70 units sub-q q.h.s., Insulin Regular 25 units sub-q q.a.m., Lisinopril 10 mg p.o. q.d., Nitroglycerin 1/150th one tablet sublingual q. 5 minutes x 3 p.r.n. chest pain, Omeprazole 20 mg p.o. q.d., Coumadin 10 mg p.o. q.h.s., Diltiazem CD 240 mg p.o. q.d., with follow-up care with her primary M.D., Dr. Jarvis Needy in the RINGBURG RITA'S PROPRES MEMORIAL HOSPITAL Clinic.

heparin

The patient is an 83-year-old female with a history of coronary artery bypass grafting (CABG) in 1993, a left main and diagonal percutaneous transluminal coronary angioplasty (PTCA) with cypher stent, and a bare metal stent in the diagonal for recurrent chest pain. She was admitted for possible myocardial infarction due to anginal pain, however 3 sets of negative cardiac enzymes and no EKG changes ruled this out. She woke up at 5am with substernal epigastric pain, which was unclear if it was angina or esophageal spasm. She took Maalox and 3 nitroglycerin (NTG) with pain that responded to nitro, blood pressure (BP) dropped 140s to 90s but came right back. Admitted medications included ECOTRIN (Aspirin Enteric Coated) 325 mg PO QD, Atenolol 50 mg PO QD, Ferro-Sequels 1 tab PO QD, Lisinopril 30 mg PO QD, Pravachol (Pravastatin) 80 mg PO QHS, Norvasc (Amlodipine) 5 mg PO QD, Imdur ER (Isosorbide Mononitrate (SR)) 120 mg PO QD, Pilocarpine 2% 1 drop OU BID, Bactrim DS (Trimethoprim/Sulfamethoxazole Double Strength) 1 tab PO BID x 12 doses starting today (10/19), Clobetasol Propionate 0.05% Cream TP BID, Allegra (Fexofenadine HCL) 60 mg PO QD, on order for Allegra PO (ref #483093734), Alphagan (Brimonidine Tartrate) 1 drop OU BID, Plavix (Clopidogrel) 75 mg PO QD, Calcium Carbonate 1,500 mg (600 mg elem Ca)/Vit D 200 IU 1 tab PO QD, Zetia (Ezetimibe) 10 mg PO QD, Metformin 250 mg PO BID, Aciphex (Rabeprazole) 20 mg PO QD, and Plavix, BB, ACE, statin, Zetia. Lipid panel was good with total cholesterol 163 and LDL 86 HDL 43. ACE was uptitrated to optimize BP, increased to 30 mg daily with improved BP with SBP in 110s. The patient had a history of anemia and was continued on iron. HCT was stable in low 30s, 32.6 at discharge. The patient was started on Bactrim for 7 days for a urinary tract infection. All other medications were the same. The patient was discharged in stable condition with instructions to monitor BP with uptitration of ACE, take calcium, follow a cardiac and diabetic diet, watch calcium, and take Lovenox and PPI.

Has a patient had ecotrin ( aspirin enteric coated )

This 63-year-old male was transferred from LMC with a positive stress test and a history of CABG LIMA-D1, V-OM1, V-OM2, V Y-graft to PDA and PLV. Upon admission, he was diagnosed with CAD and presented with exertional angina. A nuclear stress revealed inferior scar and small area of anterior ischemia, and he was then transferred to CTMC for a cath. His medications on transfer included Dilantin 300/300/250, Glyburide 10 BID, Metformin 850 TID, Toprol 100 Daily, ASA 325 Daily, Isordil 20 TID, Lasix 20 QOD, Lipitor 40 Daily, Neurontin, Celondin 300 TID, Digoxin 0.25 Daily, and Benazepril 10 Daily. His hospital course included CV: Cath LIMA-LAD, DM: holding Metformin and restarting Glyburide and RISS, Neuro: Cont Neurontin 300 TID, Dilantin 200/200/250, and Celondin, and he was switched to Plavix 75 Daily, Atorva to Simva in house, Benazepril to Lisinopril 10, and Digoxin 0.25. He was discharged with instructions to take all medications as prescribed, with a full code status and disposition of Home. Medications at discharge included DIGOXIN 0.25 MG PO DAILY, LASIX (FUROSEMIDE) 20 MG PO EVERY OTHER DAY, GLYBURIDE 10 MG PO BID, ISORDIL (ISOSORBIDE DINITRATE) 20 MG PO TID, DILANTIN (PHENYTOIN) 200 MG QAM; 250 MG QPM PO BEDTIME, TOPROL XL (METOPROLOL SUCCINATE EXTENDED RELEASE) 100 MG PO DAILY Food/Drug Interaction Instruction, NEURONTIN (GABAPENTIN) 300 MG PO TID, PLAVIX (CLOPIDOGREL) 75 MG PO DAILY, BENAZEPRIL 10 MG PO DAILY, GLUCOPHAGE (METFORMIN) 850 MG PO TID, and CELONTIN (METHSUXIMIDE) 300 MG PO TID.

Has this patient ever been treated with metformin

Patient TEWA, GERMAN M, a 74-year-old African American female with a history of NYHA III CHF (EF 45%), PHT, HTN-CMP, and obesity, was admitted to CAR service on 1/20/2005 for CHF exacerbation and UTI and was discharged on 4/28/2005 with Full Code status. She was prescribed ALLOPURINOL 100 MG PO BID, FERROUS SULFATE 325 MG PO QD, LASIX (FUROSEMIDE) 60 MG PO BID starting today (8/27), HYDRALAZINE HCL 10 MG PO TID (hold if SBP below 90), ISORDIL (ISOSORBIDE DINITRATE) 20 MG PO TID (hold if SBP below 90), LISINOPRIL 20 MG PO QD (hold if SBP below 90), LIPITOR (ATORVASTATIN) 10 MG PO QD, PROTONIX (PANTOPRAZOLE) 40 MG PO QD, TOPROL XL (METOPROLOL SUCCINATE EXTENDED RELEASE) 75 MG PO QD, LEVAQUIN (LEVOFLOXACIN) 250 MG PO QD, and ACETYLSALICYLIC ACID 325 MG PO QD. Override notices were added on 5/12/05, 10/29/05, and 10/29/05 on order for KCL IMMEDIATE RELEASE PO (ref #03030471, 01642329, 91907761, 15927551) and KCL IV (ref #78178294) for POTENTIALLY SERIOUS INTERACTION: LISINOPRIL & POTASSIUM CHLORIDE. Food/Drug Interaction Instruction to avoid milk and antacid, take consistently with meals or on empty stomach, and administer iron products a minimum of 2 hours before or after a levofloxacin or ciprofloxacin dose dose (if on tube feeds, please cycle (hold 1 hr before to 2 hr after) and take 2 hours before or 2 hours after dairy products) was provided, as well as fluid restriction and diurese aggressively with lasix 100 bid, replete lytes, keeping in mind CRI, cont BB, ACEI, and added hydralazine/isordil for CAD, hyperlipidemia: BB, ACEI, statin, ASA; RENAL: CRI with anemia; HEME: Anemia - Given aranesp, FeSO4; HTN: BB, ACEI; ID: UTI, E coli in Ucx, sensitivities pending; and empirically tx with Keflex, changed empirically on HD4 to levo. RHEUM: Gout - allopurinol. The patient was discharged in a satisfactory condition.

Has this patient ever been prescribed hydralazine/isordil

Patient DOUGLASS W. DILEO was admitted to CAR with unstable angina and discharged on 11/23/04 with a code status of full code and disposition of home w/ services. The patient has a possible allergy to NSAIDs with reaction unknown and a probable allergy to SIMVASTATIN, NSAIDs, SHELLFISH, and Codeine. The patient was given atropine and Fem stop placed over cath due to femoral hematoma. CT ruled out retroperitoneal bleed and her HCT dropped from 32 to 26, and she was transfused 2 U PRBC. The anti-ischemic regimen at discharge included ENTERIC COATED ASA (ASPIRIN ENTERIC COATED) PO 325 MG QD (ref #57541802), INSULIN NPH HUMAN 36 UNITS QAM; 40 UNITS QPM SC, NEURONTIN (GABAPENTIN) 600 MG PO BID, PLAVIX (CLOPIDOGREL) 75 MG PO QD, ZETIA (EZETIMIBE) 10 MG PO QD, LISINOPRIL 40 MG PO QD, HYDROCHLOROTHIAZIDE 25 MG PO QD, PREVACID (LANSOPRAZOLE) 30 MG PO QD, GLUCOPHAGE (METFORMIN) 1,000 MG PO BID, and ATENOLOL 25 MG PO QD, with no statin due to muscle pain history. The patient was instructed to take 1/2 their regular home dose of Atenolol until they see their cardiologist/PCP, and to follow a diet of house/low chol/low sat. fat and house/ADA 2100 cals/dy. Patient was to follow up with Dr. Brechbiel in 2 weeks and Dr. Damms for right leg ultrasound in 2-4 weeks. The patient also had a below-the knee right tibial vein DVT, was not anticoagulated for this below-the knee clot because of low risk of embolization and her recent HCT drop/hematoma. The patient was also given IBUPROFEN 600-800 MG PO Q6H PRN Pain for left knee pain after a fall one week prior. The patient was instructed to continue home diabetic regimen and followup with PCP/cardiology and schedule a repeat right leg ultrasound test (“LENI”) to follow the small blood clot in her leg in the future.

What is the current dose of ecasa

This 64-year-old patient had a past medical history of non-small cell lung cancer, status post XRT and chemotherapy, right MC embolic stroke, status post right carotid endarterectomy, Graves’ disease, depression, diabetes, hypertension, asthma, temporal lobe epilepsy, and history of subclavian steal syndrome. On admission, her blood pressure was 66/44, pulse of 100, respiratory rate normal, and blood sugar of 133. She was found to be difficult to arouse and had 1 gm of vancomycin, magnesium and Levaquin 500 mg. Her medication on admission included Mechanical soft diet, aspirin 81 mg, baclofen 5 mg t.i.d., B12 1000 mg daily, iron sulfate 325 mg daily, Cymbalta 20 mg p.o. b.i.d., Neurontin 100 mg b.i.d., Lamictal 200 mg b.i.d., Prilosec 20 daily, levothyroxine, Glucophage 500 once a day, Reglan 10 once a day, niacin 500 once a day, Senna 2 tabs b.i.d., Zocor 20 mg once a day, Nicoderm patch, Colace 100 mg p.o. b.i.d., Lopressor 100 mg p.o. b.i.d., lidoderm 5% patch to the low back, Tylenol, ducolox, Mylanta, lactulose, Seroquel 100 mg, prednisone 50 mg, and Dilaudid 1 mg. She completed a ten-day course of vancomycin for a MRSA urinary tract infection and was treated with tramadol and Tylenol for pain. Her laboratory data showed creatinine of 1, ALT 25, AST 35, hematocrit 33, white count 6.6, and platelets 241,000. She was covered with antibiotics initially, then transitioned over to a ciprofloxacin 700 mg p.o. b.i.d. regime for a total of 12 days for a presumed urinary tract infection. She had a significant polypharmacy and enumerable sedating medications, including baclofen, Dilaudid and trazodone. Her Cymbalta was continued per outpatient follow-up and her Lamictal, as well as her Cymbalta, were maintained for her history of depression. Neurologically, she had a left-sided hemiparesis, as well as agnosia on the left side, and her mental status included intermittent disorientation. She was maintained on Novolog sliding scale for diabetes, QTc monitored with serial EKGs, and prior use of Haldol and other antipsychotics for behavioral modification. She was also continued on a replacement dose levothyroxine for her history of Graves' and a history of radioiodine ablation. For behavioral modification, as well as intermittent agitation and disorientation, the patient was maintained on p.r.n. Seroquel 100 mg p.o. b.i.d., as well as Zydis 5 mg p.o. b.i.d. p.r.n., which was titrated from standing to p.r.n. over the course of her hospitalization in order to try to decrease any sedating medications that may be altering her alertness and orientation.

Has the patient had previous seroquel

This 66-year-old male with a history of CAD, MI, CABG, and PCI was admitted with chest pain and ongoing risk factors. His enzyme on presentation was negative and EKG showed nonspecific T wave flat in II, III and V2-V3. In the ED, he had a BP of 86/118 and was given NITROGLYCERIN 1/150 (0.4 mg) SL q5min x 3 with no relief; his CP was 10/10 and reduced to 4/10 with NITROGLYCERIN. Labs showed elevated BUN/Cr and mild-mod lateral wall ischemia. He was prescribed ASA 325 mg PO QD, AMIODARONE 200 mg PO BID, LOPRESSOR (METOPROLOL TARTRATE) 50 mg PO BID, ISOSORBIDE DINITRATE 30 mg PO TID (hold if sbp<100), IMDUR 60 mg PO BID, PLAVIX 75 mg PO QD, Protonix, KEFLEX (CEPHALEXIN) 500 mg PO QID, Lasix 60 mg PO BID, KCl 40 mg PO QD, Metformin 500 mg PO BID, Micronase 10 mg PO BID, Tylenol with Codeine PRN, and Ativan 5 mg PRN. He was also advised to follow-up with his PCP to discuss starting Coumadin therapy given his history of atrial fibrillation, and was instructed to take PPI for GERD and a PPI and SC Hep for ppx. He was discharged with stable condition, and lab results showed normal WBC and no signs of acute infection. The patient was also advised to continue taking POTASSIUM CHLORIDE & RAMIPRIL, ALTACE (RAMIPRIL) 1.25 mg PO QD, NEXIUM (ESOMEPRAZOLE) 20 mg PO QD, DIET: House/Low chol/low sat. fat, ACTIVITY: Resume regular exercise, and FOLLOW UP APPOINTMENT(S): Please see your PCP in Own within 2 weeks.

