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Reginald Burgos, a 76-year-old male with MMP, was admitted with chronic diarrhea of unclear etiology, likely malabsorption. He was put on a lactose free diet, NPO, and started on Imodium as diarrhea was not thought to be due to an acute infectious process. Lab tests were WNL. Medications prescribed include Acetylsalicylic Acid 81 mg PO QD, Atenolol 50 mg PO QD (hold if sbp <100, hr <60), Enalapril Maleate 20 mg PO BID (hold if sbp <100), Potassium Chloride on order for KCL Immediate Release PO (ref #61864355), Nifedipine (Extended Release) (Nifedipine (SL...)) 60 mg PO QD (hold if sbp <100, hr <60), Lipitor (Atorvastatin) 20 mg PO QHS, Zantac (Ranitidine HCl) 150 mg PO BID, Metformin 500 mg PO BID, Imodium (Loperamide HCl) 2-4 mg PO Q6H PRN Diarrhea, and Protonix (Pantoprazole) 40 mg PO QD. Follow up appointments were scheduled with Dr. Detillier (GI) 3/5 2pm, colonoscopy 6/18 9:30am, and Dr. Gaboriault (PCP) 0/8 1:30pm. He was treated with Cipro/Flagyl, but diarrhea persisted after the course was completed and he was given Protonix. He was also instructed to take Phosphate Soda the night before the colonoscopy, and to call 522-750-9060 for more directions. Allergies include CLOPIDOGREL and Penicillins. Discharge condition is stable.

has there been a prior potassium chloride

This 66-year-old male with a complicated medical history of DM2, CHB with pacer and evidence of clot on pacer wire, and non-compliance with medications and diet was admitted to the ED with symptoms of abdominal pain and SOB with FS of 500-600. On admission, his VS were 99.5, 101/62, 70s, SaO2 96% on room air. His exam was GEN: elderly ill appearing male in NAD; HEENT: Anicteric sclera, PERRL, dry mucous membranes, poor dentition; NECK: Supple, no adenopathy, JVP flat; CHEST: CTA bilaterally; CV: RRR with diffuse PMI, Nl S1, S2 S3 present; ABD: Reducible ventral hernia, NT, ND, bowel sounds present; EXT: No edema or wounds; SKIN: No rashes; EKG: paced; CXR: clear with NAD; ABD CT: small ventral hernia, gallstones, ectasia of the infrarenal aorta, RLL inflammatory changes suggestive of PNA; VQ: Low probability; LABS: Creatinine of 2.2 that dropped to 1.5 with hydration (BL 1.2-1.3). HCT 41.6 with drop after aggressive hydration. Lipase of 132 but has chronic pancreatitis and is now normalizing. UA and ACE negative. The patient received 5 liters of IVF and 36U of insulin in the ED, his blood pressure stabilized with volume, and was transferred to the medical floor. He was started on ECASA (ASPIRIN ENTERIC COATED) 325 MG PO QD, FOLATE (FOLIC ACID) 1 MG PO QD Starting Today (9/24), LISINOPRIL 30 MG PO QD, THIAMINE HCL 100 MG PO QD, MVI THERAPEUTIC (THERAPEUTIC MULTIVITAMINS) 1 TAB PO QD, LEVOFLOXACIN 500 MG PO QD Starting Today (9/24), LANTUS (INSULIN GLARGINE) 20 UNITS SC QD, LASIX (FUROSEMIDE) 40 MG PO QD, LIPITOR (ATORVASTATIN) 20 MG PO QD, COUMADIN (WARFARIN SODIUM) 5 MG PO QPM, and CREON 20 (PANCRELIPASE 20000U) 4 CAPSULE PO TID, with Override Notices added on 4/24/04 by Blain, Guillermo P., M.D. on order for COUMADIN PO (ref #11219725) (POTENTIALLY SERIOUS INTERACTION: ASPIRIN & WARFARIN) and by Degrange, Diego A., M.D. on order for SIMVASTATIN PO (ref #59315078) (POTENTIALLY SERIOUS INTERACTION: NIACIN, VIT. B-3 & ATORVASTATIN CALCIUM Reason for override: will monitor). He was given teaching regarding nutrition, diabetes, and Coumadin, and instructed to take all medications as directed, and to measure his weight daily. He was also instructed to take a shot with 20 units of insulin every night and to take iron products a minimum of 2 hours before or after a Levofloxacin or Ciprofloxacin dose dose. ADDITIONAL COMMENTS: 1.) Please take your insulin shot (20 units of Lantus) every night at bedtime, 2.) follow an ADA diet, and 3.) take all your medications. He was discharged on ECASA (ASPIRIN ENTERIC COATED) 325 MG PO QD, FOLATE (FOLIC ACID) 1 MG PO QD Starting Today (9/24), LISINOPRIL 30 MG PO QD, THIAMINE HCL 100 MG PO QD, MVI THERAPEUTIC (THERAPEUTIC MULTIVITAMINS) 1 TAB PO QD, CREON 20 (PANCRELIPASE 20000U) 4 Capsule PO TID, LEVOFLOXACIN 500 MG PO QD, LANTUS (INSULIN GLARGINE) 20 UNITS SC QD, LASIX (FUROSEMIDE) 40 MG PO QD, LIPITOR (ATORVASTATIN) 20 MG PO QD, and COUMADIN (WARFARIN SODIUM) 5 MG PO Q

What is the dosage of lisinopril

Patient Mariano Librizzi was admitted on 4/21/2005 with a viral infection and severe pulmonary hypertension, and discharged on 9/22/2005 to go home. The discharge medications included ECASA (Aspirin Enteric Coated) 81 MG PO QD, with a potentially serious interaction with Warfarin & Aspirin, COLACE (Docusate Sodium) 100 MG PO BID, LASIX (Furosemide) 160 MG PO BID, GLIPIZIDE 10 MG PO BID, OCEAN SPRAY (Sodium Chloride 0.65%) 2 SPRAY NA QID, COUMADIN (Warfarin Sodium) 5 MG PO QPM, JERICH, JOSPEH, M.D. on order for ECASA PO (ref #91585860), ZOLOFT (Sertraline) 150 MG PO QD, AMBIEN (Zolpidem Tartrate) 10 MG PO QHS, KCL SLOW RELEASE 20 MEQ PO BID, ATROVENT NASAL 0.06% (Ipratropium Nasal 0.06%) 2 SPRAY NA TID, NEXIUM (Esomeprazole) 20 MG PO QD, TRACLEER (Bosentan) 125 MG PO BID, VENTAVIS 1 neb NEB Q3H Instructions: during wake hours, ALBUTEROL INHALER 2 PUFF INH Q4H PRN Shortness of Breath, Wheezing, home O2 (8L NC). The patient was also prescribed K-Dur 20 BID, Nexium 20, Lasix 160 BID, Tracleer 125 BID, Glipizide 80 BID, Coumadin 5/7.5, ECASA 81, Zoloft 100, MVI, Oceanspray 2 Spray NA QID, Ambien 10 QHS, Ventavis nebs Q3H, Albuterol Inhaler 2 puff INH Q4H, KCl Slow Release 20 MEQ PO BID, Colace 100 MG PO BID, Atrovent Nasal 0.06%. The diet was House/Low chol/low sat. fat and 4 gram Sodium and they were advised to do walking as tolerated, with serial enzymes/EKG to be continued and Lasix, KCl, ASA 81 also advised. The patient had a history of depression which had been worse of late and was advised to continue Zoloft and Ambien, and to avoid high Vitamin-K containing foods and to give on an empty stomach (give 1hr before or 2hr after food). The patient was followed by the AH service with ACEi, cephalopsporins, GERD nexium prophylaxis and Coumadin for pulmonary microclots on Bx in tracleer 125 BID, Glipizide 80 BID, Coumadin 5/7.5, ECASA 81, Zoloft. The discharge condition was satisfactory.

Has the patient ever been on aspirin

The patient is a 64 year-old gentleman with a history of chest discomfort, dyspnea on exertion and fatigue who was scheduled for a coronary artery bypass grafting. He had cardiac catheterization at Ryhoagberg Spisus Community Hospital on November, 1999 which demonstrated a 30% tapering lesion of the left main coronary artery, 70% proximal lesion of the left anterior descending coronary artery, 80% lesion distal to D1, 100% occlusion of his left circumflex and a 100% occlusion of his right coronary artery. On March, 1999, he underwent coronary artery bypass grafting times three with a left internal mammary artery to the left anterior coronary artery, saphenous vein graft to the aorta and a saphenous vein graft from the obtuse marginal to the aorta. His intraoperative course was uncomplicated and he was weaned to extubation and he was treated with stress steroids to prevent steroid withdrawal. He was taken back to the operating room for bleeding and was reintubated and was returned in good and stable condition to the intensive care unit on renal Dopamine. He was again extubated and was seen in consultation by the Gastrointestinal Service for a question of gastrointestinal bleed since there was a clot seen on the transesophageal echocardiogram probe at its withdrawal from his first surgery. The Gastrointestinal Service saw any evidence of any upper gastrointestinal bleed and he was maintained on H2 blockers. He was sent to the step down unit on routine postoperative day number two and his Captopril was increased for afterload reduction. He continued to improve and continued to have care for his respiratory situation with continued diuresis and nebulizer treatments and ambulation. He was discharged to the care of Dr. Lou Pineault at Potmend Rehabilitation Hospital, Moorlberl Street with medications including Prednisone 5 mg p.o. twice a day, Enteric coated aspirin 325 mg p.o. q. day, Zantac 150 mg p.o. twice a day, Niferex 150 mg p.o. twice a day, Atrovent nebulizer 0.5 mg four times a day, Timolol eye drops 0.5% one drop in both eyes twice a day, Atenolol 25 mg p.o. twice a day, Captopril 12.5 mg p.o. three times a day, Lasix 40 mg p.o. q. day, Potassium SR 20 mEq p.o. q. day, Simvastatin 40 mg p.o. q. day, and Ibuprofen 200-800 mg as needed for pain q.4-6h.

has there been a prior niferex

A 66-year-old gentleman with a medical history significant for coronary artery disease and two prior MIs presented with substernal chest pain while walking that lasted 2-3 hours and was relieved by rest and sublingual nitroglycerin. He was admitted and cardiac catheterization revealed 90% proximal LAD stenosis, 90% mid LAD and 100% distal LAD stenosis, 100% mid LVB1, 80% mid circumflex, 70% proximal D1, 70% proximal PDA, and a right dominant circulation, with diffuse coronary calcification and extensive diffuse disease with small distal vessels. LAD in stent restenosis and collateral flow diffusely small left main. On 4/15/05, the patient underwent CABG x4 with SVG1 to RCA, and sequential graft of SVG2 to D1 and then OM1, with LIMA to LAD and an LAD endarterectomy. On arrival to the hospital, he was given 150 mg of Plavix, heparin 500 units for 48 hours, and aspirin that same night. He was also started on Enteric-coated aspirin 325 mg p.o. daily, atenolol 75 mg p.o. daily, Colace 100 mg p.o. t.i.d., oxycodone 5 mg to 10 mg p.o. q.6h. p.r.n. pain, Plavix 75 mg p.o. daily, Lantus 38 units subcutaneously at bedtime, NovoLog 18 units subcutaneous q.a.m., and Lasix with good effect. He required the transfusion of a unit of packed red blood cells and neosynephrine transiently, which was weaned off on postoperative day #2. He was also noted to have a preoperative urinary tract infection of E. coli for which he was started on levofloxacin on 0/5/05 and treated for five days. The patient was followed by the Diabetes Management Service for blood sugar control and was transitioned from IV insulin to subcutaneous insulin postoperatively. He was discharged to home in good condition on postoperative day #7 on the following medications and is to have a follow-up appointment with his cardiologist, Dr. Abusufait, in one to two weeks, and with his cardiac surgeon, Dr. Cederberg, in four to six weeks.

What is her current dose of oxycodone

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 there been a prior neurontin ( gabapentin )

This 54-year-old female with end-stage renal disease on hemodialysis had an apparent VFib arrest at hemodialysis and was admitted to the CCU after being intubated in the Vibay General Hospital ED. She was intubated, received amiodarone and dopamine, as her BP was low. An x-ray revealed diffuse bilateral opacities, possible pulmonary edema versus aspiration pneumonia, and an EKG showed normal sinus rhythm 100 beats per minute with no acute ST changes. Her first set of cardiac enzyme revealed a creatinine kinase of 116 and the MB fraction of 0.7 and troponin T of less than assay and lactate of 1.8. A fistulogram and angioplasty of her right AV fistula was performed on 9/14/06 with prednisone premedication but it was unsuccessful and therefore a left IJ tunneled dialysis catheter was inserted on 10/18/06 with the tip ending in the right atrium. HOME MEDICATIONS at the time of admission included amitriptyline 25 mg p.o. bedtime, enteric-coated aspirin 325 mg p.o. daily, enalapril 20 mg p.o. b.i.d., Lasix 200 mg p.o. b.i.d., Losartan 50 mg p.o. daily, Toprol-XL 200 mg p.o. b.i.d., Advair Diskus 250/50 one puff inhaler b.i.d., insulin NPH 50 units q.a.m. subcu and 25 units q.p.m. subcu, insulin lispro 18 units subcu at dinner time, Protonix 40 mg p.o. daily, sevelamer 1200 mg p.o. t.i.d., tramadol 25 mg p.o. q.6 h. p.r.n. pain. A bronchoscopy was performed on 9/14/06 with prednisone premedication but it was negative for aspiration. The patient had difficulty weaning from vent and was finally extubated on 0/22/06. She had a single set of coag-negative Staph positive blood cultures from Quinton catheter on 8/8/06 and was treated with vancomycin dose by renal levels. An Echo on 8/1/06 showed an EF of 60 to 65% with mild concentric left ventricular hypertrophy and no wall motion abnormalities. The patient was continued on telemetry and treated with her home dose of beta-blocker with good response and was gradually advanced to an oral diet with no signs of aspiration status post extubation. She was also given heparin subcutaneously and Nexium as prophylaxis. The patient is full code and will likely need rehab and is being screened by PT and OT and will likely be discharged to rehab when bed is available.

Has the patient taken any medications for mild concentric left ventricular hypertrophy management

GVERRERO , STAN O 346-21-49-8, a 74 yo woman in remission from Hodgkin's Lymphoma and s/p renal transplant( 11/12 ), was discharged to Home with the attending physician being KERSON , RODNEY S , M.D. and code status being Full code. She was prescribed FESO4 ( FERROUS SULFATE ) 300 MG PO BID, FOLATE ( FOLIC ACID ) 1 MG PO QD, SYNTHROID ( LEVOTHYROXINE SODIUM ) 100 MCG PO QD, PREDNISONE 5 MG PO QAM, ZOCOR ( SIMVASTATIN ) 20 MG PO QHS, NEORAL ( CYCLOSPORINE MICRO ( NEORAL ) ) 100 MG PO BID, LOSARTAN 50 MG PO QD, ATENOLOL 25 MG PO QD, PRILOSEC ( OMEPRAZOLE ) 20 MG PO QD, AMIODARONE 400 MG PO BID, ECASA ( ASPIRIN ENTERIC COATED ) 325 MG PO QD, FLAGYL ( METRONIDAZOLE ) 500 MG PO TID X 2 Days, LEVOFLOXACIN 500 MG PO QD X 2 Days, and DIET: House / Low chol/low sat. fat with instructions for regular exercise and follow up with Dr. Schultheiss ( cardiology ) 5/30/03 scheduled. On order for NEORAL PO ( ref # 55336954 ) with a POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & CYCLOSPORINE override added on 11/0/03 by LIU , HERMAN ANTONIO , M.D., and LOSARTAN PO ( ref # 04133525 ) with a POTENTIALLY SERIOUS INTERACTION: CYCLOSPORINE & LOSARTAN POTASSIUM override added on 11/0/03 by ELVEY , EDMUND LENNY , M.D., Alert overridden: Override added on 5/27/03 by : POTENTIALLY SERIOUS INTERACTION: LEVOFLOXACIN & AMIODARONE HCL Reason for override: aware and POTENTIALLY SERIOUS INTERACTION: AMIODARONE HCL & LEVOFLOXACIN Reason for override: aware. The patient had a hypoxic episode and EKG changes resolved, requiring 2u PRBCs, and was initially treated with lopressor 5mg IV, eventually rate controlled with dilt drip. PFT's , LFT's and TFT's were completed prior to discharge, and she was instructed to restart ecasa 5d p colonoscopy, as well as to take levofloxacin and flagyl for 5 days, and administer iron products a minimum of 2 hours before or after a levofloxacin or ciprofloxacin dose dose. Consider anticoagulation for PAF was recommended. On 1/16 she had Afib with RVR to 130s with chest arm pain which is her anginal equivalent. ECG with rate related ischemia ST depression V5-6, L. +Minimal troponin leak to 0.19, which subseq downtrended with nl CK. She was init treated with lopressor 5mg IV but had hypotension to 80's which resolved quickly with IVF. She was eventually rate controlled with dilt drip. She returned to sinus rhythm within the day. Cards c/s'd and recommended amio load. CXR showed no infiltrate/opacity. Levo/Flagyl given empirically x 5days though she remained afeb. Abdominal exam was concerning for focal peritoneal irritation. Her exam improved, and she was tolerating PO well at the time of discharge. She has been afeb and well appearing for several days prior to d/c. Plan to complete 5d abx. As per Dr. Thorburn her colonoscopy was complex, and she had polypectomy of 2.5 cm polyp. Path is pending. If + for cancer, the base looked "clean", so may be feasible to re-scope her for surveillance at a later time, as per GI. Hct after colonoscopy went to 24 ( baseline 30 ); post-transfusion HCt of 30.

Has this patient ever been on synthroid ( levothyroxine sodium )

Mr. Quigg is a 42-year-old man with history of diabetes, end-stage renal disease on hemodialysis, left Charcot foot complicated by recurrent cellulitis who presented with left lower leg swelling, erythema, and pain. On admission, his temperature was 100.8, heart rate was 111, and blood pressure was 140/70. His left lower extremity had 1+ pitting edema with erythema on the anterior shin and foot. He was uptitrated to 5mg and also lopressor, started on Lyrica and oxycodone for breakthrough pain, and received Fentanyl PCA. His home medications included Colace 100 mg b.i.d., folate 1 mg p.o. daily, gemfibrozil 600 mg b.i.d., Lantus 30 mg subcu q.p.m., Lipitor 80 mg nightly, Nephrocaps, Neurontin 300 mg daily, PhosLo 2001 mg t.i.d., Protonix 40 mg daily, Renagel 3200 mg t.i.d., Requip 2 mg p.o. b.i.d., and Coumadin. His Lipitor was decreased to 20mg due to rhabdomylosis risk, and he was also started on low dose b-blocker to reduce perioperative MI risk prior to his surgery. His Vancomycin was continued given his history of MRSA cellulitis, with a goal of a level less than 20, and he was bridged with heparin with a goal PTT of 60-80. He was restarted on his Lantus and Aspart doses with meals, and his Coumadin was held prior to surgery and decreased to 20mg with a repeat lipid panel in 4-6 weeks. He required antibiotics which were discontinued at this time and he was discharged with dry sterile dressing changes to his residual limb daily, PTT goal 60-80, INR goal 2-3 until stable off of levofloxacin, monitoring of FS and adjustment of DM regimen, monitoring pain scale and decreasing pain medications as pain improves, hemodialysis M/W/F, and follow up with Dr. Carpino voice message left on his medical assistant's voice mail and Dr. Lynes 6/10/06 at 9:30am. Psychiatry service was consulted who recommended low dose Ativan prior to him going for dialysis. He was initially placed on a ketamine drip and given IV Levofloxacin and IV Flagyl to cover gram negatives and anaerobes respectively, and started on oxycontin 80mg tid with oxycodone for breakthrough pain and Lyrica for neuropathic pain. He was comfortable prior to discharge on this current regimen.

Has the patient ever tried vancomycin.

An 81-year-old woman with Atrial Fibrillation (AF) on Fondaparinux, no Coumadin secondary to prior epistaxis, Non-small Cell Lung Cancer (NSC Lung Ca), and Pernicious Anemia (Pernicious Anemia) presents with three days of constant chest pain, pleuritic, not exertional, and mostly related to arm movement. Treatment included ACEBUTOLOL HCL 400 MG PO DAILY Starting IN AM ( 8/10 ), ALLOPURINOL 100 MG PO DAILY, VITAMIN C (ASCORBIC ACID) 500 MG PO BID, CALCIUM CARBONATE (500 MG ELEMENTAL CA++) 500 MG PO BID, CIPROFLOXACIN 250 MG PO Q12H X 4 doses (Administer iron products a minimum of 2 hours before or after a Levofloxacin or Ciprofloxacin dose dose), DIGOXIN 0.125 MG PO DAILY, COLACE (DOCUSATE SODIUM) 100 MG PO BID, LOVENOX (ENOXAPARIN) 120 MG SC BEDTIME, TARCEVA (ERLOTINIB) 100 mg PO DAILY, FOLIC ACID 1 MG PO DAILY, FUROSEMIDE 40 MG PO DAILY Starting IN AM ( 4/9 ), DILAUDID (HYDROMORPHONE HCL) 0.5 MG PO Q4H PRN Pain (on order for DILAUDID PO, ref# 925975305, POTENTIALLY SERIOUS INTERACTION: TRAMADOL HCL & HYDROMORPHONE HCL, Reason for override: aware), LIDODERM 5% PATCH (LIDOCAINE 5% PATCH) 1 EA TP DAILY, PRAVACHOL (PRAVASTATIN) 20 MG PO BEDTIME, VITAMIN B6 (PYRIDOXINE HCL) 50 MG PO DAILY, ULTRAM (TRAMADOL) 50 MG PO Q6H PRN Pain (on order for ULTRAM PO, ref# 417339527, POTENTIALLY SERIOUS INTERACTION: MORPHINE & TRAMADOL HCL). CT-PE showed no evidence of PE or Deep Venous Thrombosis (DVT) and post Right Lower Lobe Resection changes, with interval resolution of Left Upper Lobe Nodule without new nodules, and possible chronic subsegmental PE. CXR showed no acute process. Factor Xa level was checked to insure Lovenox dosing was therapeutic. Discharge plan included mammogram next week for evaluation, continue pain control with Lidoderm patch, Ultram and low dose Dilaudid as needed for severe pain, continue Tarceva as per outpatient oncologist, continue Lovenox as outpt, continue Lasix at 40mg daily, complete course of Cipro 250mg BID x 3 days, follow up with cardiologist for continued management of heart conditions, and follow up with rehabilitation specialists to try to regain strength and function. Discharge condition was stable.