Has patient ever been prescribed nexium ( esomeprazole )

Mr. Laborn is a 54-year-old male with no significant past medical history who presented to his cardiologist with chest pressure while working out. Stress test and cardiac catheterization showed diffuse LAD disease and he was referred to Dr. Pillon for coronary revascularization. His past medical history includes hypertension, diabetes mellitus, hyperlipidemia, COPD, and asthma, and he was not a tobacco user. Preoperative medications included Lisinopril 20 mg p.o. daily, atorvastatin 40 mg p.o. daily, and Xanax dose unknown. Vital signs, physical examination, and preoperative labs were all normal, and on 2/1/05 coronary anatomy showed 95% osteal LAD, 90% proximal LAD, and 70% LAD left dominant circulation. On 0/8/05 he had CABG x2 with a LIMA to the LAD, SVG1 to the D1, and was transferred to the cardiac intensive care unit under stable condition. His course was uncomplicated in the cardiac intensive care unit and all epicardial pacing wires and chest tubes were removed without complication. He was discharged home on postoperative day #4 in stable condition on aspirin 325 mg p.o. q. day, Niferex 150 mg p.o. b.i.d., oxycodone 5 mg p.o. q.6h. p.r.n. pain, Toprol XL 100 mg p.o. q. day, Flovent 44 mcg inhaler b.i.d., and Lipitor 40 mg p.o. daily, and is to follow-up with Dr. Delawyer cardiac surgeon in six weeks and Dr. Eggleston, cardiologist in two weeks.

Why was the patient on oxycodone

Everett LLOPIS was a 63-year-old male admitted on 1/6/2001 with a history of CAD, MI, s/p CABGx4, h/o PE, h/o CVA on coumadin, NIDDM and h/o recent pneumonia (6/14) who presented with intermittent epigastric pain associated with nausea, diaphoresis and SOB x 2 days which he noted as his anginal equivalent. Labs were notable for Na 133 and Cr 1.7, negative tropnin (0.00) and CK 53, LFTs normal. RUQ ultrasound was notable for normal gall bladder with a fatty liver and gallstones and no sonographic Murphy's. ECG showed NSR at 80 with flat T in I and flipped T waves in 2, 3 (all old) and new T wave inversions V5/V6. V/Q scan was intermediate probability likely secondary to recent pneumonia, but d-dimer 800. Pt had +LENI's. He was put on a House/ADA 2100 cals/dy diet and was to return to work immediately. Follow-up appointments were scheduled with Dr. Shad Palovick in one week and Dr. Emmitt Quire on 0/1/01. The patient was allergic to Procardia (Nifedipine (Immed. Release)), Isordil, and Benadryl (Diphenhydramine Hcl). Dr. Yuenger was consulted and recommended starting the patient on reduced dose Lovenox (50mg sc bid x 2 wk and 40mg sc x 3 mo). Checked heparin level (0.9) so reduced dose of Lovenox to Lovenox 40mg sc bid. LENIS to be repeated in 3 months prior to d/c Lovenox. He was discharged on ASA (Acetylsalicylic Acid) 81 mg PO QD, Gemfibrozil 600 mg PO BID, Zocor (Simvastatin) 20 mg PO QHS, Avandia (Rosiglitazone) 4 mg PO BID, Ocuflox (Ofloxacin 0.3% Oph Solution) 1 drop OS QID, Atenolol 50 mg PO QD, Prilosec (Omeprazole) 20 mg PO QD, Glucophage (Metformin) 1,000 mg PO BID, Altace (Ramipril) 2.5 mg PO QD, Maalox Plus Extra Strength 15 ML PO Q6H PRN Indigestion, and Lovenox (Enoxaparin) 40 mg SC Q12H x 14 Days with food/drug interaction instruction and potentially serious interaction: Potassium Chloride & Ramipril Reason for override: aware. He was discharged in stable condition and will follow-up with Dr. Chadwick Lafone and his primary care doctor with instructions to continue home meds, VNA for assistance with Lovenox and meds, take Lovenox as directed, follow-up LENIS in 3 months before d/c Lovenox, and follow-up with Dr. Dean Cooke AND pcp.

has there been a prior zocor ( simvastatin )

This is a 48-year-old female who was admitted to the hospital with pneumonia and Klonopin overdose two days prior to admission, having recently completed an antibiotic course at Dale Skin Sonmu Medical Center for pneumonia. She has not taken her lisinopril or methadone in the past. Upon admission, her respiratory rate was 18, O2 saturation 95% on 8 liters of oxygen and she was aggressively given fluids and was started on Levophed for blood pressure support. Her EKG was notable for low voltage on the precordial leads and her saturations were in the high 80's. She was given vancomycin, Levaquin and gentamicin and 3 liters of normal saline. She had a mild troponin elevation on admission, likely secondary to RV strain, and was given a heparin drip with a goal of 60 to 80. Her second PECT showed a small PE to the right upper lobe, but it was not large enough to explain her dramatic presentation. She had severe hypotension and was on two pressors, which were weaned off of on 4/15/06, but had an episode of hypotension when her BiPAP was started. She was given a little bit of low dose dobutamine and then weaned off of that on 3/6/06. She had an elevated eosinophilia on presentation and it was 4% on admission and increased to 8% on 4/21/06. She was empirically covered on admission with vancomycin, levofloxacin and gentamicin. Her antibiotics were given again on 10/16/06 and on 11/13/06. She did complain of bladder spasms while having the Foley in place and was started on Ditropan. She had multiple negative urinalysis and urine cultures. Once the Foley was discontinued, she was able to void and she stopped having bladder spasms. She was started on Monistat for a yeast infection. She did have a history of severe hypertension and her blood pressures were stable, but not high enough to withstand on additional blood pressure lowering medication. It was discussed with her PCP that she perhaps will need this medication restarted as an outpatient. She also had a normal increase in her cortisol level with ACTH stimulation. Her Coumadin was initially given 10, then a dose of 5 and then 2 dose of 7.5. We are continuing her methadone, which has been switched from 20 mg p.o. daily to 10 mg p.o. b.i.d. She was also given a little bit of Ativan while in-house to help with her agitation and anxiety and was initially given a little bit of Haldol, but that was discontinued on 8/4/06 and there was no additional need for that. She was on unfractionated heparin for her presumed PE until 6/15/06 and then changed to Lovenox in the morning and her methadone has been switched from 20 mg p.o. daily to 10 mg p.o. b.i.d. She was given a little bit of low dose lisinopril while in-house. Her blood pressures were stable, but her weight at that time was 157 kg.

What medication did the patient take for pneumonia

Rayford Turturo, a patient with Congestive Heart Failure, was admitted on 9/6/2004 and discharged on 5/22/2004. During his stay, he was placed on ACETYLSALICYLIC ACID 325 MG PO QD, ALLOPURINOL 100 MG PO QD, DIGOXIN 0.125 MG PO QD, LEVOXYL (LEVOTHYROXINE SODIUM) 75 MCG PO QD, TOPROL XL (METOPROLOL (SUST. REL.)) 50 MG PO QD, NEURONTIN (GABAPENTIN) 200 MG PO QD, COZAAR (LOSARTAN) 100 MG PO QD HOLD IF: SBP<100, CELEXA (CITALOPRAM) 20 MG PO QD, LANTUS (INSULIN GLARGINE) 50 UNITS SC QHS, WARFARIN SODIUM 3 MG PO QPM, LIPITOR (ATORVASTATIN) 10 MG PO QD, PRILOSEC (OMEPRAZOLE) 20 MG PO QD, TORSEMIDE 100 MG PO QAM, and TORSEMIDE 50 MG PO QPM. Override notices were added on 1/16/04 for WARFARIN SODIUM PO (ref #94959833), LEVOXYL PO (ref #70031810), and SERIOUS INTERACTIONS with ASPIRIN, LEVOTHYROXINE SODIUM, ALLOPURINOL, and WARFARIN. The patient was also instructed to measure weight daily, follow a fluid restriction of 2 liters, and a House/Low Chol/Low Sat. Fat, House/ADA 1800 cals/dy, and 2 gram Sodium diet. He was encouraged to walk as tolerated, and given follow-up appointments with Dr. Wilfinger (PCP), Corey Ortmeyer (CHF Clinic/Laxo Hospital), and Salvatore Angeli (Pacer/ICD Clinic). The patient also had an EP service place a VVI/R ICD device without complications, and was initially treated with intravenous Lasix until her respiratory status improved. During his stay, his electrolytes and magnesium were monitored and replenished, his coumadin dose decreased while being treated with levofloxacin, and he was instructed to keep appointments, have his INR checked, weight himself daily, follow written EP discharge instructions, and resume regular insulin dose when he resumes his outpatient eating habits.

How often does the patient take allopurinol

Ms. Dozois is a 64-year-old female admitted to MICU on 2/19/2005 for neutropenia, nausea, vomiting, abdominal pain, and shortness of breath, requiring intubation and pressors. Her medical problems included severe COPD (on home O2 2 liters baseline sat below 90s), nonsmall cell lung cancer (diagnosed in 1999, status post multiple chemotherapy regimens, most recently ALIMTA from 1/29/2005 to 09), diabetes, obesity, and chronic renal insufficiency. Her MEDICATIONS ON ADMISSION included Avapro, Lipitor, Decadron, ranitidine, Humalog, allopurinol, Alimta, Flonase, Vitamin D, B12, and Colace. She was initially treated with vancomycin, Levaquin, and aztreonam along with Flagyl empirically, and later changed to Levaquin only on 10/25/2005 to treat an enterococcal UTI and possible nosocomial pneumonia. She had thrombocytopenia and required multiple red blood transfusions to maintain her hematocrit greater than 26, though she was never hemodynamically unstable. She also required multiple platelet transfusions to keep her platelets greater than 30,000. She responded well initially to three units of packed red blood cells over 7/28/2005 and 09. However, in the setting of her GI bleed from a sloughing mucosa secondary to resolving neutropenic enteritis and recent chemo, she required multiple further RBC transfusions to keep her hematocrit greater than 30. Hematology was consulted secondary to suboptimal busted platelet levels status post transfusions, which was felt to be secondary to poor marrow response in the setting of recent chemo (workup was negative for other possible causes refractory thrombocytopenia, nystatin, allopurinol, were held given possible worsening of her thrombocytopenia). Surgery was consulted and she was managed conservatively with antibiotics initially and then with bowel rest. TPN was started on 4/21/2005, given her bowel rest for a neutropenic enteritis. She was changed to standing insulin on 10/25/2005 and her Lantus was up titrated along with sliding scale insulin to maintain blood sugars in the 80s to 120s. She is no longer neutropenic and was off Neupogen for one week and will stay and finish the 14-day course of Levaquin for coverage. On discharge her hematocrit and platelets were stable respectively at 29.8 and 46,000 and she had not required a transfusion in greater than 24 hours prior to discharge. Her DISCHARGE MEDICATIONS included Tylenol 650 to 1000 mg PO q. 6h PRN pain, headache, if fever is greater than 101, Peridex mouth wash 10 mL twice a day, nystatin mouth wash 10 mL swish and swallow 4 x day as needed, oxycodone 5 mg PO q. 6h PRN pain, simethicone 80 mg PO q.i.d. PRN gaseousness, trazodone 25 mg PO at bedtime, miconazole nitrate 2% powder topical BID to areas between skin folds including under the right breast, Nexium 20 mg PO daily, Lantus 30 mg subcutaneous daily, DuoNeb 3/0.5 mg Nebs q. 3 h. PRN shortness of breath, aspart 4 units before each meal subcutaneously, folate 3 mg PO daily, Avapro 150 mg PO daily, meclizine 25 mg PO TID, Combivent 2 puffs inhaled q.i.d., Vitamin D 125 0.25 mcg PO daily. She will follow up with infectious disease and hematology for her neutropenia, which has since resolved, and will stay and finish the 14-day course of Levaquin for UTI coverage.