Has this patient ever been prescribed lovenox ( enoxaparin )

The patient had been taking Ativan of 3-4 mg q.d. for anxiety for the past two months and abruptly stopped taking it on March 1995 after which she started to have feelings of disorientation, and had been taking chloral hydrate 500 to 1000 mg q.h.s. for five days and Compazine with one dose. CURRENT MEDICATIONS: At home, patient took insulin NPH 25 units in the morning with Regular 10 units in the morning, aspirin 81 mg q.d., Lopressor 25 mg b.i.d., Compazine 5 mg q.6h. p.r.n. anxiety of which she took only one dose, and chloral hydrate 500 to 1000 mg q.h.s. for five days. On admission, her laboratory examination was significant for BUN of 17, creatinine of 1.0, glucose was 364, liver function tests were within normal limits, white count was 7.2, hematocrit was 36, and platelet count was 266. Neurology consultation was obtained who felt that patient's peripheral neuropathy was probably secondary to longstanding diabetes but felt that some of her symptomatology could be consistent with porphyria. Psychiatry felt that this episode was consistent with generalized anxiety disorder separated by post dysthymia and suggested phenothiazines which are proven to be safe in porphyria for treatment. She was started on Trilafon 2 to 4 mg p.o. p.r.n. q.6h. for anxiety and Keflex 500 mg p.o. t.i.d. for treatment. The patient was also seen to be orthostatic which was felt to be secondary to dehydration secondary to poor p.o. intake prior to admission and was treated with normal saline boluses and her orthostasis improved. Her Lopressor was also held with this episode of orthostasis. The Watson-Schwartz test done by Dr. Mohar on patient very early in the admission was negative which made an acute porphyria attack very unlikely. These episodes were felt to be secondary to a combination of anxiety attack and rapid taper of Ativan which she had been taking at moderately high doses for the last two months. Patient also developed urinary tract infection symptoms and her urine culture showed greater than 100,000 colonies of E. coli which were pansensitive. She was discharged to home on August in good condition on medications Aspirin 81 mg p.o. q.d., insulin NPH 25 units subcutaneously q.a.m., insulin regular 10 units subcutaneously q.a.m., Trilafon 2 mg p.o. q.6h., and Keflex 500 mg p.o. t.i.d. Follow-up will be with Dr. Dario Rodriquz.

Has the pt. ever been on chloral hydrate before

Patient Omar J. Coolbaugh, a 71-year-old female post cardiac transplant with allograft coronary artery disease, bilateral carotid disease, TIA, diabetes, and obesity, was admitted on 11/8/2007 and discharged on 4/14/2007 with s/p angioplasty and stenting. The medications on admission included Mycophenolate Mofetil 1000 mg PO BID, Oxybutynin Chloride XL 10 mg PO QD, Insulin Glargine 20 units SC QAM, Furosemide PO QD, Clopidogrel 75 mg PO QD, Pravastatin 40 mg PO QHS, Prednisone 5 mg PO QD, Cyclosporine (Sandimmune) 75 mg PO BID, Metoprolol Succinate Extended Release 50 mg PO QD, and Fenofibrate (Tricor) 48 mg PO QD. Elective cardiac catheterization was performed, revealing double vessel disease and successful PTCA/Stenting of LAD was done using XB3.5 guide, BMW, with no residual stenosis. The patient was advised to take Enteric Coated ASA 325 mg PO Daily, Plavix (Clopidogrel) 75 mg PO Daily, Cyclosporine (Sandimmune) 75 mg PO BID, Tricor (Fenofibrate (Tricor)) 48 mg PO Daily, Lasix (Furosemide) 40 mg PO Daily, Insulin Glargine 20 units SC Daily, Toprol XL (Metoprolol Succinate Extended Release) 50 mg PO Daily, CellCept (Mycophenolate Mofetil) 1,000 mg PO BID, Ditropan XL (Oxybutynin Chloride XL) 10 mg PO Daily, Pravachol (Pravastatin) 40 mg PO Bedtime, Prednisolone Sodium Phosphate 5mg/5ml 5 mg PO Daily, and vitamins, with ASA 325 and Plavix for life and other medications at usual doses, plus TNG 0.4 mg (Nitroglycerin 1/150 (0.4 mg)) 1 tab SL q5min x 3 doses PRN Chest Pain. The importance of both aspirin and taking medications consistently was stressed and the patient understands, with diet house/low chol/low sat. fat and activity light activity with no heavy lifting or driving x 2 days, ok to shower, no swimming or bathing x 5 days and lift restrictions of not lifting greater then 10-15 pounds. Follow up appointments were scheduled for Heart Failure Clinic 2-4 weeks and patient was discharged in stable condition and advised to drink plenty of fluids over the next several days, and to call with any questions or concerns.

Is there history of use of prednisone

The patient had continued to remain stable from an ischemia standpoint and a beta-blocker was added back to his regimen and was titrated to a dose of Lopressor 12.5 mg p.o. t.i.d. He continues on aspirin and statin, and he also continues on Isordil 20 mg p.o. t.i.d. and hydralazine 50 mg p.o. t.i.d. for after load reduction, as well as digoxin at 0.125 mg p.o. q.o.d. The patient was aggressively diuresed with intravenous Lasix and Zaroxolyn followed by conversion to oral diuresis with torsemide at the dose of 100 mg p.o. q.d. He was also found to have atrial clot on transesophageal echocardiogram and thus was started on a heparin drip and transitioned on Coumadin, but after a discussion with the CHF Team, the decision was made not to continue Coumadin anticoagulation and instead he was given aspirin and Plavix at full doses. The patient's medication regimen also includes Colace 100 mg p.o. b.i.d., Folate 1 mg p.o. q.d., Robitussin A-C 5 mL p.o. q.4h. p.r.n. cough, Simethicone 80 mg p.o. q.i.d. p.r.n. upset stomach, Multivitamin one tab p.o. q.d., Compazine 5-10 mg p.o. q.6h. p.r.n. nausea, Tessalon 100 mg p.o. t.i.d. p.r.n. cough, Lipitor 80 mg p.o. q.d., Plavix 75 mg p.o. q.d., Lantus 5 units subcu q.p.m., NovoLog 3 units subcu a.c. and NovoLog sliding scale. The patient is on ACE inhibitor and was restarted on a low-dose beta-blocker at 12.5 mg p.o. t.i.d. as well as his insulin regimen can be adjusted as an outpatient and possibly oral diabetes medications restarted. He is to be discharged to the Com Medical Center for further rehabilitation, with follow-up appointments with Dr. Kyle Yandle in the T Las on 2/28/05 at 08:30 a.m., Dr. Clyde Chatampaya of Elmert Hospital Cardiology 9/26/05 and Raymond Banaag of TRISTONTERN MEDICAL CENTER PCP on 10/3/05 at 01:50 p.m. His sister, Alexis Fernendez, is his health care proxy and is providing substantial social support.

Why does the patient take compazine

Mr. Legions is a 54 year old professor who presented to Menjack Hospital Medical Center with recurrent substernal chest pain one day after coronary artery bypass graft (5 vessel bypass) 8 years ago. His coronary risk factors include a positive family history and a previous diagnosis of hyperlipidemia. He was given Lovastatin 40 mg q q.m. and 20 mg q p.m., as well as enteric-coated aspirin one tablet q day. At Skaggssin Hospital, he was given IV nitroglycerin, IV heparin, Nifedipine SL, and morphine, in addition to aspirin and Lovastatin. The patient's pain was relieved with four sublingual nitroglycerin and an EKG demonstrated one sublingual nitroglycerin and these EKG changes resolved. He was treated symptomatically with Tylenol and started on Biaxin 500 mg po bid, and also received a five day course of oral Biaxin with Cholestyramine one packet po q hs, Lopressor 50 mg po tid, and Sublingual nitroglycerin 1/150 tablets to be taken prn. The patient had episodes of fever, achieving a maximum temperature of 101.4, and a chest x-ray on 0/26/95 demonstrated evidence of early congestive heart failure. The patient was treated with daily doses of IV Lasix with resolution of his rales. He was admitted to the Cardiac Intensive Care Unit on IV heparin and nitroglycerine as well as continuation of his aspirin and Lovastatin. His pain was treated with morphine sulfate and relieved with four sublingual nitroglycerin. An EKG demonstrated one sublingual nitroglycerin and these EKG changes resolved. After 24 hours pain-free, the patient was transferred to the Cardiac Step-Down floor and the IV nitroglycerin and IV heparin were discontinued. An echocardiogram demonstrated inferior and posterior hypokinesis with an ejection fraction of approximately 46%, and the patient underwent a submax MIBI to assess coronary perfusion of the heart. The exercise component of this examination demonstrated EKG changes consistent with ischemic coronary flow. Nuclear imaging demonstrated a fixed apical lateral defect in the patient's heart consistent with a healed or healing transmural infarct. The patient also complained of progressive anterior and lateral thigh pain, symptoms consistent with an upper respiratory viral infection, and rales 4 to 5 cm above the bases bilaterally. He was discharged to home with followup in MERH under Drs. Dwayne Ariel Bremme with the medications Enteric-coated aspirin 325 mg po q day, Cholestyramine one packet po q hs, Lovastatin 20 mg po q hs, Lopressor 50 mg po tid, and Sublingual nitroglycerin 1/150 tablets to be taken prn with chest pain.

Has patient ever been prescribed morphine

A 83-year-old male patient with a history of CAD, IMI, CABG (2000), HTN, and BPH presented with sore throat, cough, and weakness, and was admitted to a medical service with a diagnosis of viral syndrome. He had an EKG showing A-paced at 69, IMI, normal axis, and no acute ischemic changes, a MIBI showing an EF of 45% and multiple pulmonary nodules, a CXR was negative, and a CT Chest showed several pulmonary nodules in RUL inferiorly, the largest being 0.6cm, and other tiny nodules in the upper lobes bilaterally, 2-3mm, and several small nodes in the mediastinum with no LAD. CTAB, RRR were normal. He was given TYLENOL (Acetaminophen) 650 mg PO Q4H PRN Headache, CEPACOL 1-2 Lozenge PO Q4H PRN Other:sore throat, Vitamin B12 (Cyanocobalamin) 1,000 mcg IM QD x 3 doses, Dipyridamole 25 mg PO QPM, Lasix (Furosemide) 10 mg PO QD, Isordil (Isosorbide Dinitrate) 30 mg PO TID, Ativan (Lorazepam) 3.5 mg PO QHS PRN Insomnia, Inderal (Propranolol HCl) 10 mg PO QID, Norvasc (Amlodipine) 2.5 mg PO QD, Nitroglycerin 0.2% Topical TP BID Instructions: 1 inch, Zetia (Ezetimibe) 10 mg PO QD, Azithromycin 500 mg pack 500 mg PO QD x 4 doses, and Calcium Phosphate, Oral, Reason for override: aware. He had no significant fever or WBC and his symptoms improved on admission with no cough. He was observed O/N with IVF and improved in the morning and will be D/C'd on Azithromycin x 5 days. For the pulmonary nodules, he will follow-up with Dr. Muether as an outpatient for w/u. For Heme, he was given anemia, iron studies, B12, and folate sent and got B12 1000ug IM x 1 and was instructed to follow-up with the doctor's office to get injections for 2 more days, then monthly, likely due to a gastrectomy. He was given instructions to continue TYLENOL (Acetaminophen) 650 mg PO Q4H PRN Headache, CEPACOL 1-2 Lozenge PO Q4H PRN Other:sore throat, Ativan (Lorazepam) 3.5 mg PO QHS PRN Insomnia, Azithromycin 500 mg pack 500 mg PO QD x 4 days, B12 1000ug QD for 2 more days, then qmonth, and to call his doctor if he continues to feel unwell or returns to the hospital, and to go to the doctor's office on Thursday and Friday to receive the B12 injections. He was discharged in a stable condition.