Is the patient currently or have they ever taken insulin

The patient is a 54 year old white male with cardiac risk factors of diabetes, borderline hypertension, male gender, and a positive family history, who presented to Leyson Memorial Hospital complaining of substernal chest pain. On arrival to Icoson Hospital, the patient's blood pressure was 126/80 and heart rate was 80, and the electrocardiogram showed new ST depressions in V2-V5, T wave inversions in AVL, and flat T's in 1 and V6. The patient was treated with two sublingual nitroglycerins and sent to the Mendwood Hospital. On route to Icoson Hospital, the patient received an aspirin, a sublingual nitroglycerin, nitro paste, Lopressor 5 mg x 1 intravenously, and intravenous heparin. Upon transfer to the CCU, the patient was pain free and was maintained on heparin and intravenous nitroglycerin for 72 hours after admission. The patient was started on Lopressor and Glucotrol 5 mg p.o. q.d., as well as enteric-coated aspirin at admission, and was maintained on his glipizide and atenolol, 50 mg p.o. q.d., and enteric-coated aspirin, as well as nitroglycerins p.r.n. chest pain. Two days after the cardiac catheterization, the patient was pain free and was maintained on heparin overnight. The patient's condition at the time of discharge was stable, and was discharged with diabetic teaching as an outpatient with CH, follow-up with Dr. Kalert, atenolol 50 mg PO q.d., sublingual nitroglycerins PRN chest pain, and Glucotrol 5 mg PO q.d.

Was the patient ever prescribed atenolol

The patient is a 42-year-old white man who presented with complaints of fever to 103 and chills, a productive cough, and groin pain lasting three days. At age three, he was diagnosed with Wilms' tumor on the left, which was resected and subsequently treated with wide field radiation, after which he developed radiation-induced tyroid cancer, at which time he underwent subtotal thyroidectomy. In May of 1997, he underwent living related donor renal transplantation for chronic renal failure, however, the postoperative course was complicated by cytomegalovirus infection, presenting with diarrhea and requiring hospitalization in February 1997. He was treated with ganciclovir and subsequently maintained on Cytovene. He had one fever spike on hospital day one and Levaquin was initiated on hospital day three along with intravenous antibiotics, after which he was switched to oral antibiotics, including Levaquin and Augmentin. His blood pressures were stabilized at 130/80 with the initiation of a second antihypertensive medication, Nifedipine XL, for which he was maintained for two days at 30 mg. Hematologic studies revealed that he was continued on anticoagulation for atrial fibrillation at 4 mg daily with an INR remaining in his goal parameters. His creatinine level was 2.5 and his cyclosporine level was 303 on admission, reaching a maximum of 19.8 on hospital day four. Endocrine studies revealed a TSH of 0.02, a T4 of 6.0, and a THPR of 1.47. The patient's pulmonary status improved on oxygen and on intravenous antibiotics, and all studies for atypical organisms were negative. Prior to discharge, the patient's pulmonary status had returned to baseline and had entirely resolved. The patient was discharged on Augmentin 250/125 mg t.i.d., Levaquin 250 mg q.d., CellCept 500 mg b.i.d., Neoral 100 mg b.i.d., Prednisone 10 mg q.d., Synthroid 125 mcg q.d., INP insulin 14 units subcu q.a.m., regular insulin subcu p.r.n., Axid 150 mg q.d., nadolol 80 mg q.d., nifedipine XL 30 mg q.d., Coumadin 4 mg q.d., and iron sulfate 300 mg q.d., and follow-up was scheduled for bone densitometry in July 1998, with Dr. Clinton Ardizone in January 1998, and with Dr. Win in March.

has the patient used nph insulin in the past

The patient is a 54-year-old man with nonischemic dilated cardiomyopathy who presents with weight gain, weakness, and azotemia. He was admitted with decompensated heart failure and was treated with dobutamine, seretide, and diuretics with good effect, functioning on ACE inhibitor. Two weeks prior to presentation, Digoxin 0.125 mg q.o.d., Imdur 30 mg q.d., hydralazine 25 mg t.i.d., torsemide was being held, Coumadin 1 mg q.d., carvedilol 3.125 mg b.i.d., allopurinol 100 mg q.d., Glucophage, and glyburide were administered. On 2/19/03, Diuril was added to his regimen and his creatinine was noted to increase from 2.6 to 3.6 and diuretics were subsequently held. The patient was loaded on amiodarone, unfortunately still required low dose dobutamine to maintain his cardiac output and was transferred back to the floor and continued to have decrease urine output on maximal diuretic doses and ionotropes. On 6/8/03, the renal surgery recommended that the dobutamine be stopped in order to enhance renal perfusion and Lasix be increased to 80 mg per hour. He has beyond less invasive measures such as digoxin and ACE inhibitors, and he is now dobutamine dependent dobutamine between 1 and 2.5 mcg/kg/minute to maintain his cardiac output, currently loaded on amiodarone without any further events. He has a chronic osteomyelitis, currently in a six-week course of ceftazidime, vancomycin, Flagyl, and Diflucan for complicated osteomyelitis, end date is on 2/30/03. He has diabetes and was on oral hypoglycemic as an outpatient, however, now this renal function, he has been transitioned over to insulin with his standing doses of Lantus with a lispro sliding scale. The patient was started on TPN for quite severe malnutrition and has increasing albumin with increased appetite. Additionally, he is on maintenance doses of hydrocortisone and was seen by Psychiatry, who suggested starting low dose of Zyprexa in the evening, which has greatly improved his mood. He is planned to be evaluated by Plastic Surgery prior to discharge for final plans whether a flap or healing by secondary retention. The patient currently is stable and would be discharged with home dobutamine and frequent and careful follow up by his primary cardiologist Dr. Mongiovi.

Has this patient ever been treated with dobutamine

Ms. Dozois is a 64-year-old female admitted to MICU on 2/19/2005 for neutropenia, nausea, vomiting, abdominal pain, and shortness of breath, requiring intubation and pressors. Her medical problems included severe COPD (on home O2 2 liters baseline sat below 90s), nonsmall cell lung cancer (diagnosed in 1999, status post multiple chemotherapy regimens, most recently ALIMTA from 1/29/2005 to 09), diabetes, obesity, and chronic renal insufficiency. Her MEDICATIONS ON ADMISSION included Avapro, Lipitor, Decadron, ranitidine, Humalog, allopurinol, Alimta, Flonase, Vitamin D, B12, and Colace. She was initially treated with vancomycin, Levaquin, and aztreonam along with Flagyl empirically, and later changed to Levaquin only on 10/25/2005 to treat an enterococcal UTI and possible nosocomial pneumonia. She had thrombocytopenia and required multiple red blood transfusions to maintain her hematocrit greater than 26, though she was never hemodynamically unstable. She also required multiple platelet transfusions to keep her platelets greater than 30,000. She responded well initially to three units of packed red blood cells over 7/28/2005 and 09. However, in the setting of her GI bleed from a sloughing mucosa secondary to resolving neutropenic enteritis and recent chemo, she required multiple further RBC transfusions to keep her hematocrit greater than 30. Hematology was consulted secondary to suboptimal busted platelet levels status post transfusions, which was felt to be secondary to poor marrow response in the setting of recent chemo (workup was negative for other possible causes refractory thrombocytopenia, nystatin, allopurinol, were held given possible worsening of her thrombocytopenia). Surgery was consulted and she was managed conservatively with antibiotics initially and then with bowel rest. TPN was started on 4/21/2005, given her bowel rest for a neutropenic enteritis. She was changed to standing insulin on 10/25/2005 and her Lantus was up titrated along with sliding scale insulin to maintain blood sugars in the 80s to 120s. She is no longer neutropenic and was off Neupogen for one week and will stay and finish the 14-day course of Levaquin for coverage. On discharge her hematocrit and platelets were stable respectively at 29.8 and 46,000 and she had not required a transfusion in greater than 24 hours prior to discharge. Her DISCHARGE MEDICATIONS included Tylenol 650 to 1000 mg PO q. 6h PRN pain, headache, if fever is greater than 101, Peridex mouth wash 10 mL twice a day, nystatin mouth wash 10 mL swish and swallow 4 x day as needed, oxycodone 5 mg PO q. 6h PRN pain, simethicone 80 mg PO q.i.d. PRN gaseousness, trazodone 25 mg PO at bedtime, miconazole nitrate 2% powder topical BID to areas between skin folds including under the right breast, Nexium 20 mg PO daily, Lantus 30 mg subcutaneous daily, DuoNeb 3/0.5 mg Nebs q. 3 h. PRN shortness of breath, aspart 4 units before each meal subcutaneously, folate 3 mg PO daily, Avapro 150 mg PO daily, meclizine 25 mg PO TID, Combivent 2 puffs inhaled q.i.d., Vitamin D 125 0.25 mcg PO daily. She will follow up with infectious disease and hematology for her neutropenia, which has since resolved, and will stay and finish the 14-day course of Levaquin for UTI coverage.

Has this patient ever been treated with nexium

Ms. Christin is an 80-year-old female who presented to an outside hospital with chest pain and shortness of breath. She took one sublingual Nitroglycerin without relief, followed by two more without relief and was then treated with intravenous Lasix, morphine, and Nitroglycerin which resulted in resolution of her pain. Her medical history includes hypertension, hypercholesterolemia, angina, Paget's disease, anemia, and osteoarthritis. An EKG at the hospital showed anterolateral ST depression and her enzymes were negative, ruling out myocardial infarction. Her cardiac symptomatology began in the fall of 1999 and evaluation showed high cholesterol with an LDL 141, EKG with LVH and nonspecific T wave flattening, and a Thallium stress test that was stopped secondary to shortness of breath. Upon admission to Ster Hospital for evaluation of her angina, her laboratory values were consistent with a myocardial infarction and her peak CK was 459 with an MB of 28.7. Her discharge medications include Aspirin 81 mg daily, iron 300 mg three times a day, Hydrochlorothiazide 25 mg daily, Lisinopril 5 mg daily, multivitamin one daily, Relafen 500 mg orally a day, Imdur 60 mg orally a day, Plavix 75 mg daily for 29 days, Lipitor 40 mg daily, Atenolol 25 mg orally a day, and magnesium oxide 420 mg daily. Follow-up with Dr. Porter Luckenbaugh in SH Cardiovascular Group on January at 1:00 p.m. and with Dr. Sammy Kleindienst in the Greenetons Opi Hospital Hematology Clinic.

What is her current dose of multivitamin

This 70-year-old woman with no known CAD, cardiac RF: HTN, DM, hyperchol., current tob., H/O PAF on no anticoag 2/2 distant h/o LGIB, a/w palpitations followed by 10 hrs of chest pain was admitted on 1/10/2001 and treated medically with lovenox/integrilin (refused cath) for NSTE MI. In the ED, pain was relieved with NITROGLYCERIN 1/150 (0.4 MG) 1 TAB SL q5min x 3 and SLNG, and 2" NTP. EKG with TWflattening v5-6 but no ST elevations, and CK160, TnI 0.3. During her stay, she was on heparin, integrelin for NSTE MI, ASA, BB, ACEI, statin, nexium, colace, and levofloxacin for UTI, and lovenox for DVT proph. Her blood pressure was titrated to 130-160 and HCTZ was added for better control because her HR was in the 50's, and a repeat echo was done to check for any changes in function. Upon discharge, she will be on ECASA (ASPIRIN ENTERIC COATED) 325 MG PO QD, MICRONASE (GLYBURIDE) 5 MG PO QD, HCTZ (HYDROCHLOROTHIAZIDE) 25 MG PO QD, NITROGLYCERIN 1/150 (0.4 MG) 1 TAB SL q5min x 3, ZOCOR (SIMVASTATIN) 20 MG PO QHS, LEVOFLOXACIN 250 MG PO QD X 4 Days, ZESTRIL (LISINOPRIL) 20 MG PO QD, ATENOLOL 50 MG PO QD Food/Drug Interaction Instruction, PRILOSEC (OMEPRAZOLE) 20 MG PO QD, and POTENTIALLY SERIOUS INTERACTION: POTASSIUM CHLORIDE & LISINOPRIL, POTENTIALLY SERIOUS INTERACTION: HYDROCHLOROTHIAZIDE & OMEPRAZOLE, and SLNG PRN. She was also instructed to take atenolol consistently with meals or on empty stomach and to avoid grapefruit unless MD instructs otherwise. Follow up appointments were scheduled with Dr. Truman Thro 1-2 wks, Dr. Stevie Gilani, cardiology, Mon, 1/2/02 1:00 pm, and Bock 0/12/02.

Has the patient had previous zestril ( lisinopril )

Mr. Slunaker is a 56-year-old gentleman who underwent coronary artery bypass grafting x4 and was discharged to home in stable condition on 10/20/06. He presented to see Dr. Emory Bebeau in clinic with a warm and swollen left lower leg with redness and was placed on levofloxacin and vancomycin and had him admitted for left lower leg cellulitis. On admission, he was taking Toprol 25 mg daily, diltiazem 30 mg t.i.d., aspirin 325 mg daily, Lasix 40 mg daily, atorvastatin 40 mg daily, Tricor 145 mg daily, Zetia 10 mg daily, metformin 500 mg daily and potassium chloride slow release 20 mEq daily. Infectious disease was consulted and recommended discontinuing the vancomycin and levofloxacin and changing to Ancef 1 gm IV q.8h. and monitoring his wound. The patient remained afebrile and his white count trended down and leg wound improved on exam. On the day of discharge, he was evaluated by Dr. Manvelyan and cleared for discharge to home with Augmentin 875/125 mg b.i.d. for a total of 10 days, enteric-coated aspirin 325 mg daily, Lipitor 40 mg daily, diltiazem 30 mg t.i.d., Zetia 10 mg daily, Tricor 145 mg nightly, Diflucan 200 mg daily for one dose for a penile yeast infection, due to antibiotic use, Metformin 500 mg q.p.m., Toprol-XL 25 mg daily and oxycodone 5-10 mg q.4h. p.r.n. pain. He was instructed to monitor his leg wound and call if he had any increased weight, temperature greater than 101 degrees, any drainage from the wound, redness, swelling or change of any kind in his leg wound. He was cleared by Infectious Disease Service and discharged to home in stable condition and will follow up with Dr. Noah Schaffhauser on 5/7/06 at 1 o'clock, Dr. Aaron Phung in three-four days, his primary care physician, and his cardiologist, Dr. Jonathon Sopata in one to two weeks.

pain meds on in past

Mrs. Denman is a 63-year-old, insulin-dependent diabetic with a long history of peripheral vascular disease and multiple surgical procedures. She underwent a right transmetatarsal amputation in 1990 and subsequently underwent a right femoral distal saphenous vein bypass graft in 1991 which was later revised in 1992. In July of this year, she underwent a left superficial femoral artery to anterior tibial artery bypass using non-reversed basilic vein harvested from the right arm and had a large great toe ulcer, possibly attributed to hammertoe, which subsequently underwent a left great toe amputation. On the day prior to admission she was exercising with 4 pound weights on her legs with the physical therapist when she described a cool sensation in her foot and reported that her foot had been blue, and there were no Dopplerable pulses. Admission labs were unremarkable and she was placed on intravenous Heparin until the following morning. During Angiography Suite she was found to have two 95% stenosis in a long segment of the left SFA and the left distal SFA and anterior tibial vein graft was completely thrombosed. She was successfully treated with stent placement and received heparin and urokinase in the Intensive Care Unit overnight with a turn-over pulses of the left leg Doppler. During the remainder of the hospital course, her left foot remained pink and warm with an infection of exposed bone. She was discharged with Vancomycin 1250 mg IV q d, Ofloxacin 200 mg p.o. b.i.d., Coumadin with target INR of 2.0, last target 1.6, then received 10 mg in evening x 2., Percocet 1-2 tablets p.o. q 4 prn, Colace 100 mg p.o. b.i.d., insulin NPH 10 units subcu b.i.d., sliding scale insulin subcu q 4, Isordil 30 mg t.i.d., Zestril 5 mg q d, Lopressor 50 mg b.i.d., Axid 150 mg p.o. b.i.d. and was advised to follow up with Dr. Noah in one to two weeks.

Has the pt. ever been on colace before

Ms. Dozois is a 64-year-old female admitted to MICU on 2/19/2005 for neutropenia, nausea, vomiting, abdominal pain, and shortness of breath, requiring intubation and pressors. Her medical problems included severe COPD (on home O2 2 liters baseline sat below 90s), nonsmall cell lung cancer (diagnosed in 1999, status post multiple chemotherapy regimens, most recently ALIMTA from 1/29/2005 to 09), diabetes, obesity, and chronic renal insufficiency. Her MEDICATIONS ON ADMISSION included Avapro, Lipitor, Decadron, ranitidine, Humalog, allopurinol, Alimta, Flonase, Vitamin D, B12, and Colace. She was initially treated with vancomycin, Levaquin, and aztreonam along with Flagyl empirically, and later changed to Levaquin only on 10/25/2005 to treat an enterococcal UTI and possible nosocomial pneumonia. She had thrombocytopenia and required multiple red blood transfusions to maintain her hematocrit greater than 26, though she was never hemodynamically unstable. She also required multiple platelet transfusions to keep her platelets greater than 30,000. She responded well initially to three units of packed red blood cells over 7/28/2005 and 09. However, in the setting of her GI bleed from a sloughing mucosa secondary to resolving neutropenic enteritis and recent chemo, she required multiple further RBC transfusions to keep her hematocrit greater than 30. Hematology was consulted secondary to suboptimal busted platelet levels status post transfusions, which was felt to be secondary to poor marrow response in the setting of recent chemo (workup was negative for other possible causes refractory thrombocytopenia, nystatin, allopurinol, were held given possible worsening of her thrombocytopenia). Surgery was consulted and she was managed conservatively with antibiotics initially and then with bowel rest. TPN was started on 4/21/2005, given her bowel rest for a neutropenic enteritis. She was changed to standing insulin on 10/25/2005 and her Lantus was up titrated along with sliding scale insulin to maintain blood sugars in the 80s to 120s. She is no longer neutropenic and was off Neupogen for one week and will stay and finish the 14-day course of Levaquin for coverage. On discharge her hematocrit and platelets were stable respectively at 29.8 and 46,000 and she had not required a transfusion in greater than 24 hours prior to discharge. Her DISCHARGE MEDICATIONS included Tylenol 650 to 1000 mg PO q. 6h PRN pain, headache, if fever is greater than 101, Peridex mouth wash 10 mL twice a day, nystatin mouth wash 10 mL swish and swallow 4 x day as needed, oxycodone 5 mg PO q. 6h PRN pain, simethicone 80 mg PO q.i.d. PRN gaseousness, trazodone 25 mg PO at bedtime, miconazole nitrate 2% powder topical BID to areas between skin folds including under the right breast, Nexium 20 mg PO daily, Lantus 30 mg subcutaneous daily, DuoNeb 3/0.5 mg Nebs q. 3 h. PRN shortness of breath, aspart 4 units before each meal subcutaneously, folate 3 mg PO daily, Avapro 150 mg PO daily, meclizine 25 mg PO TID, Combivent 2 puffs inhaled q.i.d., Vitamin D 125 0.25 mcg PO daily. She will follow up with infectious disease and hematology for her neutropenia, which has since resolved, and will stay and finish the 14-day course of Levaquin for UTI coverage.

Why is the patient taking duoneb

Harrison Fullwood was admitted on 4/3/2005 for ICD placement for HCM. On 7/13/05, Medtronic Dual Chamber DDI/ICD was placed under general anesthesia with a CODE STATUS of Full Code and disposition of Home. ECHO 5/13 showed septal thickness 16mm, posterior wall thickness 19mm with preserved EF 65% and LV outflow tract peak gradient 125mmHg. Holter monitoring 0/2 without any arrhythmias. On admission PE, VS 96.4 74 140/90 20 93% RA. Labs/Studies included CBC, BMP, Coags wnl, EKG NSR. TW flat V5/V6 (old), CXR (portable): cardiomegaly, no e/o ptx, PA/lat CXR AM after no ptx, leads in place, no overt failure. The patient was prescribed Albuterol, Advair 250/50 bid, Rhinocort 2 sprays bid, Atrovent 2 puff qid, Singulair 10mg qhs, Nexium 40mg daily, Lasix 20mg daily (inc to 40 or 60 during period), Kcl 20meq daily, Verapamil 120mg daily, Patanol 1-2 OU bid prn, Loratidine 10mg daily, Zocor 20mg qhs, Effexor 75mg daily, Metformin 1250mg bid, Mgoxide 500mg daily, Ambien prn, Amox prior to procedures. On order for Motrin PO (ref# 234611479), the patient had a POSSIBLE allergy to Aspirin; reaction is Unknown. The patient was instructed to take Keflex for a 3 day total course, take all medications with food, and avoid grapefruit unless MD instructs otherwise. The patient was also given Diet instructions to measure his weight daily, fluid restriction, house/low chol/low sat. fat, and house/ADA 2100A. ENDO: ISS. restarted Metformin on morning of d/c. NEURO: cont Effexor. On discharge, the patient was prescribed Albuterol Inhaler 2 puff inh QID PRN Shortness of Breath, Wheezing, Lasix (Furosemide) 20 mg PO QD Starting Today (10/19) with instructions to titrate his dose 20mg/40mg/60mg as he normally does depending on his degree of swelling, Motrin (Ibuprofen) 600 mg PO Q6H PRN Pain, Headache, Magnesium Oxide 560 mg PO QD, Verapamil Sustained Release 120 mg PO QD Starting Today (10/19) with instructions to confirm home dose and resume home dose, Keflex (Cephalexin) 250 mg PO QID X 10 doses, Zocor (Simvastatin) 20 mg PO QHS, Ambien (Zolpidem Tartrate) 10 mg PO QHS PRN Insomnia, Loratadine 10 mg PO QD, Potassium Chloride Slow Rel. (KCl Slow Release) 20 mEq PO QD As per AH Potassium Chloride Policy, each 20 mEq dose to be given with 4 oz of fluid, Metformin 1,250 mg PO BID Starting IN AM (10/19), Rhinocort Aqua (Budesonide Nasal Inhaler) 2 Spray Inh BID, Singulair (Montelukast) 10 mg PO QD, Effexor XR (Venlafaxine Extended Release) 75 mg PO QD Number of Doses Required (approximate): 5, Advair Diskus 250/50 (Fluticasone Propionate/...) 1 Puff Inh BID, Nexium (Esomeprazole) 40 mg PO QD, Oxycodone 10 mg PO Q4H PRN Pain, and Atrovent HFA Inhaler (Ipratropium Inhaler) 2 Puff Inh QID. November of 2004, HF symptoms were controlled on Lasix and at baseline he could work. The patient was also advised to take all medications with food and to avoid grapefruit unless MD instructs otherwise, and to take Keflex for a 3 day total course and to take all other medications as the same. The patient was also given Diet instructions to measure his weight daily, fluid restriction, house/low chol/low sat. fat, and house/ADA 2100A.

Has this patient ever tried magnesium oxide

A 65 year old African-American female with a history of chronic pancreatitis was admitted to the Staho Health 10 of November to 3 of May for her chronic pancreatitis and returned on the 24 of January with recurrent abdominal pain and symptoms consistent with her chronic pancreatitis. On admission, she had a low grade temperature of 100.2, was tachycardic with a heart rate of 131, respiratory rate 20, blood pressure 132/80. Abdominal exam was significant for decreased bowel sounds and abdominal tenderness in the midepigastric region with guarding. Laboratory data showed sodium 128, potassium 4.1, chloride 95, bicarb 26, BUN 23, creatinine 0.8, glucose 433, WBC 17.8, hematocrit 33, platelets 370, alk level of 434, T-bili was 0.6, D-bili was 0.2, lipase was 123, and amylase was 37. An ultrasound showed no gallstones and a 6 cm cyst in the region of the pancreatic head. EKG showed her to be in sinus tachycardia with the rate of 122. Her past medical history was significant for pancreatitis, asthma, insulin dependent diabetes mellitus, history of vascular necrosis of both hips, status post a total hip replacement on the right and left, known coronary artery disease, history of chronic obstructive pulmonary disease, history of GI bleed, status post a Nissen fundoplication with redo, hypertension, alpha thalassemia, history of congestive heart failure, and chronic low back pain secondary to spinal stenosis. Her medications included Metformin, Atrovent, Albuterol, Flovent, Elavil, Cisapride, Flexeril, Axid, NPH insulin, Cardizem CD, lisinopril, Lasix, magnesium oxide, Percocet, Premarin, Provera, Prilosec, Lipitor, Tums and multi-vitamins. She had allergies to Aspirin, Ibuprofen, meperidine, prednisone, penicillin, fophonomide, codeine, morphine, and was not a drinker or smoker. She had developed a urinary tract infection with yeast and was started on fluconazole, and was also begun on H. pylori therapy of Biaxin and bismuth. At the time of discharge, the patient was relatively pain-free, tolerating a p.o. diet, and afebrile and was discharged to the Triadnockum for rehabilitation on her usual medications plus the above-mentioned antibiotics, to complete a seven-day course, and will follow up in the Gug University in the next one to two weeks and will be followed by her primary care physician, Dr. Lorenzo.