Why was cepacol originally prescribed

A 57 year old woman with multiple cardiac risk factors presented with substernal chest pain relieved by two sublingual nitroglycerins, nausea, and an acid taste. She was ruled out for myocardial infarction by enzyme sets respectively, with no change in EKGs. Her physical examination was afebrile with a blood pressure of 132/96, pulse 95, on one liter of oxygen, saturation of 97%, and respiratory rate of 20. She was treated with aspirin, beta blockers, and nitroglycerin and was started on Axid for possibility of gastroesophageal reflux disease, as well as provided with Maalox and told to keep the head of the bed elevated. She was continued on Glucotrol for diabetes mellitus and was instructed on risk factor modifications, including diabetes mellitus control, controlling cholesterol and hypertension. Upon discharge she was prescribed Atenolol 100 mg p.o. q.d., Ecasa 325 mg q.d., Glucotrol 20 mg b.i.d., Hydrochlorothiazide 12.5 mg q.d., Trazadone 50 mg q.h.s., aspirin 1 q.d., Lopressor 75 mg q.d., nitroglycerin sublingual p.r.n., Ambien 5 mg q.h.s., and was instructed on the possibility of gastroesophageal reflux disease, as well as to follow-up with Dr. Jonker as an outpatient for further workup and management of gastroesophageal reflux disease, as well as following her for her cardiac disease via the risk factor modification.

What is the dosage of oxygen

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 ever been on novolog

This 46-year-old male with a history of Insulin dependent diabetes, currently managed with 32 units of NPH Humulin, presented with pain with motion of the subtalar joint or the mid foot. He had a long history of ankle pain on the right side due to two fractures, one as a child and one due to a fall from a ladder, and was controlling his pain with Darvocet as well as intramuscular Tordal 15 to 30 mg four times a day. He was admitted as a same day surgery candidate and underwent tibiotalar fusion with cross-cannulated AO screws and local bone graft, with a tourniquet time of 1 hour and 57 minutes and received 2500 cc of crystalloid intraoperatively. His current medications include NPH Insulin 32 units every morning, Procardia XL 90 mg q.a.m., Lotensin 40 mg p.o. q.d., Lasix 40 mg p.o. q.d., potassium supplement, Ketorolac 15-30 mg intramuscularly q.i.d., and Darvocet N-100 one to four tablets q.d., with no known drug allergies. He was also prescribed Vicodan one to two p.o. q.3-4h. p.r.n., Naprosyn 500 mg p.o. b.i.d. as a substitute for the Tordal, and Halcion 0.125 to 0.25 mg p.o. q.h.s. p.r.n. Post-operatively, his motor and sensory examinations were intact and he was discharged on post-operative day three with the medications prescribed. He will follow-up with Dr. Norman Dutko in approximately three weeks at which time the cast will be changed and stitches removed.

Has patient ever been prescribed halcion

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.

provera

A 59 year-old woman with metastatic breast cancer and a history of pulmonary embolism presented with symptoms of fatigue, lethargy, tachycardia and fever. CXR showed LLL opacity, LUL opacity and hilar fullness on the right with prominent bronchi (?cuffing) and vertebral fractures. She was admitted with bacteremia on 7/0/2006 and treated with whole brain radiotherapy in March 2006 and with weekly Taxol. Restaging studies showed stable visceral disease but progression of bony metastatic disease, so in January 2006, she initiated a second-line Navelbine therapy. At the ER, she was administered 1UPRBC, 1L NS, Levofloxacin 500 mg IV, and placed CVP~20. Her blood pressure systolic initially 120s but decreased to 90s (MAPS>70), and norepinephrine was administered. She was given TYLENOL (ACETAMINOPHEN) 650 MG PO Q6H PRN Pain, Temperature greater than:101, Other:transfusion premedication, ALBUTEROL NEBULIZER 2.5 MG INH Q4H PRN Wheezing, TESSALON PERLES (BENZONATATE) 100 MG PO TID PRN Other:congestion, BENADRYL (DIPHENHYDRAMINE) 12.5 MG PO x1 PRN Other:pre-transfusion, COLACE (DOCUSATE SODIUM) 100 MG PO BID PRN Constipation, ENOXAPARIN 40 MG SC DAILY, NEXIUM (ESOMEPRAZOLE) 40 MG PO DAILY, FLOVENT HFA (FLUTICASONE PROPIONATE) 110 MCG INH BID, INSULIN ASPART Sliding Scale.

What medications has patient been on for bs is 201-250 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.

insulin

This 70-year-old woman with a complex medical history, including cerebrovascular accident x two in 1980s without deficits, seizure history probably secondary to ETOH withdrawal, hypertension x 30 years, asthma, gout, and status post repair of subclavian artery stenosis in 1993, presented to the Dagha Medical Center with severe chest pain. A chest CT revealed a 2.3 x 2.8 cm lobulated mass in the right lower lobe involving the pleura, with extensive hilar and mediastinal constitutions consistent with prior granulomatous disease, and tests were positive for multiple precarinal and right peritracheal areas of adenopathy recent from metastatic disease. The patient was admitted to the Thoracic Surgery Service on 3/27/99 and taken to the Operating Room for a video assisted thorascopic right lower lobe lobectomy by Dr. Minick. Postoperatively, the patient did well, with no complications, and was followed by the Internal Medicine Service. The patient went into rapid atrial fibrillation postoperatively, and was successfully converted into a normal sinus rhythm using Diltiazem IV, which was converted to p.o. Diltiazem. The patient's postoperative course was largely unremarkable but for dysrhythmia, and the patient's pain was well controlled with p.o. pain medications, Percocet. Final pathology was read as squamous cell carcinoma, 4.0 cm., moderately differentiated with focal characterization with extensive necrosis. The patient was discharged to home with medications including Adalat 200 mg p.o. b.i.d., Zantac 150 mg p.o. b.i.d., Magnesium Oxide 40 mg t.i.d., Ultram 300 mg q.d., Trazodone 100 mg q.h.s., Azmacort 80 mg p.r.n., aspirin 81 mg q.d., Dyazide 25 mg q.d., nose spray b.i.d., calcium chloride pills q.d., Colchicine 600 mg q.d., cyproheptadine hydrochloride 4 mg b.i.d. q.h.s., anticholesterol med., Albuterol nebulizers 250 mg q.4h., Allopurinol 300 mg q.d., Colchicine 0.6 mg q.d., cyproheptadine hydrochloride by mouth 400 mg q.d., Digoxin 0.125 mg q.d., Diltiazem 30 mg t.i.d., Colace 100 mg t.i.d., Lasix 40 mg p.o. q.d., Percocet 1-2 tablets p.o. q.4h. p.r.n., Dilantin 200 mg p.o. b.i.d., and Trazodone 100 mg p.o. q.h.s., with follow-up with Thoracic Surgery Service as well as with primary care physician and Cardiology as needed.

What patient's pain medications have ever been prescribed for pt. in the VA or mentioned in the record

This is a 63-year-old female who presented with bilateral lower extremity edema, increasing shortness of breath, 3+ edema in the extremities, areas of erythematous and shiny shallow ulcerations, significant laboratory data of sodium 147, potassium 3.4, chloride 110, CO2 26, BUN 23, creatinine 1.6, and glucose 69, CBC significant for white count of 6.7, hematocrit 39.4, and platelets of 258, CK 432, troponin less than assay, BNP greater than assay, and D-dimer 50 and 69, chest x-ray showed decreased lung volumes with moderate cardiac enlargement, EKG showed sinus bradycardia with a rate of 59, axis of -36 and no acute changes. The patient has a history of congestive heart failure, deep venous thrombosis bilaterally with PE, acute renal failure, nephrotic syndrome, pneumonia, iron and folate deficiency anemia, paroxysmal atrial fibrillation with rapid ventricular response, nonsustained ventricular tachycardia, insulin-dependent diabetes mellitus, hypertension, cholesterol, chronic knee and back pain, arthroscopic knee surgery bilaterally, gastritis, benign colon polyps greater than 10, cataracts, and glaucoma. She was prescribed Lasix 120 mg p.o. b.i.d., Atenolol 50 mg p.o. q.d., Iron sulfate 300 b.i.d., Folate 1 mg q.d., NPH insulin 20 units q.d., Oxycodone 5 mg to 10 mg q.4-6h. p.r.n. pain., Senna, Multivitamins, Zocor 40 mg p.o. q.d., Norvasc 10 mg p.o. q.d., Accupril 80 mg p.o. q.d., Miconazole 2% topical b.i.d., Celexa 20 mg p.o. q.d., Avandia 8 mg p.o. q.d., Nexium 20 mg p.o. q.d., Albuterol p.r.n., aspirin as well as statin, a low-dose short-acting beta-blocker (Lopressor), an ACE inhibitor with this switched to captopril as a short-acting ACE inhibitor for a goal blood pressure of systolic of 120, an adenosine MIBI, runs of NSVT and Coumadin 5 mg p.o. q.h.s., folate and iron replacement, NPH 20 units for her known diabetes, Bactrim one tablet p.o. b.i.d. for 7 days, Celebrex and other antiinflammatory medications, Colace 100 mg p.o. b.i.d., Prozac 20 mg p.o. q.d., NPH human insulin 20 units subcu q.p.m., Zestril 30 mg p.o. q.d., Senna tablets 2 mg p.o. b.i.d., Aldactone 25 mg p.o. q.d., Multivitamins with minerals one tablet p.o. q.d., Toprol XL p.o. q.d., Imdur 30 mg p.o. q.d., Prednisolone acetate 0.125% one drop OU q.i.d., Albuterol inhaler 2 puffs inhaler q.i.d. p.r.n. wheezing., Miconazole nitrate powder topical b.i.d. p.r.n., Aspirin 81 mg p.o. q.d., and her creatinine continued to rise until 8/3/03, when it reached 2.7, diuresis was put on hold on 3/15/03 and 10/5/03, and her ACE inhibitor dose was halved on 10/5/03, in order to monitor her creatinine function, she was found to have a UTI with E. Coli that was sensitive to Bactrim and she was treated with Bactrim with resolution, for her chronic pain and arthritis, her Celebrex was held given her increased creatinine and she was given oxycodone p.r.n. for pain, joint exam revealed swollen PIP joints of both hands as well as marked swelling over both wrists, and an ANA test came back negative, she was continued on Celexa for depression, a goal INR of 2 to 3 was set for her Coumadin, which was restarted on 4/12/03 for known paroxys

has there been a prior prednisolone acetate 0.125%

A 66-year-old gentleman with a medical history significant for coronary artery disease and two prior MIs presented with substernal chest pain while walking that lasted 2-3 hours and was relieved by rest and sublingual nitroglycerin. He was admitted and cardiac catheterization revealed 90% proximal LAD stenosis, 90% mid LAD and 100% distal LAD stenosis, 100% mid LVB1, 80% mid circumflex, 70% proximal D1, 70% proximal PDA, and a right dominant circulation, with diffuse coronary calcification and extensive diffuse disease with small distal vessels. LAD in stent restenosis and collateral flow diffusely small left main. On 4/15/05, the patient underwent CABG x4 with SVG1 to RCA, and sequential graft of SVG2 to D1 and then OM1, with LIMA to LAD and an LAD endarterectomy. On arrival to the hospital, he was given 150 mg of Plavix, heparin 500 units for 48 hours, and aspirin that same night. He was also started on Enteric-coated aspirin 325 mg p.o. daily, atenolol 75 mg p.o. daily, Colace 100 mg p.o. t.i.d., oxycodone 5 mg to 10 mg p.o. q.6h. p.r.n. pain, Plavix 75 mg p.o. daily, Lantus 38 units subcutaneously at bedtime, NovoLog 18 units subcutaneous q.a.m., and Lasix with good effect. He required the transfusion of a unit of packed red blood cells and neosynephrine transiently, which was weaned off on postoperative day #2. He was also noted to have a preoperative urinary tract infection of E. coli for which he was started on levofloxacin on 0/5/05 and treated for five days. The patient was followed by the Diabetes Management Service for blood sugar control and was transitioned from IV insulin to subcutaneous insulin postoperatively. He was discharged to home in good condition on postoperative day #7 on the following medications and is to have a follow-up appointment with his cardiologist, Dr. Abusufait, in one to two weeks, and with his cardiac surgeon, Dr. Cederberg, in four to six weeks.