Has the patient had multiple atrovent prescriptions

A 58 year old female smoker with a history of Coronary Artery Disease (CAD), Cirrhosis, Diabetes Mellitus Type II (DMII), Hypertension (HTN), and Hyperlipidemia was admitted to the CCU after an elective cardiac catheterization following an abnormal stress test. The cath showed impaired flow in the inferior and posterolateral zones due to obstructive degenerative disease in the SVGs to the RCA and LCF-OM, and a stent was placed in the RCA graft though there was extensive calcification and difficulty obtaining full stent expansion. After the stent deployment there was poor reflow accompanied by mild chest pain and EKG changes, without hemodynamic embarrassment. The patient experienced jaw and chest pain post-procedure which she described as different from previous episodes of angina. The pump-function was preserved, BP low-normal, and rhythm was NSR on telemetry. For pulmonary issues, the patient had a chronic cough due to post nasal drip which was taken off of her antihistamine on admission and CXR was normal with no acute changes. There were no renal issues during the hospital course and the patient was on Lantus, Novolog SS, and FS Glu monitored while in the hospital. Heme-wise, the patient had a cath and subsequent oozing from the site in the groin and was discharged on home meds including Plavix and ASA. Medications prescribed include ENTERIC COATED ASA 325 MG PO DAILY, TESSALON PERLES ( BENZONATATE ) 100 MG PO TID, PLAVIX ( CLOPIDOGREL ) 75 MG PO DAILY, CODEINE PHOSPHATE 15 MG PO Q3H PRN Pain, DEXTROMETHORPHAN HBR 10 MG PO Q6H PRN Other:cough, ZETIA ( EZETIMIBE ) 10 MG PO DAILY, LANTUS ( INSULIN GLARGINE ) 20 UNITS SC BEDTIME, POTASSIUM CHLORIDE IMMED. REL. ( KCL IMMEDIATE... ) 1.Only KCL Immediate Release products may be used for KCL, 4.As per SMH Potassium Chloride Policy: each 20 mEq dose, on order for DIOVAN PO ( ref # 032637277 ), VALSARTAN Reason for override: aware, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach, MAGNESIUM GLUCONATE Sliding Scale PO ( orally ) DAILY: -&gt; Mg-scales cannot be used and magnesium doses must be, If Mg level is less than 1 , then give 3 gm Mg Gluconate, NITROGLYCERIN 1/150 ( 0.4 MG ) 1 TAB SL q5min x 3, OXYCODONE 5-10 MG PO Q6H PRN Pain, PINDOLOL 5 MG PO BID HOLD IF: sbp&lt;90 , HR&lt;50, ZOCOR ( SIMVASTATIN ) 80 MG PO BEDTIME, DIOVAN ( VALSARTAN ) 160 MG PO DAILY, Lantus 40u qd Estradiol 0.05, Diltiazem 180 mg qd HCTZ 25 mg qd, Zetia 10mg qd, Plavix 75 mg qd, Zocor 80 mg qd, ASA 325 mg qd, Famotidine 20 mg BID, Lovenox 40 sc qd, nicotine patch MgSO4 qd, Novolog SS Pt as outpt and heparin and Integrelin have been discontinued, insulin, and was stable post cath, with anticoagulation stopped. The patient was prescribed ENTERIC COATED ASA 325 MG PO DAILY, TESSALON PERLES ( BENZONATATE ) 100 MG PO TID, PLAVIX ( CLOPIDOGREL ) 75 MG PO DAILY, CODEINE PHOSPHATE 15 MG PO Q3H PRN Pain, DEXTROMETHORPHAN HBR 10 MG PO Q6H PRN Other:cough, ZETIA ( EZETIMIBE ) 10 MG PO DAILY, LANTUS ( INSULIN GLARGINE ) 20 UNITS SC BEDTIME, POTASSIUM CHLORIDE IMMED. REL. ( KCL IMMEDIATE... ), 1.Only KCL Immediate Release products may be used for KCL, 4.As per SMH Potassium Chloride Policy: each 20 mE

Has a patient had magnesium

Mr. Forde has recovered very well following his elective coronary artery bypass graft procedure and is hemodynamically stable with left lower extremity erythema and tenderness significantly improved 24 hours following initiation of Keflex course. White blood cell count was within normal limits and patient continued to remain afebrile. A course of Keflex was administered on postoperative day seven for sinus rhythm in the high 90s with blood pressure mildly hypertensive, additionally with frequent PVCs noted on telemetry. Mr. Notarnicola continued to remain afebrile and his knee pain has significantly improved. Additionally, of note, Mr. Hovenga's Toprol was increased to 150 mg p.o. daily with an extra 2 mg of magnesium. Mr. Neth is discharged to rehabilitation today having recovered well following his elective CABG procedure. Mr. Marcusen is discharged to rehabilitation today, postoperative day eight, hemodynamically stable, to continue a course of Keflex for left lower extremity erythema and additionally to continue one week of diuresis in the form of low dose Lasix for mild persistent postoperative pulmonary effusions. Mr. Brannigan has been instructed to shower and monitor incisions for signs of increasing infection such as fever, drainage, worsening pain or increase in redness. He is to follow up with his primary care physician for continued evaluation and management of hypertension, dyslipidemia, obesity, obstructive sleep apnea, and uncontrolled Type II diabetes mellitus. Additionally, the patient will follow up with his cardiologist for continued evaluation and management of blood pressure, heart rate, heart rhythm, lipid levels, and for possible future adjustment in medication. Mr. Connin will follow up with his cardiac surgeon, Dr. Quinn Dalio, in six to eight weeks. Additionally, he will follow up with his cardiologist, Dr. Octavio Wulffraat, in two to four weeks and with his primary care physician, Dr. Barrett Mittleman, in one to two weeks. The patient is discharged with medications including Tylenol 325 mg p.o. q.6h. p.r.n. pain for temperature greater than 101 degrees Fahrenheit, amlodipine 5 mg p.o. daily, atorvastatin 10 mg p.o. daily, captopril 6.25 mg p.o. t.i.d., Keflex 500 mg p.o. q.i.d. times total of seven days, last dose on 9/15/06, Colace 100 mg p.o. b.i.d. p.r.n. constipation, enteric-coated aspirin 325 mg p.o. daily, Lasix 40 mg p.o. daily x7 days, hydrochlorothiazide 12.5 mg p.o. daily, NovoLog 3 units subcu AC, Lantus 24 units subcu q. 10 p.m., hold if n.p.o., potassium slow release 20 mEq p.o. daily x7 days, Toprol-XL 150 mg p.o. daily, Niferex 150 mg p.o. b.i.d., oxycodone 5 to 10 mg p.o. q.4h. p.r.n. pain, Ambien 5 mg p.o. nightly p.r.n. insomnia, NovoLog 6 units subcu with breakfast, hold if n.p.o., NovoLog 4 units subcu with lunch, hold if n.p.o., NovoLog 4 units subcu with dinner, hold if n.p.o., NovoLog sliding scale subcu AC, blood sugar less than 125, give 0 units subcu, blood sugar 125 to 150, give 2 units subcu, blood sugar 151 to 200, give 3 units subcu, blood sugar 201 to 250, give 4 units subcu, blood sugar 251 to 300, give 6 units subcu, blood sugar 301 to 350, give 8 units subcu, if blood sugar 351 to 400, NovoLog sliding scale subcu q.h.s. Please recheck blood sugar less than 200, give 0 units subcu, if blood sugar 201 to 250, give 2 units subcu, blood sugar 251 to 300, give 3 units subcu, blood sugar 301 to 350, give 4 units subcu, blood sugar 351 to 400, give 10 units subcu, call physician if blood sugar greater than 400.

What was the dosage prescribed of atorvastatin

A 57-year-old female with macromastia and abdominal skin laxity s/p massive weight loss 2/2 gastric bypass was admitted to plastic surgery on 5/8/07. On admission, the patient was prescribed 1. ACETAMINOPHEN 1000 MG PO Q6H, 2. LEVOTHYROXINE SODIUM 75 MCG PO QD, 3. QUINAPRIL 20 MG PO QAM, 4. RANITIDINE HCL 150 MG PO QD, 5. MULTIVITAMINS 1 CAPSULE PO QD, TYLENOL ( ACETAMINOPHEN ) 650 MG PO Q4H PRN Headache, VITAMIN C ( ASCORBIC ACID ) 500 MG PO BID, DULCOLAX ( BISACODYL ) 5-10 MG PO DAILY PRN Constipation, KEFLEX ( CEPHALEXIN ) 500 MG PO QID, COLACE ( DOCUSATE SODIUM ) 100 MG PO BID, PEPCID ( FAMOTIDINE ) 20 MG PO BID, DILAUDID ( HYDROMORPHONE HCL ) 2-4 MG PO Q3H PRN Pain (ref #901341233), on order for DILAUDID PO 2-4 MG Q3H (ref #901341233), INSULIN REGULAR HUMAN, supplemental (sliding scale) insulin, If receiving standing regular insulin, please give at same, SYNTHROID ( LEVOTHYROXINE SODIUM ) 75 MCG PO DAILY, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H, MILK OF MAGNESIA ( MAGNESIUM HYDROXIDE ), REGLAN ( METOCLOPRAMIDE HCL ) 10 MG IV Q6H PRN Nausea, ZOFRAN ( POST-OP N/V ) ( ONDANSETRON HCL ( POST-... ), on order for KCL IV (ref #964491549), POTENTIALLY SERIOUS INTERACTION: QUINAPRIL HCL & POTASSIUM CHLORIDE, POTENTIALLY SERIOUS INTERACTION: QUINAPRIL HCL & POTASSIUM, SIMETHICONE 80 MG PO QID PRN Upset Stomach, MULTIVITAMIN THERAPEUTIC ( THERAPEUTIC MULTIVI... ) 1 TAB PO DAILY, TIGAN ( TRIMETHOBENZAMIDE HCL ) 200 MG PR Q6H PRN Nausea, ibuprfen. Do not drink/drive/operate machinery with pain medications., Take a stool softener to prevent constipation., 4. Continue your antibiotics as long as you have a drain in place., Sliding Scale (subcutaneously) SC AC+HS Medium Scale, If BS is 125-150, then give 0 units subcutaneously, 30 MILLILITERS PO DAILY PRN Constipation, 1 MG IV Q6H X 2 doses PRN Nausea, Number of Doses Required (approximate): 10, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach, TYLENOL ( ACETAMINOPHEN ) 650 MG PO Q4H PRN Headache, DULCOLAX ( BISACODYL ) 5-10 MG PO DAILY PRN Constipation, DILAUDID ( HYDROMORPHONE HCL ) 2-4 MG PO Q3H PRN Pain. The patient tolerated all procedures without difficulty and post-op period was uneventful, and at discharge, the patient was afebrile with stable vitals, taking po's/voiding q shift, ambulating independently and pain was well-managed with Tigan (Trimethobenzamide HCl) 200 mg PR Q6H PRN Nausea, Tigan (Trimethobenzamide HCl) 300 mg PO Q6H PRN Nausea, Simethicone 80 mg PO QID PRN Upset Stomach, Maalox-Tablets Quick Dissolve/Chewable 1-2 TAB PO Q6H PRN Upset Stomach, 1 mg IV Q6H x 2 doses PRN Nausea, 30 Milliliters PO Daily PRN Constipation and TYLENOL (Acetaminophen) 650 mg PO Q4H PRN Headache, DULCOLAX (Bisacody

Has the patient ever had synthroid ( levothyroxine sodium )

Marcelo Walts was admitted to the medical service for a CHF exacerbation and was given ECASA (Aspirin Enteric Coated) 325 mg PO QD, Captopril 12.5 mg PO TID with a potential serious interaction with Potassium Chloride, Lasix (Furosemide) 40 mg PO TID, Levoxyl (Levothyroxine Sodium) 100 mcg PO QD, Nitroglycerin 1/150 (0.4 mg) 1 tab SL Q5 min x 3 PRN Chest Pain HOLD IF: SBP<[ ], Zocor (Simvastatin) 20 mg PO QHS with a potential serious interaction with Niacin, Vit. B-3, Plavix (Clopidogrel) 75 mg PO QD, Atenolol 25 mg PO QD, Nitropatch (Nitroglycerin Patch) 0.2 mg/hr TP QHS, Glyburide 5 mg PO BID, Isordil (Isosorbide Dinitrate) 10 mg PO BID, and a diet of House/Low Chol/Low Sat. Fat and 4 gram Sodium. Activity was limited to Walking as tolerated, and the patient was also given instructions to give ECASA on an empty stomach, and to avoid grapefruit with Zocor unless instructed otherwise. Upon discharge, the patient was given a Full Code status and was sent Home with a follow up appointment with Sandler on 11/28/02. The patient also underwent cardiac catheterization and stent placement of RCA with the medications Heparin, ASA, Plavix, Metoprolol, nitrates, ACE-I, statin, lasix, and nebs for wheezing, and was monitored for lytes. Upon discharge, the patient was stable and advised to follow up with Dr. Lidstone and Dr. Darlin for post-cath management and overall management of CHF and flash pulmonary edema.