Has this patient ever been prescribed plavix

A 66-year-old gentleman with a medical history significant for coronary artery disease and two prior MIs presented with substernal chest pain while walking that lasted 2-3 hours and was relieved by rest and sublingual nitroglycerin. He was admitted and cardiac catheterization revealed 90% proximal LAD stenosis, 90% mid LAD and 100% distal LAD stenosis, 100% mid LVB1, 80% mid circumflex, 70% proximal D1, 70% proximal PDA, and a right dominant circulation, with diffuse coronary calcification and extensive diffuse disease with small distal vessels. LAD in stent restenosis and collateral flow diffusely small left main. On 4/15/05, the patient underwent CABG x4 with SVG1 to RCA, and sequential graft of SVG2 to D1 and then OM1, with LIMA to LAD and an LAD endarterectomy. On arrival to the hospital, he was given 150 mg of Plavix, heparin 500 units for 48 hours, and aspirin that same night. He was also started on Enteric-coated aspirin 325 mg p.o. daily, atenolol 75 mg p.o. daily, Colace 100 mg p.o. t.i.d., oxycodone 5 mg to 10 mg p.o. q.6h. p.r.n. pain, Plavix 75 mg p.o. daily, Lantus 38 units subcutaneously at bedtime, NovoLog 18 units subcutaneous q.a.m., and Lasix with good effect. He required the transfusion of a unit of packed red blood cells and neosynephrine transiently, which was weaned off on postoperative day #2. He was also noted to have a preoperative urinary tract infection of E. coli for which he was started on levofloxacin on 0/5/05 and treated for five days. The patient was followed by the Diabetes Management Service for blood sugar control and was transitioned from IV insulin to subcutaneous insulin postoperatively. He was discharged to home in good condition on postoperative day #7 on the following medications and is to have a follow-up appointment with his cardiologist, Dr. Abusufait, in one to two weeks, and with his cardiac surgeon, Dr. Cederberg, in four to six weeks.

Has the patient had plavix in the past

The patient, Emile Daron 493-31-10-1, was admitted on 3/17/2003 for pancreatitis with a Discharge Date of 2/1/2003 and was placed on a Full Code status and discharged to Home. She had a definite allergy (or sensitivity) to muscle relaxants, skeletal, and possible allergy (or sensitivity) to sulfa. The patient is a 64-year-old with known CAD, atherosclerotic peripheral vascular disease, and type 2 diabetes who presented with 8/10 stabbing back pain 4 days ago without a clear precipitant, which was non-raditating and partially relieved with analgesics. She denied any bowel or bladder incontinence or saddle anesthes ia, fevers, chills, nausea, vomiting, or diarrhea, however she did complain of urinary frequency (on lasix) in the last few days with out any dysuria or urgency. The patient also has increasing shortness of breath over the past month and abdominal distension over the last month, as well as intermittent left sided chest pain that radiates to her left arm. In the ED the patient was ruled out for an aortic dissection, MI, and had a negative D-Dimer, however lipase levels were elevated with normal LFTs. The patient had poor glucose control and her LDL was 151 and her triglycerides were very high, which could be a cause of her pancreatitis. The patient was placed on a House/Adv. as tol. / ADA 1800 cals/day / Very low fat (20gms/day) diet and was encouraged to resume regular exercise. Discharge medications included ACETYLSALICYLIC ACID 81 MG PO QD, AMITRIPTYLINE HCL 30 MG PO QHS, PREMARIN (CONJUGATED ESTROGENS) 0.625 MG PO QD, FLEXERIL (CYCLOBENZAPRINE HCL) 10 MG PO TID PRN Pain, COLACE (DOCUSATE SODIUM) 100 MG PO BID, FLUOXETINE (FLUOXETINE HCL) 40 MG PO QD, GEMFIBROZIL 600 MG PO BID with SERIOUS INTERACTION: SIMVASTATIN & GEMFIBROZIL, NPH HUMULIN INSULIN (INSULIN NPH HUMAN) 10 UNITS SC QAM and NPH HUMULIN INSULIN (INSULIN NPH HUMAN) 50 UNITS SC QHS, LORAZEPAM 1 MG PO QD, AMLODIPINE 10 MG PO QD Food/Drug Interaction Instruction, TOPROL XL (METOPROLOL (SUST. REL.)) 100 MG PO QD, IRBESARTAN 300 MG PO QD, LASIX (FUROSEMIDE) 40 MG PO QD, and LIPITOR (ATORVASTATIN) 80 MG PO QD with SERIOUS INTERACTION: GEMFIBROZIL & ATORVASTATIN CALCIUM, and was instructed to take consistently with meals or on empty stomach and to avoid grapefruit unless MD instructs otherwise. Follow up appointments included Dr. Bouy, vascular surgery, U Daylis Ont, 12:50 pm, Dr. Blaine Wehrley, 11:30 AM 5/14/03, MRI/A of abdomen, SHS Re Na, New Hampshire 59460, 11:20 AM, and Dr. Colleen on 10/2. We changed ATENOLOL to TOPROL XL 100 MG PO QD and AMLODIPINE 10 MG PO QD with Food/Drug Interaction Instruction. Endocrine- Has had poor glucose control. HbA1c 13. We continued NPH HUMULIN INSULIN 10 UNITS SC QAM and started AM NPH as well. Number of Doses Required (approximate): 5. Please take insulin in the morning as well as the night, and ask Dr. Colleen to help with your insulin regimen.

Was the patient ever prescribed lasix ( furosemide )

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

Is there a mention of of dilaudid ( hydromorphone hcl ) usage/prescription in the record

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.

Has this patient ever tried linsinopril

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.

Was the patient ever given medication for graves'

Arron Umbaugh was admitted on 4/30/2001 and discharged on 7/10/2001 with a code status of full code and disposition of home w/ services. The discharge medications included ASA (Acetylsalicylic Acid) 325 mg PO QD, Atenolol 25 mg PO QD Starting Today (1/24) HOLD IF, Colace (Docusate Sodium) 100 mg PO BID, Lasix (Furosemide) 60 mg PO QD Starting Today (1/24) Instructions: Take 60mg per day for 3 days and then change, Zestril (Lisinopril) 7.5 mg PO QD, on order for KCL IMMEDIATE REL. PO (ref # 85723815) POTENTIALLY SERIOUS INTERACTION: LISINOPRIL & POTASSIUM CHLORIDE Reason for override: will follow, on order for KCL SLOW REL. PO (ref # 68279429), COUMADIN (Warfarin Sodium) 6 mg PO QD, on order for ZOCOR PO (ref # 88249805) POTENTIALLY SERIOUS INTERACTION: WARFARIN & SIMVASTATIN, ZOCOR (Simvastatin) 20 mg PO QHS, on order for ERYTHROMYCIN TP (ref # 53201344) POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & ERYTHROMYCIN, TOPICAL OR OPHTHALMIC, Metformin 1,000 mg PO BID Starting Today (1/24), Prilosec (Omeprazole) 20 mg PO QD, with instructions to take consistently with meals or on empty stomach, and a warning for a potentially serious interaction: Furosemide & Omeprazole, Valacyclovir 1,000 mg PO Q8H X 7 Days, with Tylenol. Please page Dr. Blouir about your eye pain and come to the ED, lasix qd and see Dr. boeshore on wed. as well as daily weights, and to call Dr. Pradel if they can't control their pain due to zoster on your back. The patient was admitted with CHF exacerbation, increased SOB over past few days, orthopnea and PND, with left sided failure and diastolic dysfunction, and IV lasix 40 in ED, which decreased SOB. The patient was also prescribed Metformin 1000 mg PO BID, Prilosec (Omeprazole) 20 mg PO QD, and Valacyclovir 1000 mg PO Q8H X 7 Days with instructions to take consistently with meals or on empty stomach, and a warning for a potentially serious interaction: Furosemide & Omeprazole. Override Notices were added for COUMADIN PO (ref # 29560859), KCL IMMEDIATE REL. PO (ref # 85723815), KCL SLOW REL. PO (ref # 68279429), and ZOCOR PO (ref # 88249805) due to potentially serious interactions: Aspirin & Warfarin, Lisinopril & Potassium Chloride, Warfarin & Simvastatin, respectively. The patient was also instructed to take lasix qd and see Dr. boeshore on wed. as well as daily weights, and to call Dr. Pradel if they can't control their pain due to zoster on their back. The patient was discharged with discharge medications including ASA (Acetylsalicylic Acid) 325 mg PO QD, Atenolol 25 mg PO QD Starting Today (1/24) HOLD IF, Colace (Docusate Sodium) 100 mg PO BID, Lasix (Furosemide) 60 mg PO QD Starting Today (1/24) Instructions: Take 60mg per day for 3 days and then change, Zestril (Lisinopril) 7.5 mg PO QD, COUMADIN (Warfarin Sodium) 6 mg PO QD with instructions to avoid high Vitamin-K containing foods, and ZOCOR (Simvastatin) 20 mg PO QHS with instructions to avoid grapefruit unless MD instructs otherwise.

has the patient used furosemide in the past

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.

What medications, if any, has the patient tried for pain in the past

The patient is a 37-year-old gentleman with known coronary artery disease who underwent coronary artery bypass grafting times three with bilateral internal mammary arteries and a saphenous vein graft. The patient was found to have extremely pronounced atherosclerosis of his coronary arteries and had an entirely smooth postoperative course. He was maintained on low molecular weight Dextran for 48 hours for his endarterectomy and was started on enteric coated aspirin on the first day of his operation. The patient diuresed very well and was started on beta blockers. On discharge, the patient's medications included Tenormin, 75 mg po q day; enteric coated aspirin, one po q day; Carafate, 1 gram po q.i.d.; iron sulfate, 325 mg po q day; Percocet and Colace.