Has the patient ever had captopril

A 79-year-old male with history of non-insulin dependent diabetes, coronary artery disease, congestive heart failure, hypertension, chronic renal failure, and left toe amputation on 7/1/06 was admitted for debridement and antibiotics. An MRA on 10/3/06 demonstrated on the right a multifocal high-grade stenosis of the proximal, anterior tibial, the tibioperoneal trunk and the proximal, posterior tibial arteries and included peroneal artery at the midcalf, two-vessel runoff and on the left diffuse high-grade stenoses of the anterior tibial, posterior tibial arteries and occlusion of the peroneal artery in the dorsalis pedis. The patient presented with bleeding from the site of the left toe amputation beginning two weeks ago associated with throbbing pain, soreness, erythema and swelling and exacerbated blood pressure when walking and only treated by narcotics. Neuro and Psych: The patient has delirium postoperatively for which he was placed on soft restraints and received Zyprexa. Cardiac: Upon admission, potassium was noted to be elevated and the patient had EKG changes associated with hyperkalemia and received Aspirin, Lopressor, Norvasc, Zocor, Plavix, PhosLo, Prandin for coronary artery disease related event prophylaxis. Blood pressure was controlled with isosorbide dinitrate, Norvasc, lisinopril, and Lopressor. Pulmonary: No events. Maintained oxygen saturation greater than 90% on room air. Renal: Creatinine was stable in the mid 3s and trended down to 2.6 at the time of discharge below his baseline of 4-5. Voiding without difficulty at the time of discharge. Maintained on his renal medications. FEN/GI: Tolerated regular diet. Lactulose and Colace to prevent constipation while taking narcotics, also had Dulcolax p.r.n. Zinc and Vitamin C was started per the Nutrition consult. Hematology: He received heparin for DVT prophylaxis. His hematocrit remained stable. He had some oozing from the right thigh but this resolved with a pressure dressing. ID: He was treated throughout his hospitalization with vancomycin, levofloxacin and Flagyl for methicillin-resistant Staphylococcus aureus that grew from the wound after the first and second irrigation and debridement. The levofloxacin and Flagyl were discontinued prior to discharge. He will continue his vancomycin at the time of discharge. Endocrine: Diabetes controlled. He was maintained on his Prandin and insulin sliding scale for glycemic control. He also received Vitamin D, Calcitriol, Nephrocaps, Epogen, and Aranesp. His incision remained clean, dry and intact without erythema or exudate. He was afebrile with stable signs at the time of discharge. ACTIVITY INSTRUCTIONS: He is nonweightbearing on the left lower extremity to protect the open toe. COMPLICATIONS: None. DISCHARGE LABS: Laboratory tests at the time of discharge include sodium 138, potassium 4.1, chloride 111, bicarbonate 21, BUN 35, creatinine 2.6, calcium 9.0, magnesium 1.9, vancomycin 19.5, white blood cell count 7.3, hemoglobin 9.9, hematocrit 30.2, platelets 221. DISCHARGE MEDICATIONS: His medications at discharge include aspirin 325 mg p.o. daily, vitamin C 500 mg p.o. b.i.d., calcitriol 0.5 mcg p.o. daily, Colace 100 mg p.o. daily, heparin 5000 units subcutaneous t.i.d., isosorbide dinitrate 10 mg p.o. t.i.d., lactulose 30 mL p.o. t.i.d., lisinopril 50 mg p.o. daily, Lopressor 50 mg p.o. q.6h., Prandin 0.5 mg p.o. with each meal, Aranesp 40 mcg subcutaneous every week, sliding scale insulin, insulin aspart 4 units, Tylenol p.r.n., Dilaudid 2-4 mg p.o. q.4h. as needed for pain, milk of magnesia as needed for constipation, Reglan for nausea, oxycodone for pain 5-10 mg p.o. q.4h. hours

Has the patient ever been on renal medications.

A 57-year-old female with macromastia and abdominal skin laxity s/p massive weight loss 2/2 gastric bypass was admitted to plastic surgery on 5/8/07. On admission, the patient was prescribed 1. ACETAMINOPHEN 1000 MG PO Q6H, 2. LEVOTHYROXINE SODIUM 75 MCG PO QD, 3. QUINAPRIL 20 MG PO QAM, 4. RANITIDINE HCL 150 MG PO QD, 5. MULTIVITAMINS 1 CAPSULE PO QD, TYLENOL ( ACETAMINOPHEN ) 650 MG PO Q4H PRN Headache, VITAMIN C ( ASCORBIC ACID ) 500 MG PO BID, DULCOLAX ( BISACODYL ) 5-10 MG PO DAILY PRN Constipation, KEFLEX ( CEPHALEXIN ) 500 MG PO QID, COLACE ( DOCUSATE SODIUM ) 100 MG PO BID, PEPCID ( FAMOTIDINE ) 20 MG PO BID, DILAUDID ( HYDROMORPHONE HCL ) 2-4 MG PO Q3H PRN Pain (ref #901341233), on order for DILAUDID PO 2-4 MG Q3H (ref #901341233), INSULIN REGULAR HUMAN, supplemental (sliding scale) insulin, If receiving standing regular insulin, please give at same, SYNTHROID ( LEVOTHYROXINE SODIUM ) 75 MCG PO DAILY, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H, MILK OF MAGNESIA ( MAGNESIUM HYDROXIDE ), REGLAN ( METOCLOPRAMIDE HCL ) 10 MG IV Q6H PRN Nausea, ZOFRAN ( POST-OP N/V ) ( ONDANSETRON HCL ( POST-... ), on order for KCL IV (ref #964491549), POTENTIALLY SERIOUS INTERACTION: QUINAPRIL HCL & POTASSIUM CHLORIDE, POTENTIALLY SERIOUS INTERACTION: QUINAPRIL HCL & POTASSIUM, SIMETHICONE 80 MG PO QID PRN Upset Stomach, MULTIVITAMIN THERAPEUTIC ( THERAPEUTIC MULTIVI... ) 1 TAB PO DAILY, TIGAN ( TRIMETHOBENZAMIDE HCL ) 200 MG PR Q6H PRN Nausea, ibuprfen. Do not drink/drive/operate machinery with pain medications., Take a stool softener to prevent constipation., 4. Continue your antibiotics as long as you have a drain in place., Sliding Scale (subcutaneously) SC AC+HS Medium Scale, If BS is 125-150, then give 0 units subcutaneously, 30 MILLILITERS PO DAILY PRN Constipation, 1 MG IV Q6H X 2 doses PRN Nausea, Number of Doses Required (approximate): 10, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach, TYLENOL ( ACETAMINOPHEN ) 650 MG PO Q4H PRN Headache, DULCOLAX ( BISACODYL ) 5-10 MG PO DAILY PRN Constipation, DILAUDID ( HYDROMORPHONE HCL ) 2-4 MG PO Q3H PRN Pain. The patient tolerated all procedures without difficulty and post-op period was uneventful, and at discharge, the patient was afebrile with stable vitals, taking po's/voiding q shift, ambulating independently and pain was well-managed with Tigan (Trimethobenzamide HCl) 200 mg PR Q6H PRN Nausea, Tigan (Trimethobenzamide HCl) 300 mg PO Q6H PRN Nausea, Simethicone 80 mg PO QID PRN Upset Stomach, Maalox-Tablets Quick Dissolve/Chewable 1-2 TAB PO Q6H PRN Upset Stomach, 1 mg IV Q6H x 2 doses PRN Nausea, 30 Milliliters PO Daily PRN Constipation and TYLENOL (Acetaminophen) 650 mg PO Q4H PRN Headache, DULCOLAX (Bisacody

has the patient used dilaudid in the past

This 66-year-old male with a history of CAD, MI, CABG, and PCI was admitted with chest pain and ongoing risk factors. His enzyme on presentation was negative and EKG showed nonspecific T wave flat in II, III and V2-V3. In the ED, he had a BP of 86/118 and was given NITROGLYCERIN 1/150 (0.4 mg) SL q5min x 3 with no relief; his CP was 10/10 and reduced to 4/10 with NITROGLYCERIN. Labs showed elevated BUN/Cr and mild-mod lateral wall ischemia. He was prescribed ASA 325 mg PO QD, AMIODARONE 200 mg PO BID, LOPRESSOR (METOPROLOL TARTRATE) 50 mg PO BID, ISOSORBIDE DINITRATE 30 mg PO TID (hold if sbp<100), IMDUR 60 mg PO BID, PLAVIX 75 mg PO QD, Protonix, KEFLEX (CEPHALEXIN) 500 mg PO QID, Lasix 60 mg PO BID, KCl 40 mg PO QD, Metformin 500 mg PO BID, Micronase 10 mg PO BID, Tylenol with Codeine PRN, and Ativan 5 mg PRN. He was also advised to follow-up with his PCP to discuss starting Coumadin therapy given his history of atrial fibrillation, and was instructed to take PPI for GERD and a PPI and SC Hep for ppx. He was discharged with stable condition, and lab results showed normal WBC and no signs of acute infection. The patient was also advised to continue taking POTASSIUM CHLORIDE & RAMIPRIL, ALTACE (RAMIPRIL) 1.25 mg PO QD, NEXIUM (ESOMEPRAZOLE) 20 mg PO QD, DIET: House/Low chol/low sat. fat, ACTIVITY: Resume regular exercise, and FOLLOW UP APPOINTMENT(S): Please see your PCP in Own within 2 weeks.

Has the patient taken medication for atrial fibrillation.

A 60 year old Spanish speaking woman with multiple cardiac risk factors and a two to three year history of exertional angina presented complaining of unstable chest pain. Dr. Maximo Bryum in C&O MEDICAL CENTER Clinic initiated an antianginal regimen, however the patient recently stopped taking Aspirin and her symptoms then recurred. The patient was given three sublingual Nitroglycerins after her primary M.D. was called and her pain resolved after approximately 15 minutes. On the 27 of January, 1995, the patient underwent a Dobutamine MIBBE on which she went 6 minutes and 48 seconds reaching a maximal heart rate of 154, a blood pressure of 172/82, with 2 mm ST depressions diffusely and moderate to severe reversible anterior and anteroseptal wall ischemia. Medications on admission included Atenolol 50 mg p.o. q.d., Axid 150 mg p.o. b.i.d., Enteric Coated Aspirin 325 mg p.o. q.d., Coumadin 10 mg p.o. q.h.s., Diltiazem 240 mg p.o. q.d., Lisinopril 10 mg p.o. q.d., Lopipd 600 mg p.o. q.d., Lasix 40 mg p.o. q.d., Insulin NPH 75 units sub-q q.a.m., 50 units q.p.m., Insulin Regular 25 units sub-q q.a.m., Nitroglycerin 1/150th one tablet sublingual q. 5 minutes x 3 p.r.n. chest pain, and Omeprazole 20 mg p.o. q.d. The Cardiology Team was consulted and serial CK, MB and EKG's were done, with Heparin initially started given the possibility that this was unstable angina. The patient's Insulin dosages were adjusted in the manner to keep her blood sugars in the approximately 200 range and she was discharged with medications including Enteric Coated Aspirin 325 mg p.o. q.d., Lasix 40 mg p.o. q.d., Lopid 600 mg p.o. q.d., Insulin NPH 100 units sub-q q.a.m., 70 units sub-q q.h.s., Insulin Regular 25 units sub-q q.a.m., Lisinopril 10 mg p.o. q.d., Nitroglycerin 1/150th one tablet sublingual q. 5 minutes x 3 p.r.n. chest pain, Omeprazole 20 mg p.o. q.d., Coumadin 10 mg p.o. q.h.s., Diltiazem CD 240 mg p.o. q.d., with follow-up care with her primary M.D., Dr. Jarvis Needy in the RINGBURG RITA'S PROPRES MEMORIAL HOSPITAL Clinic.

Is the patient currently or have they ever taken insulin regular

Mr. Lumadue is a 68-year-old man with significant cardiac history and vascular disease who came in with a chief complaint of hip pain after a mechanical fall. At that time, his hospital course was complicated by a non-Q wave MI, and Cardiology recommended medical management with Lopressor. An echocardiogram revealed an ejection fraction of 45%, and Dobutamine MIBI revealed a severe fixed perfusion defect in the inferoposterior and inferoseptal left ventricle with an ejection fraction of 26%. His medications included HCTZ 50 mg PO q.d., enteric-coated aspirin 325 mg PO q.d., Zestril 20 mg PO q.d., glyburide 5 mg PO q.d., multivitamins, and cough medicine PRN. Upon admission, his vital signs were afebrile, temperature 97.3, tachycardia, heart rate 106, blood pressure 162/77, oxygenation 94% on room air. X-rays of his left pelvis and femur revealed fracture of the left intertrochanter and subtrochanteric fracture with lesser trochanteric fracture intact by 3 cm, less than five degrees angulation. His femoral head was reduced. During his hospital course, the patient was started on a beta blocker, Ace inhibitor, and continued on an aspirin. He was aggressively diuresed with Lasix for diuresis and was treated with vancomycin, Flagyl, and levofloxacin for presumed aspiration pneumonia. He was continued on Lovenox 60 mg subcu. b.i.d. for prophylaxis against DVT post-hip surgery to continue for six months minimal followed by orthopedic surgery, and restarted on oral hypoglycemics prior to discharge in addition to sliding scale insulin. He was discharged on standing 20 mEq of K-Dur q.d., lisinopril 5 mg PO q.d., hold for systolic blood pressure less than 100, Lasix 100 mg PO q.d., Lovenox 60 mg subcu. b.i.d. x6 months, glipizide 2.5 mg PO q.d., sliding scale insulin, Nexium 20 mg PO q.d., Silvadene wet-to-dry dressing, DuoDerm to left lower leg wound and change q.3 days, and Lopressor 12.5 mg PO t.i.d., hold for systolic blood pressure less than 100. He was maintained on Nexium prophylaxis in the setting of his anticoagulation and on two liters of nasal cannula oxygen at the time of transfer to rehab. Upon discharge, he was instructed to follow up with his primary care physician, orthopedic surgery, cardiology, and pulmonary medicine within two weeks, with labs for a metabolic panel, magnesium, and calcium q.o.d. and physical therapy as needed, with a weightbearing status of non-weightbearing on the left lower extremity and weightbearing as tolerated on the right lower extremity.

has the patient had beta blocker

The patient is a 59 year-old right-handed woman admitted for suspected acute stroke with a PMH of hypertension, hypercholesterolemia, prior TIA vs. stroke, recurrent left Bell's palsy, obesity, allergic rhinitis, history of TIA vs. stroke, obstructive sleep apnea, and chronic renal insufficiency. She was put on Acetylsalicylic Acid 325 mg PO QD, Atenolol 50 mg PO QD Starting in AM (2/11), Atorvastatin 40 mg PO QD, Hydrochlorothiazide 25 mg PO QD, Amlodipine 10 mg PO QD Food/Drug Interaction Instruction, and PRN albuterol and loratadine. She was also placed on aspirin 325 mg qd for stroke and heart prophylaxis and should supplement her diet with folic acid, taking a full dose of aspirin (325 mg) and folate supplementation. She should discuss raising her dose of atorvastatin (Lipitor) with her PCP, because her cholesterol and LDL levels were high this admission and she has an outpt appointment for carotid non-invasive studies 4/0/03.