Has a patient had iron sulfate

This 90+-year-old male with a complex past medical history including CAD, CHF, AF and diabetes mellitus presented to the SICU for removal of chronically MRSA-infected mesh from prior abdominal surgery. He was intubated with etomidate, succinylcholine and kept sedated with Versed and fentanyl. He received intraoperative vancomycin and levofloxacin as well as 2200 mL of lactated Ringer's. In an attempt to reverse anticoagulation, one unit of FFP was begun but then aborted due to hypotension, which resolved with epinephrine injection, likely due to transfusion reaction. Another unit of FFP was administered, with platelets also given at the request of the Plastic Surgery Team in light of aspirin and Plavix, which were continued due to the patient's cardiac stents. Despite bolus Lasix, the patient did develop CHF with symptomatic pulmonary edema and increased oxygen requirement, concomitantly becoming delirious. He developed hypertension refractory to beta-blockade, calcium channel blockers and IV ACE inhibitors, and was thus placed on a nitroglycerin drip, a furosemide drip with ginger blood product resuscitation to address bleeding and an elevated INR, responding well to this regimen and aggressive pulmonary toilet. The patient was advanced to clear liquids, on medications including Amiodarone 200 mg p.o. daily, Calcium, Colace 100 mg by mouth t.i.d., Coumadin alternating doses of 4 mg and 3 mg, Diltiazem CD 360 mg p.o. daily, Aspirin 81 mg p.o. daily, Folate 1 mg p.o. daily, Lisinopril 10 mg p.o. daily, Metamucil p.r.n., Clopidogrel 75 mg p.o. daily, Potassium, Protonix 40 mg p.o. daily, Simvastatin 80 mg p.o. daily, Synthroid 25 mcg p.o. daily, Thiamine 100 mg p.o. daily, Metoprolol SR 100 mg p.o. b.i.d., Zyprexa 2.5 mg at bedtime p.r.n., and Vancomycin for MRSA-infected mesh. He does experience more significant delirium with morphine and less so with sparing Dilaudid p.r.n., and Haldol is written p.r.n. as needed. Weaning off nitroglycerin drip, nitro paste added, hematocrit 25%, one unit of packed red blood cells with Lasix and potassium to be given, RISS, and PICC line consult ordered for anticipated long-term vancomycin. Services following the patient include Medicine, Dr. Harcar, patient's PCP, Cardiology, Dr. Pagliari, and Plastic Surgery, Dr. Dunshie. Patient anticipated to be transferred to the floor on 9/28/06.

Has the patient ever had dilaudid

Patient KOMLOS, COLEMAN 223-66-98-9 was admitted on 10/26/2000 and discharged on 9/4 AT 04:00 PM to Home w/ services with a code status of Full code. A 78F with HTN, PAFon amiodarone, MS s/p MVR on coumadin, and ?CAD/IMI with clean coronaries on cath '91, presented with two episodes of ?syncope. The patient had 2.1 CXR showing mild CHF and is on an extensive cardiac regimen including TYLENOL (ACETAMINOPHEN) 650-1,000 MG PO Q4H PRN pain, AMIODARONE 200 MG PO QD, COLACE (DOCUSATE SODIUM) 100 MG PO BID, LASIX (FUROSEMIDE) 80 MG PO BID, MICRONASE (GLYBURIDE) 10 MG PO BID, PLAQUENIL (HYDROXYCHLOROQUINE) 200 MG PO BID, ISORDIL (ISOSORBIDE DINITRATE) 40 MG PO TID, LISINOPRIL 20 MG PO BID, KCL IMMEDIATE REL. PO SCALE QD, LOPRESSOR (METOPROLOL TARTRATE) 25 MG PO BID, NITROGLYCERIN 1/150 (0.4 MG) 1 TAB SL q5min x 3 PRN chest pain HOLD IF: SBP <100, COUMADIN (WARFARIN SODIUM) EVEN days: 5 MG qTTHSat; ODD days: 2.5 MG qMWF PO QD, NORVASC (AMLODIPINE) 10 MG PO QD HOLD IF: sbp <100, LOVENOX (ENOXAPARIN) 70 MG SC Q12H X 4 Days. Override Notices were added on 0/28 by KNIGHTSTEP, HAYDEN S. on order for COUMADIN PO (ref # 03417627) for POTENTIALLY SERIOUS INTERACTION: AMIODARONE HCL & WARFARIN, POTENTIALLY SERIOUS INTERACTION: LISINOPRIL & POTASSIUM CHLORIDE Reason for override: tolerates. Cardiology consulted, and recommended an event monitor to assess for specific rhythms while she is symptomatic. Follow up plan: Event monitor to be ordered. Patient to follow up with Dr. Bergerson and Dr. Gamma in 1-2 weeks. Visiting nurse to do home safety eval, and monitor INR/administer Lovenox if needed, and check BP/HR/symptoms. For visiting nurse: Please draw blood qd for 5 days to check INR. If it is less than 2 please give the Lovenox injections for the day. If it remains in 2-3 range, just continue the regular Coumadin dosing. Please check BP and heart rate and call primary doctor Dr. Mickles if it is excessively low or high and patient is complaining of symptoms. Please ensure she is wearing her event monitor.

Previous warfarin

This 66-year-old male with a complicated medical history of DM2, CHB with pacer and evidence of clot on pacer wire, and non-compliance with medications and diet was admitted to the ED with symptoms of abdominal pain and SOB with FS of 500-600. On admission, his VS were 99.5, 101/62, 70s, SaO2 96% on room air. His exam was GEN: elderly ill appearing male in NAD; HEENT: Anicteric sclera, PERRL, dry mucous membranes, poor dentition; NECK: Supple, no adenopathy, JVP flat; CHEST: CTA bilaterally; CV: RRR with diffuse PMI, Nl S1, S2 S3 present; ABD: Reducible ventral hernia, NT, ND, bowel sounds present; EXT: No edema or wounds; SKIN: No rashes; EKG: paced; CXR: clear with NAD; ABD CT: small ventral hernia, gallstones, ectasia of the infrarenal aorta, RLL inflammatory changes suggestive of PNA; VQ: Low probability; LABS: Creatinine of 2.2 that dropped to 1.5 with hydration (BL 1.2-1.3). HCT 41.6 with drop after aggressive hydration. Lipase of 132 but has chronic pancreatitis and is now normalizing. UA and ACE negative. The patient received 5 liters of IVF and 36U of insulin in the ED, his blood pressure stabilized with volume, and was transferred to the medical floor. He was started on ECASA (ASPIRIN ENTERIC COATED) 325 MG PO QD, FOLATE (FOLIC ACID) 1 MG PO QD Starting Today (9/24), LISINOPRIL 30 MG PO QD, THIAMINE HCL 100 MG PO QD, MVI THERAPEUTIC (THERAPEUTIC MULTIVITAMINS) 1 TAB PO QD, LEVOFLOXACIN 500 MG PO QD Starting Today (9/24), LANTUS (INSULIN GLARGINE) 20 UNITS SC QD, LASIX (FUROSEMIDE) 40 MG PO QD, LIPITOR (ATORVASTATIN) 20 MG PO QD, COUMADIN (WARFARIN SODIUM) 5 MG PO QPM, and CREON 20 (PANCRELIPASE 20000U) 4 CAPSULE PO TID, with Override Notices added on 4/24/04 by Blain, Guillermo P., M.D. on order for COUMADIN PO (ref #11219725) (POTENTIALLY SERIOUS INTERACTION: ASPIRIN & WARFARIN) and by Degrange, Diego A., M.D. on order for SIMVASTATIN PO (ref #59315078) (POTENTIALLY SERIOUS INTERACTION: NIACIN, VIT. B-3 & ATORVASTATIN CALCIUM Reason for override: will monitor). He was given teaching regarding nutrition, diabetes, and Coumadin, and instructed to take all medications as directed, and to measure his weight daily. He was also instructed to take a shot with 20 units of insulin every night and to take iron products a minimum of 2 hours before or after a Levofloxacin or Ciprofloxacin dose dose. ADDITIONAL COMMENTS: 1.) Please take your insulin shot (20 units of Lantus) every night at bedtime, 2.) follow an ADA diet, and 3.) take all your medications. He was discharged on ECASA (ASPIRIN ENTERIC COATED) 325 MG PO QD, FOLATE (FOLIC ACID) 1 MG PO QD Starting Today (9/24), LISINOPRIL 30 MG PO QD, THIAMINE HCL 100 MG PO QD, MVI THERAPEUTIC (THERAPEUTIC MULTIVITAMINS) 1 TAB PO QD, CREON 20 (PANCRELIPASE 20000U) 4 Capsule PO TID, LEVOFLOXACIN 500 MG PO QD, LANTUS (INSULIN GLARGINE) 20 UNITS SC QD, LASIX (FUROSEMIDE) 40 MG PO QD, LIPITOR (ATORVASTATIN) 20 MG PO QD, and COUMADIN (WARFARIN SODIUM) 5 MG PO Q

has there been a prior other medications

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 the patient had hydralazine/isordil

The patient is a 55-year-old man with a history of smoking and a left sided hemisphere stroke, who underwent a right-sided femoral to popliteal bypass graft in February of 1986 for severe claudication. He was readmitted in March of 1988 for increase in pain in the calves and again in February of 1988 for graft stenosis and underwent angioplasty. He presented in July of 1989 with progressive pain and three months of rest pain in the right calf and claudication of the left calf. He also has a history of chest pain, esophageal reflux, anxiety disorder, chronic low back pain, peptic ulcer disease, herniated nucleus pulposus, and cholecystectomy. On admission, medications included Pepcid, 40 mg at h.s.; trazodone, 15 mg at h.s.; Carafate, one q.i.d.; nitroglycerin p.r.n. and Flexeril, 10 mg q eight hours p.r.n. back pain. Allergies include QUESTION OF PENICILLIN AND QUESTION OF DYE. He was taken to the Operating Room in March of 1990 for a right reverse saphenous bypass graft from the in situ vein graft to below the knee popliteal artery, and discharged with excellent palpable pulses.

What medications has this patient tried for back pain

This 64-year-old male with a history of coronary artery disease, CHF, EF of 15%, status post AVR, and NSTEMI initially presented to outside hospital with chief complaint of shortness of breath and was found to have a BNP of 747 as well as a troponin I of 0.43. He was diuresed, started on Carvedilol and improved, and placed on a heparin drip. His medications on admission included Aspirin 81, Lisinopril 20, Plavix 75, Verapamil 240 sustained release, Gemfibrozil 600 b.i.d., Nystatin 500 b.i.d., Paxil 20 daily, Glipizide 10 daily, Coumadin 4 prior to admission to outside hospital, Carvedilol 6.25 daily, heparin drip and Spironolactone. During his hospital stay, he was continued on Aspirin, Plavix, beta-blocker and ACE inhibitor, which were titrated to effect, started on a statin and continued on Niaspan, and maintained on a nicotine patch. He was also prescribed Spironolactone 25 mg p.o. daily, Atorvastatin 80 mg daily, Niaspan 0.5 gm p.o. twice daily, and Coumadin 5 mg p.o. at night. The patient's diabetes was controlled with regular insulin and placed back on his oral hypoglycemics, which were discontinued on admission and was encouraged to stop smoking. He had runs of ectopy and SVT, so was placed on a heparin drip. Left heart cath revealed wall defect consistent with a right coronary artery infarct and the patient was continued on Spironolactone. He was discharged in a stable condition on Aspirin 325 p.o. daily, Lisinopril 4 mg p.o. daily, Nicotine patch 14 mg per day topical, Spironolactone 25 mg p.o. daily, Paxil 25 mg p.o. daily, Atorvastatin 80 mg daily, Niaspan 0.5 gm p.o. twice daily, Carvedilol 12.5 mg p.o. twice daily, Plavix 75 mg daily, Gemfibrozil 900 mg p.o. twice daily and Coumadin 5 mg p.o. at night, with instructions to follow up with PCP and Cardiology as well as EP, to check his daily weights and report any increases to his PCP, and to arrange to have his INR drawn on 6/21/06 and follow-up INRs to be drawn every seven days.