Has the patient had multiple aspirin prescriptions

The patient was admitted for right leg pain and poor ambulation. She had a history of OA and chronic right sided hip/knee pain with ambulation. On examination, she had pain with ambulation to her right leg, hip, and achy not sharp. X-rays of the right lower extremity joints showed no abnormality, and physical therapy recommended use of a cane. To treat her pain she was given TYLENOL 650mg PO Q6HR ATC and PRN IBUPROFEN. She was maintained on her outpatient cardiovascular medications, including Lisinopril 20 mg PO qd, Hydrochlorothiazide 25 mg PO qd starting today (2/4), Lipitor (Atorvastatin) 10 mg PO qd, Multivitamin Therapeutic (Therapeutic Multivi... ) 1 TAB PO QD, Calcium Carbonate (500 mg elemental Ca++) 500 mg PO TID, and Niacin/Vitamin B3 & Atorvastatin Calcium with an override for awareness of a potentially serious interaction. Blood pressure should be followed up as an outpatient and BP meds titrated as needed. She was cleared to go home with instructions to take TYLENOL at least twice daily to help improve her leg pain, seek medical attention if the leg becomes more red, swollen, or tender, or if there are any fevers or new problems with the leg, and use the cane to assist with walking. She was discharged in stable condition to her son, with instructions to follow up with Lenard Dimmitt for blood pressure, take Tylenol for pain, take Ibuprofen as needed, and call the nurse practitioner within 2 weeks for an appointment.

Has the patient had calcium carbonate (500 mg elemental ca++) in the past

Shaull Darin was admitted on 8/12/2007 and discharged on 7/17/2007 with a full code status and disposition to home. During his stay, he was prescribed ACETYLSALICYLIC ACID 325 MG PO DAILY, with an Override Notice added on 10/30/07 by LAUB , STERLING B M. , M.D. on order for COUMADIN PO ( ref # 853955570 ) due to a POTENTIALLY SERIOUS INTERACTION: ASPIRIN & WARFARIN, ATENOLOL 37.5 MG PO DAILY, CAPTOPRIL 12.5 MG PO BID, on order for KCL IMMEDIATE RELEASE PO ( ref # 545368405 ) due to a POTENTIALLY SERIOUS INTERACTION: CAPTOPRIL & POTASSIUM CHLORIDE, CELEXA ( CITALOPRAM ) 40 MG PO DAILY, PLAVIX ( CLOPIDOGREL ) 75 MG PO DAILY, DIGOXIN 0.125 MG PO DAILY, EPLERENONE 25 MG PO DAILY, FOLATE ( FOLIC ACID ) 1 MG PO DAILY, LASIX ( FUROSEMIDE ) 60 MG PO BID, Alert overridden: Override added on 10/30/07 by GOODWINE , BUFORD H B. , M.D. on order for LASIX PO ( ref # 145213873 ), NEURONTIN ( GABAPENTIN ) 100 MG PO TID, LORAZEPAM 0.5 MG PO DAILY PRN Anxiety, LOVASTATIN 40 MG PO DAILY, with an Override Notice added on 10/30/07 by PERAULT , SHELBY H M. , M.D. on order for COUMADIN PO ( ref # 853955570 ) due to a POTENTIALLY SERIOUS INTERACTION: LOVASTATIN & WARFARIN, POTENTIALLY SERIOUS INTERACTION: NIACIN , VIT. B-3 & LOVASTATIN, OMEPRAZOLE 20 MG PO DAILY, TEMAZEPAM 15-30 MG PO BEDTIME PRN Insomnia, MULTIVITAMIN THERAPEUTIC ( THERAPEUTIC MULTIVI... ) 1 TAB PO DAILY, COSOPT ( TIMOLOL/DORZOLAMIDE ) 1 DROP OU BID, Alert overridden: Override added on 11/14/07 by LUTHY , LANNY D E. , M.D. on order for COSOPT OU ( ref # 517414331 ), COUMADIN ( WARFARIN SODIUM ) 1 MG PO QPM, TRAVATAN 1 DROP OU BEDTIME Instructions: OU. thanks., amiodarone toxicity, Peripheral neuropathy, restless legs, Spinal, ASA/Plavix, BB. Some concern for ischemia causing his, to 60 bid. Cont Dig/nitrate/BB, ACEi. Checked echo, no change., Rhythym: Tele. Lyte replete78M with significant CAD, iCM EF 15-20%, presenting with SOB, underwent Adenosine MIBI with no focal defects, LHC with no new disease and no interventions, RHC with wedge of 16, PFTs 1992 with no COPD, CR 1.4-1.8, Barrett's on PPI, neuropathy, neurontin, celexa, glaucoma on eye drops, CV, NAS, 2L fluid restrict diet, held coumadin for cath then restarted it with 2mg on 8/1, 1mg on 6/10, INR of 1.7 on d/c, additional comments included measuring daily weights and calling MD if weight increases by more than 5 lbs in one week or 2-3 lbs in one day, continuing coumadin and checking INR on Monday, taking lasix 60 twice a day, and resuming all home medications. Patient discharged in stable condition with instructions to follow up volume status and check INR on 2/21/07. Number of Doses Required ( approximate ): 7. Override Notice: Override added on 10/30/07 by LAUB, STERLING B M. , M.D. on order for COUMADIN PO ( ref # 853955570 ) and Alert overridden: Override added on 11/14/07 by LUTHY , LANNY D E. , M.D. on order for

Has the patient ever been on lyte

This is a 61-year-old gentleman with severe pulmonary hypertension secondary to chronic PEs, OSA, gout, bilateral hip replacements who presents with two falls in the past two days. He was compliant with his medication regimen and denies dietary indiscretion. He was on his beta-blocker and anticoagulated on Coumadin with an INR goal of 2.5, initially being supertherapeutic with a daily goal of negative 500 to 1 L with IV Lasix once or twice a day as needed, his home dose being 160 mg p.o. His baseline room air oxygen saturation was 90-93% and he should use oxygen as treatment for his pulmonary hypertension and be provided with oxygen at home. He was treated for his hip pain initially with oxycodone which was changed to Dilaudid for better pain control, and he should be changed back to his home dose of oxycodone when discharged. He also has a history of gout which was exacerbated with diuresis and he is on his home doses of allopurinol and colchicine, Indocin being added and he should receive a total of three days of Indocin. Tylenol and narcotics as previously described can be used to help with his gouty pain. His GI regimen includes Nexium at home and Prilosec while an inpatient, and he should be switched back to Nexium when discharged from rehabilitation. His lab results on discharge include a creatinine of 1, hematocrit of 53.1 and INR of 2.3, potassium being 3.9 and magnesium being 2.0. The discharge medications include Coumadin 11 mg on Monday, Wednesday and Friday and 12 mg the other days of the week, Diovan 320 a day, multivitamin 1 tab daily, Toprol-XL 50 once a day, nifedipine extended release 30 once a day, Revatio 20 mg 3 times a day, hydrochlorothiazide 25 once a day, Lasix 160 IV once per day, allopurinol 200 once per day, colchicine 0.6 once per day, Colace, Prilosec 20 once a day, Dilaudid 2 mg q.4 h. p.o. p.r.n. pain, Tylenol 500-1000 mg p.o. q.6 h. p.r.n. pain not to exceed 4 gm total from all sources in a 24-hour period, Ambien 10 mg p.o. nightly p.r.n. insomnia. He is being discharged to rehab with a followup with his cardiologist, Dr. Insco, and an appointment with Endocrinology.

Has the patient had multivitamin in the past

Lupe Rumble, a 42 year old female with a history of asthma, hypertension, obesity, hyperlipidemia, hyperglycemia, hirsutism, chiari malformation, spinal stenosis, and spinal syrinx, was admitted to the hospital with a recent asthma flare, productive cough, low grade fevers, shortness of breath, and wheezing. Her chest x-ray showed a linear opacity in the right lower lobe most consistent with platelike atelectasis, but could not rule out resolving or new pneumonia. Treatment included ALBUTEROL INHALER 2 PUFF INH QID, ALBUTEROL NEBULIZER 2.5 MG NEB Q4H, Advair Diskus 500/50 (Fluticasone Propionate/...), Combivent (Ipratropium and Albuterol Sulfate) 2 PUFF INH TID, LISINOPRIL 20 MG PO DAILY, Singulair (Montelukast) 10 MG PO DAILY, and a prednisone taper starting at 60 mg q 24 h x 2 doses, then 50 mg daily x 3 days, then 40 mg daily x 3 days, then 30 mg daily x 3 days, then 20 mg daily x 3 days, and then 10 mg daily x 2 days and stop. The peak flow had improved to 250 and ambulating oxygen saturation was 92-94% at discharge. The patient was also advised to try a nicotine patch and was given Lovenox as a prophylaxis. Her lisinopril was increased to 20mg due to hypertension, and she was discharged on order for KCL IMMEDIATE RELEASE PO (ref #) with instructions to continue all home medications, a prednisone taper, nebs, and advair, singulair, albuterol, and combivent. Smoking cessation was encouraged and she was interested in trying a nicotine patch.

Has the patient had multiple prednisone taper prescriptions

This 75-year-old female vasculopath was admitted for further evaluation of her peripheral vascular disease which was suspected to be contributing to her new ulcerations and progressively worsening bilateral foot pain, foot mottling and wrist pain as an exacerbating factor to likely atheroembolic phenomenon, status post coronary catheterizations earlier in the year. She was placed on broad-spectrum antibiotics and plan was made for an MRA to evaluate her anatomy, unfortunately, the patient was unable to tolerate the MR and did experience some mental status changes that prevented further noninvasive imaging when she received some narcotic following her hemodialysis round. Over the ensuing days she required rather significant doses of Zyprexa and Haldol to contain agitation and delirium, as the patient would also get physical and violent. This appeared to sedate her sufficiently and over the following days, she did manage to calm significantly and returned to her baseline mental status. Cardiology was consulted during this time to optimize her prior to the OR and her primary cardiologist, Dr. Fugle, did make some recommendations including an echocardiogram that showed preserved ejection fraction and no wall motion abnormalities. Her beta blockade was titrated up and she was instructed to follow up with cardiology. She did tolerate hemodialysis throughout this time without undue difficulty and they offered an angiogram to delineate aortic and bilateral lower extremity runoff anatomy. After extensive discussions with the patient and the patient's family, the patient did agree to a left femoral to dorsalis pedis bypass graft which was performed on 0/25/2006 without complication. By time of discharge, she was tolerating a regular diet and ambulating at baseline with her rolling walker. The pain was well controlled with minimal analgesics that were not narcotic based. Medications on admission included Aspirin 325 mg p.o. daily, Plavix 75 mg p.o. daily, Cardizem 60 mg p.o. t.i.d., Lipitor 80 mg daily, Atrovent 2 puffs four times a day, Albuterol 2 puffs b.i.d., Renagel 806 mg p.o. every meal, Allopurinol 100 mg p.o. daily, Zaroxylyn 2.5 mg p.o. daily p.r.n. overload, Lantus 10 units subcutaneous nightly, Regular insulin sliding scale, Valium 5 mg p.o. b.i.d. p.r.n., Isordil 40 mg p.o. t.i.d., Hydralazine 20 mg p.o. t.i.d., Lopressor 75 mg p.o. t.i.d., Zantac 150 mg p.o. b.i.d., Aciphex 20 mg p.o. daily, Neurontin 300 mg p.o. post-dialysis, Metamucil, Nitroglycerine p.r.n., Procrit 40,000 units subcutaneously every week, Lilly insulin pen, unknown dosage 20 units every morning and 10 units every evening, Loperamide 2 tabs p.o. four times a day, Ambien 10 mg p.o. nightly p.r.n., Tylenol 325 mg p.o. every four hours p.r.n. pain, Albuterol inhaler 2 puffs b.i.d., Calcitriol 1.5 mcg p.o. every Monday and every Friday, Darbepoetin alfa 100 mcg subcutaneous every week, Ferrous sulfate 325 mg p.o. t.i.d., Prozac 40 mg p.o. daily, Motrin 400 mg p.o. every eight hours p.r.n. pain, Insulin regular sliding scale, and Sevelamer 800 mg p.o. t.i.d. Discharge instructions included touchdown weightbearing on the left heel, legs are to be elevated as much as possible while sitting or lying down, all home medications were to be resumed except for Lopressor, VNA was ordered to assist with wound care including Betadine paint to incisions daily, showering only, no bathing or immersion in water for prolonged periods of time, and follow-up visits with Dr. Amorose in one to two weeks and Dr. Morici primary care physician in one week.