What is the patient's current dose does the patient take of her paxil

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 used nitroglycerine in the past

The patient, a 77 year old woman, was admitted with complaint of urinary frequency and AMS. She has a possible allergy to Penicillins with a reaction of RASH and cannot tolerate floroquinolones. She was prescribed ACETYLSALICYLIC ACID 81 MG PO QD, LISINOPRIL 10 MG PO QD Starting Today ( 6/25 ), KCL SLOW RELEASE PO ( ref # 761602437 ), TOPROL XL ( METOPROLOL SUCCINATE EXTENDED RELEASE ) 100 MG PO BID HOLD IF: hr&lt;55 , sbp&lt;95, LANTUS ( INSULIN GLARGINE ) 19 UNITS QAM SC QAM Starting Today ( 6/17 ), WARFARIN SODIUM 5 MG PO QPM Starting ROUTINE , 20:00 ( Standard Admin Time ), ROSIGLITAZONE 2 MG PO QD, FUROSEMIDE 20 MG PO BID Starting Today ( 6/25 ) PRN Other:LE edema, SIMVASTATIN 10 MG PO QHS, CEFPODOXIME PROXETIL 200 MG PO BID X 16 doses Starting Today ( 6/25 ) HOLD IF: rash, and DIGOXIN 0.125 MG PO QOD with Food/Drug Interaction Instruction to Give with meals. Her AFIB became tachy to 140's with an elevated troponin to 1.69 which rose to a max of 2.41 with no EKG changes and was rate controlled and started on Levofloxacin. She was given 2 doses of vancomycin to cover potential staph infection and had an adenosine MIBI that showed no perfusion defects. Her INR was increasing due to the levofloxacin effect and was switched to ceftriaxone consistant with blood culture succeptabilities. Follow up blood cultures on 0/27 demostrated gram positive cocci in clusters and antibiotics were d/c'd after repeat cultures were negative. Her cardiac workup included an echocardiogram with RV dialation and wall akinesis with apical sparing , a new finding since last echo in '03. We have altered cardiac medications for better rate control by cancelling the coreg( carvedelol ) and Norvasc( amilodipine ) and replacing them with a blood pressure medication, Toprol XL( Metoprolol XL ) to better control the rate of her atrial fibrillation and the digoxin was also added for heart rate control. The patient was discharged in good condition and was given instructions to take the full course of antibiotics which cover the next 8days, to take medications with meals or on empty stomach and to avoid high Vitamin-K containing foods, to call PCP with any changes in urinary symptoms, or fever >101.0, return to ER if any changes in mental status, chest pain, SOB, or syncope, and follow-up with PCP within the next week with INR and digoxin levels. Do not use lasix unless necessary and contact PCP if using more than 1-2 times per week due to possible toxicity with digoxin use.

Did the patient receive cardiac medications for better rate control

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

What is has been given for treatment of her headache

75 yo Spanish speaking F was admitted for pre-syncope and discharged on 9/15/04 with full code status to home with medications including TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Headache, ALBUTEROL INHALER 2 PUFF INH QID Starting Today (2/9), ECASA (ASPIRIN ENTERIC COATED) 81 MG PO QD, ATENOLOL 25 MG PO BID, LEVOXYL (LEVOTHYROXINE SODIUM) 75 MCG PO QD, ZOCOR (SIMVASTATIN) 40 MG PO QHS with food/drug interaction instruction to avoid grapefruit unless MD instructs otherwise and IMDUR (ISOSORBIDE MONONIT.(SR)) 30 MG PO QD with food/drug interaction instruction to give on an empty stomach (give 1hr before or 2hr after food) and ZANTAC (RANITIDINE HCL) 150 MG PO BID and CELEBREX (CELECOXIB) 200 MG PO QD with food/drug interaction instruction to take with food with diet of house/low chol/low sat. fat and activity of walking as tolerated. An EKG showed sinus brady and a TSH test was mildly elevated at 5.3. Labs showed an elevated LDL, cardiac enzymes negative, UA negative, Hct 40 at baseline, and an aMIBI 3/24 showed a small reversible defect of mild intensity in the distal ant wall and apex c/w small area ischemia in the distal LAD. The patient was given TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN Headache, ALBUTEROL INHALER 2 PUFF INH QID Starting Today (2/9), ECASA (ASPIRIN ENTERIC COATED) 81 MG PO QD, ATENOLOL 25 MG PO BID, LEVOXYL (LEVOTHYROXINE SODIUM) 75 MCG PO QD, ZOCOR (SIMVASTATIN) 40 MG PO QHS on order for ZOCOR PO (ref # 63128567), IMDUR (ISOSORBIDE MONONIT.(SR)) 30 MG PO QD, ZANTAC (RANITIDINE HCL) 150 MG PO BID, CELEBREX (CELECOXIB) 200 MG PO QD, NSAIDS, and LOVENOX for DVT ppx. The patient was advised of the benefits of ASA for her and was started on 81mg qd and may benefit from EGD as well as increasing Imdur if persistent hypertension. It is important to call Dr. Mcquade for a follow up appointment within the next 1-2 weeks and to take all medications on the discharge list at the doses specified. The patient presents with pre-syncope, hypothyroidism, asthma, left hip pain, headache and polyarthralgias. The patient was monitored on tele and the atenolol could be a contributing factor to the bradycardia and was switched to bid frequency with 1/2 dose (25mg). GI symptoms include dyspepsia and was started on PPI and checked for H.pylori. Endocrine symptoms included a mildly subtherapeutic levoxyl which was increased to 75mcg qd. Pulmonary symptoms included asthma which was continued on albuterol inhaler PRN and DVT ppx with Lovenox. MSK symptoms included trochanteric bursitis which was treated with Tylenol.

ecasa ( aspirin enteric coated )

A 45-year-old man with a history of familial cardiomyopathy and status post cardiac transplant in 2002, and chronic renal insufficiency presented with greater than two weeks of polyuria, polydipsia, blurry vision, muscle cramps, and myalgias and reported approximately a 15-pound weight loss over three weeks with decrease in usual lower extremity edema. On admission, notable for a blood glucose of 1064, creatinine 2.2 from a baseline of 1.8, sodium 130, potassium 4.9. Endocrine service was consulted and the patient was controlled with a combination regimen of Lantus, Novolog q. a.c., combined with a Novolog sliding scale. The patient was discharged with followup with Napoleon Mettee, the diabetic teaching nurse and with Dr. Jonson in the diabetes clinic and with VNA services to assist with home medications. The patient had mild acute gout flare during admission for which he was started on colchicine. The patient was discharged with medications including Calcium carbonate 1250 mg t.i.d., Cartia XT 300 mg daily, CellCept 1500 mg b.i.d., colchicine 0.6 mg daily p.r.n., Neoral 150 mg b.i.d., folate 1 mg daily, K-dur 20 mg daily, magnesium oxide 400 mg b.i.d., methotrexate 2.5 mg daily, Pravastatin 20 mg daily, prednisone 7 mg daily, Rocaltrol 0.25 mg daily, Synthroid 150 mcg daily, Torsemide 40 mg daily, Vitamin C, Vitamin E, and cyclosporin 150 mg b.i.d., Vitamin C 500 mg b.i.d., Rocaltrol 0.25 mcg daily, calcium carbonate 500 mg t.i.d., colchicine 0.3 mg p.o. b.i.d., cyclosporin 150 mg b.i.d., folic acid 1 mg daily, Synthroid 150 mcg daily, magnesium oxide 420 mg b.i.d., prednisone 7.5 mg q.a.m., Vitamin E 400 units daily, Pravachol 20 mg at night, Cartia XT that is diltiazem extended release 300 mg daily, CellCept 1500 mg b.i.d., Lantus insulin (Glargine) 40 units subcutaneous q.a.m., Novolog 12 units before breakfast, Novolog 12 units before lunch, Novolog 14 units before dinner, and Novolog sliding scale q. a.c. The patient demonstrated proper understanding of blood glucose testing and insulin administration prior to discharge.

Has the patient had multiple calcium carbonate prescriptions

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

Why is the patient on lopressor

The patient is a 76-year-old female with a history of mitral regurgitation, congestive heart failure, recurrent UTIs, and uterine prolapse who presented with chills and hypotension and was admitted to the Medical ICU for treatment of septic shock. Mean arterial pressures were kept above 65 with Levophed and antibiotics were changed to penicillin 3 million units IV q.4h. and gentamicin 50 mg IV q.8h. An ATEE on 10/19 showed severe mitral regurgitation with posterior leaflet calcifications and linear density concerning for endocarditis, for which a PICC line was placed on 1/19 for a six-week course of penicillin 3 million units IV q.4h. and two-week course of gentamicin 50 mg IV q.8h. until 2/25. The patient was initially treated with Levophed for her hypotension until 11/0, and was placed on Levofloxacin and Vancomycin to treat Gram-positive cocci bacteremia and UTI. She was maintained on telemetry and was found to be a normal sinus rhythm with ectopy, including short once of nonsustained ventricular tachycardia. She was started on Lopressor 12.5 mg t.i.d. on 3/18, and this was increased to 25 mg b.i.d. at discharge, with her heart rates continuing to be between the 70s and the 90s, however, with less episodes of ectopy. Aspirin was given, and Lipitor was initially held for an initial transaminitis presumed to be secondary to shock liver. She had guaiac positive stools in the medical ICU, her hematocrit was stable around 33%, and her iron studies suggested anemia of chronic disease with possibly overlying iron deficiency. She had a normal random cortisol level of 35.3, and her Hemoglobin A1c was 6.5, so she was maintained thereafter only on insulin sliding scale and rarely required any coverage. The patient was kept on Lovenox and Protonix and her DISCHARGE MEDICATIONS include Aspirin 81 mg daily, iron sulfate 325 mg daily, gentamicin sulfate 50 mg IV q.8h. until 2/25 for a two-week course, penicillin G potassium 3 million units IV q.4h. until 0/12 for a six-week course, Lopressor 25 mg b.i.d., Caltrate plus D2 tablets p.o. daily, Lipitor 10 mg daily, and Protonix 40 mg daily. She was discharged to rehabilitation at Acanmingpeerra Virg Tantblu Medical Center in order to be able to get her antibiotic therapy, and her physicians will attempt to add the ACE back onto her medical regimen for better afterload reduction as her blood pressure tolerates, and potentially they will add her back on to the Lasix as well. She will require weekly lab draws to check her electrolytes and CBC while she is on the antibiotics.

How often does the patient take aspirin

Ms. Fought is a 50-year-old female with a history of bipolar disorder, schizophrenia, obstructive sleep apnea, hypertension, and diabetes who presented with right knee swelling, redness, and pain and was admitted to the Emergency Department. She was given therapeutic doses of heparin because of the concern of pain, as well as IV fluids, Oxycodone 5 mg to 10 mg p.o. q.4h. p.r.n. pain, Tylenol 650 mg p.o. q.4h. p.r.n. pain, Ibuprofen 600 mg q.6h. p.r.n. pain, Klonopin 1 mg p.o. at bedtime, Levofloxacin 500 mg p.o. daily for six days after the day of discharge, and NSAIDs, and was prescribed Lisinopril 10 mg daily, Lipitor 40 mg daily, Klonopin, MetroGel p.o. at bedtime, Lithium 900 mg at bedtime, Acebutolol 200 mg daily, and Risperdal 0.5 mg at bedtime, with no known drug allergies. She responded well to normal saline fluid boluses for a total of 3 liters over her hospital course, and was treated with Unasyn and vancomycin, and then switched to levofloxacin, with six more days after discharge from the hospital. Her bradycardia was resolved either over beta blockade or lithium toxicity, for which her beta-blocker was held and her lithium was also held, resulting in an improved heart rate in the 50s and 60s. Upon discharge, she was given instructions to draw blood for lithium level checks daily until it is below 0.5, at which time, she should be restarted on lithium 300 mg p.o. at bedtime, and to follow up with her primary care physician, Dr. Aurelio Gilberto Hencheck at Li County Hospital.