Has the patient taken any medications for overload management

This is a 48-year-old female who was admitted to the hospital with pneumonia and Klonopin overdose two days prior to admission, having recently completed an antibiotic course at Dale Skin Sonmu Medical Center for pneumonia. She has not taken her lisinopril or methadone in the past. Upon admission, her respiratory rate was 18, O2 saturation 95% on 8 liters of oxygen and she was aggressively given fluids and was started on Levophed for blood pressure support. Her EKG was notable for low voltage on the precordial leads and her saturations were in the high 80's. She was given vancomycin, Levaquin and gentamicin and 3 liters of normal saline. She had a mild troponin elevation on admission, likely secondary to RV strain, and was given a heparin drip with a goal of 60 to 80. Her second PECT showed a small PE to the right upper lobe, but it was not large enough to explain her dramatic presentation. She had severe hypotension and was on two pressors, which were weaned off of on 4/15/06, but had an episode of hypotension when her BiPAP was started. She was given a little bit of low dose dobutamine and then weaned off of that on 3/6/06. She had an elevated eosinophilia on presentation and it was 4% on admission and increased to 8% on 4/21/06. She was empirically covered on admission with vancomycin, levofloxacin and gentamicin. Her antibiotics were given again on 10/16/06 and on 11/13/06. She did complain of bladder spasms while having the Foley in place and was started on Ditropan. She had multiple negative urinalysis and urine cultures. Once the Foley was discontinued, she was able to void and she stopped having bladder spasms. She was started on Monistat for a yeast infection. She did have a history of severe hypertension and her blood pressures were stable, but not high enough to withstand on additional blood pressure lowering medication. It was discussed with her PCP that she perhaps will need this medication restarted as an outpatient. She also had a normal increase in her cortisol level with ACTH stimulation. Her Coumadin was initially given 10, then a dose of 5 and then 2 dose of 7.5. We are continuing her methadone, which has been switched from 20 mg p.o. daily to 10 mg p.o. b.i.d. She was also given a little bit of Ativan while in-house to help with her agitation and anxiety and was initially given a little bit of Haldol, but that was discontinued on 8/4/06 and there was no additional need for that. She was on unfractionated heparin for her presumed PE until 6/15/06 and then changed to Lovenox in the morning and her methadone has been switched from 20 mg p.o. daily to 10 mg p.o. b.i.d. She was given a little bit of low dose lisinopril while in-house. Her blood pressures were stable, but her weight at that time was 157 kg.

What types of medications have been tried for her presumed pe management

A 58 year old female smoker with a history of Coronary Artery Disease (CAD), Cirrhosis, Diabetes Mellitus Type II (DMII), Hypertension (HTN), and Hyperlipidemia was admitted to the CCU after an elective cardiac catheterization following an abnormal stress test. The cath showed impaired flow in the inferior and posterolateral zones due to obstructive degenerative disease in the SVGs to the RCA and LCF-OM, and a stent was placed in the RCA graft though there was extensive calcification and difficulty obtaining full stent expansion. After the stent deployment there was poor reflow accompanied by mild chest pain and EKG changes, without hemodynamic embarrassment. The patient experienced jaw and chest pain post-procedure which she described as different from previous episodes of angina. The pump-function was preserved, BP low-normal, and rhythm was NSR on telemetry. For pulmonary issues, the patient had a chronic cough due to post nasal drip which was taken off of her antihistamine on admission and CXR was normal with no acute changes. There were no renal issues during the hospital course and the patient was on Lantus, Novolog SS, and FS Glu monitored while in the hospital. Heme-wise, the patient had a cath and subsequent oozing from the site in the groin and was discharged on home meds including Plavix and ASA. Medications prescribed include ENTERIC COATED ASA 325 MG PO DAILY, TESSALON PERLES ( BENZONATATE ) 100 MG PO TID, PLAVIX ( CLOPIDOGREL ) 75 MG PO DAILY, CODEINE PHOSPHATE 15 MG PO Q3H PRN Pain, DEXTROMETHORPHAN HBR 10 MG PO Q6H PRN Other:cough, ZETIA ( EZETIMIBE ) 10 MG PO DAILY, LANTUS ( INSULIN GLARGINE ) 20 UNITS SC BEDTIME, POTASSIUM CHLORIDE IMMED. REL. ( KCL IMMEDIATE... ) 1.Only KCL Immediate Release products may be used for KCL, 4.As per SMH Potassium Chloride Policy: each 20 mEq dose, on order for DIOVAN PO ( ref # 032637277 ), VALSARTAN Reason for override: aware, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach, MAGNESIUM GLUCONATE Sliding Scale PO ( orally ) DAILY: -&gt; Mg-scales cannot be used and magnesium doses must be, If Mg level is less than 1 , then give 3 gm Mg Gluconate, NITROGLYCERIN 1/150 ( 0.4 MG ) 1 TAB SL q5min x 3, OXYCODONE 5-10 MG PO Q6H PRN Pain, PINDOLOL 5 MG PO BID HOLD IF: sbp&lt;90 , HR&lt;50, ZOCOR ( SIMVASTATIN ) 80 MG PO BEDTIME, DIOVAN ( VALSARTAN ) 160 MG PO DAILY, Lantus 40u qd Estradiol 0.05, Diltiazem 180 mg qd HCTZ 25 mg qd, Zetia 10mg qd, Plavix 75 mg qd, Zocor 80 mg qd, ASA 325 mg qd, Famotidine 20 mg BID, Lovenox 40 sc qd, nicotine patch MgSO4 qd, Novolog SS Pt as outpt and heparin and Integrelin have been discontinued, insulin, and was stable post cath, with anticoagulation stopped. The patient was prescribed ENTERIC COATED ASA 325 MG PO DAILY, TESSALON PERLES ( BENZONATATE ) 100 MG PO TID, PLAVIX ( CLOPIDOGREL ) 75 MG PO DAILY, CODEINE PHOSPHATE 15 MG PO Q3H PRN Pain, DEXTROMETHORPHAN HBR 10 MG PO Q6H PRN Other:cough, ZETIA ( EZETIMIBE ) 10 MG PO DAILY, LANTUS ( INSULIN GLARGINE ) 20 UNITS SC BEDTIME, POTASSIUM CHLORIDE IMMED. REL. ( KCL IMMEDIATE... ), 1.Only KCL Immediate Release products may be used for KCL, 4.As per SMH Potassium Chloride Policy: each 20 mE

Is there a mention of of zetia usage/prescription in the record

The patient was admitted on 5/5/2006 with a history of mechanical fall, with the attending physician being Dr. Clemente Armand Bolstad, with a full code status and disposition of Rehabilitation. Medications on Admission included Amiodarone 100 QD, Colace 100 bid, lasix 40mg QD, Glyburide 5mg bid, Plaquenil 200mg bid, Isordil 20mg tid, Lisinopril 20mg QD, Coumadin 5mg 3dys/week, 2.5mg 4dys/week, Norvasc 10mg QD, Neurontin 300mg TID, with APAP prn. An override was added on 10/2/06 by Gerad E. Dancy, PA for POTENTIALLY SERIOUS INTERACTION: AMIODARONE HCL & WARFARIN with the reason for override being monitoring. The patient was rehydrated with IVF and PO's were encouraged, holding Glypizide while in house, Novolog sliding scale was started on 1/2, Low dose NPH 6 units BID was started on 1/2, bridged with lovenox and INR therapeutic 1/2 and restarted on home regimen of 5/2.5mg variable dose. Pain was controlled with TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Pain, Headache. A CT pelvis showed a right adnexal cyst which will need further characterization by US and outpatient follow up. The patient has an extensive cardiac history and the fall is not likely related to a cardiac issue as it appears mechanical, with no syncope, chest pain, etc. She was diagnosed with an NSTEMI with a small TnI leak, likely demand related in the setting of hypovolemia and the fall. Enzymes trended down. She was dry on admission and rehydrated with IVF, PO's encouraged, and became euvolemic by 1/2. Her JVP was up to 12cm, although it was difficult to gauge her volume status due to TR. She had a prolonged QT on admission, on telemetry, of unclear etiology, possibly starvation. This was monitored on telemetry until ROMI and drugs that confound were avoided. The QTc resolved to low 500s and a DDD pacer was functioning with V-pacing at 60bpm. Additional medications included NATURAL TEARS (ARTIFICIAL TEARS) 2 DROP OU BID, COLACE (DOCUSATE SODIUM) 100 MG PO BID, PLAQUENIL SULFATE (HYDROXYCHLOROQUINE) 200 MG PO BID, ISORDIL (ISOSORBIDE DINITRATE) 20 MG PO TID, LISINOPRIL 20 MG PO DAILY HOLD IF: SBP <110, MILK OF MAGNESIA (MAGNESIUM HYDROXIDE) 30 MILLILITERS PO DAILY PRN Constipation, COUMADIN (WARFARIN SODIUM) 2.5 MG PO QPM, NORVASC (AMLODIPINE) 10 MG PO DAILY HOLD IF: SBP <110, NEURONTIN (GABAPENTIN) 300 MG PO TID, NEXIUM (ESOMEPRAZOLE) 20 MG PO DAILY, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach, DULCOLAX RECTAL (BISACODYL RECTAL) 10 MG PR DAILY PRN Constipation, CLOTRIMAZOLE 1% TOPICAL TOPICAL TP BID, GLYBURIDE 5 MG PO BID, LASIX (FUROSEMIDE) 20 MG PO DAILY, and corrected pt restarted on lasix 20 qd on d/c. A PT consult was obtained 3/21 and to follow daily at rehab. Labs showed Na 146, CK 3320, CKMB 12.9, Trop 0.23--->0.10, AST 107, Cr 1.2-->1.6. Pain was controlled with TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Pain, Headache, rehydrated with IVF, po's encouraged, holding Glypizide while in house, Novolog sliding scale was started on 1/2, Low dose NPH 6 units BID was started on 1/2, bridged with lovenox and INR therapeutic 1/2 and restarted on home regimen of 5/2.5mg variable

What medications has patient been on for constipation in the past

Mr. Kanaan is a 68-year-old gentleman with stage IV esophageal cancer who presented with progressive shortness of breath over the three days prior to admission and had a known ejection fraction of 20%. His medical regimen was maximized with an ACE inhibitor or statin and baby aspirin was started on him. He was admitted with diarrhea related to chemotherapy, pulmonary edema secondary to decompensated heart failure, and gout in his right great toe. He was diuresed with Lasix and torsemide in addition to his spironolactone dose with a goal of 1.5 liters a day and received Atrovent nebulizers to help with his shortness of breath, with the combination of dopamine, nesiritide, and Lasix drips being most effective. His medications included amiodarone, digoxin, colchicine, Atrovent, lisinopril, spironolactone, torsemide, Ativan, Zocor, and Prilosec, with instructions to follow up with his primary care doctor with DVT prophylaxis with Lovenox. He also received ferrous sulfate 325 mg daily, trazodone 50 mg at night, multivitamins one tablet daily, and simvastatin 80 mg at night. He was discharged home with oxygen to use overnight and when symptomatic.

Is there history of use of prilosec

The 65-year-old female patient with a history of hypertension, hypercholesterolemia, non-insulin-dependent diabetes mellitus, and no known hx of CAD was admitted with chest pain. On November 1997, an exercise treadmill test revealed a maximal heart rate of 127 and maximal blood pressure of 134/80, with 1 millimeter of ST depression in V5 and T-wave inversions in V4-V6, consistent with, but not diagnostic ischemia. She had a history of sarcoidosis, seizure disorder, pacemaker placement, appendectomy, total abdominal hysterectomy for cervical cancer, adult onset diabetes mellitus, and left calf deep vein thrombosis in 1993. Medications at the time of admission included Linsinopril 5 mg q.d., Pravachol 20 mg q.h.s., aspirin 325 mg q. day, atenolol 0.5 mg b.i.d., Dilantin 200 mg b.i.d., Ventolin inhaler p.r.n., and ferrous gluconate 325 mg t.i.d. Hematocrit on June 1997 was noted to be 29.3 and the patient had been on iron supplements since then. On admission, she was given Nitrol paste and, for her ischemia, she was transfused with one unit of packed red cells. Diagnostic ischemia was present, and she was started on aspirin and atenolol. In the past, she has been treated with prednisone and black secondary to iron supplementation. Two cardiac catheterizations were performed, which showed a 70% residual osteal diagonal stenosis and 0% left anterior descending stenosis. A stent was placed in the diagonal artery with 0% residual stenosis and her left anterior descending was stented. At the time of discharge her medications included Ticlid 250 mg p.o. b.i.d., albuterol inhaler 2 puffs q.i.d. as needed for shortness of breath, enteric-coated aspirin 325 mg p.o. q.d., atenolol 37.5 mg p.o. b.i.d., nitroglycerin 1/150 sublingual one tablet q. 5 minutes times three for chest pain, and Dilantin 200 mg p.o. b.i.d. She was also taking linsinopril 5 mg q.d., Pravachol 20 mg q.h.s., ferrous gluconate 325 mg t.i.d., and Ventolin inhaler p.r.n. She is scheduled to followup with Dr. Doug Millis in her office in one week and will follow up with cardiology as an outpatient.

What was the dosage prescribed of ferrous gluconate