Has a patient had vancomycin

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 pt. ever been on simethicone before

A 69-year-old female with a history of coronary disease status post prior myocardial infarction and surgery in 2002 presented to R.healt Medical Center Emergency Department on 10/9/05 with three days of chest pain and shortness of breath. Of note, she had been noncompliant with prior regimens and treatments and despite diuretics started three days by her primary care physician she reported new shortness of breath and chest pain at rest. An EKG in the emergency department revealed widespread ST depressions, prompting treatment for pulmonary edema with IV nitroglycerin, Lasix, aspirin, heparin, beta-blockers, and urgent transfer to the cath lab where coronary angiography revealed a left main coronary artery thrombosis with proximal and distal stenoses of about 70%, 50% of her LAD, and 60% of her first diagonal. After placement of an intraaortic balloon pump for further management and evaluation, the patient was transferred to the coronary care unit and her home medications included Aspirin, hydralazine, nitroglycerin, quinine, Norvasc, Lasix, Toprol, lisinopril, albuterol, and famotidine. Despite treatment, her condition continued to deteriorate, necessitating an exploratory laparotomy and emergent intubation, and ultimately, the family decided to withdraw care on 11/12/05 at 2:20 a.m., leading to her death at 2:24 a.m. the same day.

has there been a prior quinine

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 had keflex ( cephalexin ) in the past

This 46-year-old male with a history of Insulin dependent diabetes, currently managed with 32 units of NPH Humulin, presented with pain with motion of the subtalar joint or the mid foot. He had a long history of ankle pain on the right side due to two fractures, one as a child and one due to a fall from a ladder, and was controlling his pain with Darvocet as well as intramuscular Tordal 15 to 30 mg four times a day. He was admitted as a same day surgery candidate and underwent tibiotalar fusion with cross-cannulated AO screws and local bone graft, with a tourniquet time of 1 hour and 57 minutes and received 2500 cc of crystalloid intraoperatively. His current medications include NPH Insulin 32 units every morning, Procardia XL 90 mg q.a.m., Lotensin 40 mg p.o. q.d., Lasix 40 mg p.o. q.d., potassium supplement, Ketorolac 15-30 mg intramuscularly q.i.d., and Darvocet N-100 one to four tablets q.d., with no known drug allergies. He was also prescribed Vicodan one to two p.o. q.3-4h. p.r.n., Naprosyn 500 mg p.o. b.i.d. as a substitute for the Tordal, and Halcion 0.125 to 0.25 mg p.o. q.h.s. p.r.n. Post-operatively, his motor and sensory examinations were intact and he was discharged on post-operative day three with the medications prescribed. He will follow-up with Dr. Norman Dutko in approximately three weeks at which time the cast will be changed and stitches removed.

Has the patient had vicodan in the past

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.

Has patient ever been prescribed insulin

Patient SAMU, CURTIS 759-74-53-9 is a 61-year-old female with multiple medical problems including dilated CMP, s/p chemo and XRT for Breast CA, CAD, s/p MI, COPD, and occasional O2 use. On admission, her VS are T97.8, HR73, BP113/71, RR18, and O2Sat 92%. She presents with dry cough associated with SOB x 2 days and increased DOE after 1/2 block, orthopnea and PND, chronic abd pain, increased Alk Phos, increased bloating, and wheezing without increased O2 need at night. She was prescribed ACETYLSALICYLIC ACID 81 MG PO QD, on order for COUMADIN PO (ref #29937145) with POTENTIALLY SERIOUS INTERACTION: ASPIRIN & WARFARIN, DIGOXIN 0.125 MG PO QD, on order for LEVOTHYROXINE SODIUM PO (ref #13700176) with POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & WARFARIN, COLACE (DOCUSATE SODIUM) 100 MG PO BID, FERROUS SULFATE 325 MG PO BID, MOTRIN (IBUPROFEN) 600 MG PO Q8H Starting Today (10/7) with PRN Pain Food/Drug Interaction Instruction Take with food, REGLAN (METOCLOPRAMIDE HCL) 5 MG PO AC, SIMETHICONE 80 MG PO QID, VITAMIN B1 (THIAMINE HCL) 100 MG PO QD, TRAZODONE 50 MG PO HS, COUMADIN (WARFARIN SODIUM) 5 MG PO QPM, POTENTIALLY SERIOUS INTERACTION: LEVOFLOXACIN & WARFARIN, MVI THERAPEUTIC (THERAPEUTIC MULTIVITAMINS) 1 TAB PO QD, POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & NIACIN, VIT. B-3 Reason for override: aware, TOPROL XL (METOPROLOL SUCCINATE EXTENDED RELEASE) 75 MG PO QD, GABAPENTIN 200 MG PO QD, TORSEMIDE 100 MG PO BID, COZAAR (LOSARTAN) 50 MG PO QD, LEVOCARNITINE 1 GM PO QD Starting Today (8/21), CITALOPRAM 20 MG PO QD, ADVAIR DISKUS 250/50 (FLUTICASONE PROPIONATE/...) 1 PUFF INH BID, NEXIUM (ESOMEPRAZOLE) 20 MG PO QD, LANTUS (INSULIN GLARGINE) 60 UNITS SC QHS, NOVOLOG (INSULIN ASPART), LIPITOR (ATORVASTATIN) 10 MG PO QPM, ATORVASTATIN CALCIUM, COMBIVENT (IPRATROPIUM AND ALBUTEROL SULFATE) 2 PUFF INH QID, and Sliding Scale (subcutaneously) SC AC with Food/Drug Interaction Instructions to Avoid milk and antacid, Take with food, Take consistently with meals or on empty stomach, and If BS is less than 125, then give 0 units subcutaneously. The patient was placed on order for COUMADIN PO (ref #29937145) and Adriamycin induced CMP HTN IDDM Sarcoid for DVT on 0/29 (goal 2-3). She was placed on po levofloxacin for 7 days and symptoms resolved. Her weight was 227lbs 7/6/05 (dry weight ~200), and she was on torsemide 100mg bid at baseline, with po lasix increased to 200bid x 2 doses, and zaroxyln 5mg po BID x 6 doses added. Tests included ALK Phos: 627, ALT: 71, AST: 65, Card Enzymes: neg, WBC: 6.4, UA: 1.011, 1+prot, 5-10WBC, 2+bact, CXR: LLL opacity, seen best on lateral view, EKG: prolonged PR, q in AVL, flat Ts laterally, unchanged from 9/5, RUQ US: sludge, gall bladder wall thickened 8mm, neg sonographic Murphy's sign, 2/4 Echo

Has the patient ever had toprol xl ( metoprolol succinate extended release )

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 there been a prior captopril

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 lovenox ( enoxaparin )

Ms. Hesby is a 36-year-old woman with very poorly controlled type 1 diabetes, end-stage renal disease, right eye blindness, lower extremity neuropathy, gastroparesis, and a history of extensive infections. She presented to Path Community Hospital with a right thigh burn and infection, and was given a prescription for antibiotics, 20 units of IV insulin, 500 mL normal saline boluses, and several 250 mL boluses, as well as 2 amps of calcium gluconate, Kayexalate, albuterol nebs, and Augmentin and IV vancomycin for her right thigh cellulitis. For long-term management, she was prescribed Lantus 24 units subcu each night, NovoLog sliding scale, PhosLo, Nephrocaps, Vitamin D, Sevelamer 1600 t.i.d., Toprol 100 mg p.o. daily, Lisinopril 5 mg p.o. daily, Plavix 75 mg p.o. daily, Keppra 500 mg p.o. b.i.d., Flovent two puffs b.i.d., Albuterol p.r.n., Baclofen 5 mg p.o. t.i.d., and Ambien 10 mg p.o. at bedtime p.r.n. The patient was admitted with a diagnosis of Diabetic Ketoacidosis (DKA) and was stabilized in the MICU on an insulin waves. She was then transitioned to NPH and finally to Lantus 24 units subcu and her hypertension is being managed on her home dose of Lopressor 25 q.i.d. and switched to Captopril, which is being titrated. Her area of cellulitis has completely resolved, and if she becomes acidotic, the patient can be managed with sodium bicarbonate and D5W in small boluses. The patient is taking her Nephrocaps and sevelamer and is receiving prophylaxis with heparin 5000 units subcu t.i.d., however she has consistently refused her heparin. Of note, on the night of 1/26/06, the patient complained of severe cramping, right lower quadrant pain, which is new. She noted this pain has increased rapidly in the setting of diarrhea. Several C. diff studies, which were sent recently have been negative and the patient has had no blood in her diarrhea. Presumed cause is Augmentin, which has been stopped. The patient has continued to eat freely and is passing diarrhea despite her complaints of 10/10 severe abdominal pain. A CT scan of her abdomen was ordered, but she refused to take oral or IV contrast. The results of this CT scan are pending and will be followed up by the new medical team.

has there been a prior toprol

A 42-year-old male was admitted on 4/30 with congestive heart failure exacerbation, hyperhomocysteinemia, chronic renal failure, obesity, hypercholesterolemia, h/o DVT, asthma, OSA, and a worsening of his dyspnea of exertion (DOE) to 3 miles of flat ground with a suspicion of multifocal pneumonia (PNA). He had a D-dimer of 1400, BNP of 2009, and Troponin of 0.84-0.54, which was not considered ischemic, and was not treated. On this admission, his D-dimer was 1207, BNP was 2917, and Troponin was not sent. He had a JVP to earlobe, bibasilar rales, no wheezes, and diffuse pitting edema to his bilateral shins. He had a chest X-ray (CXR) showing increased bilat LL opacities to the periphery with some cephalization of vessels and some opacification. An electrocardiogram (ECG) showed 98 bpm with left anterior fascicular block (LAE) and strain. A chest CT scan from 8/18 (comparing to 4/30) showed per pulm c/w scarring/persistent changes after recent multifocal PNA 4/30, no e/o of new primary lung path, and ground glass c/w pulmonary edema. An echocardiogram showed an ejection fraction (EF) of 25%, moderate right ventricular (RV) dysfunction, and severe tricuspid regurgitation (TR). A follow-up cardiac MRI from 10/16 showed an EF of 23%, global hypokinesis, no wall motion abnormality (WMA), normal RV, and no valve disease. In the ED, he received Duonebs, ASA 325, and Lasix 80mg. His shortness of breath was secondary to CHF exacerbation and fluid overload with no evidence of an infectious pulmonary process contributing to his symptoms. His hypertension was most likely due to taking the wrong dose of Coreg (taking QOD instead of BID). On a BID Coreg regimen, his BP was much better controlled. His renal function remained stable but impaired while he was being evaluated for dialysis as an outpatient but no vascular access was placed yet. He was discharged on 6/7/05 with a full code status and disposition to home with food/drug interaction instruction to take consistently with meals or on empty stomach and activity to walk as tolerated with follow up appointments with Dr. Sackrider at ACH 5/6/05 at 1:30 PM scheduled, Dr. Dauphin at CMC 0/4/05 at 1:40 PM scheduled. He was discharged with ACETYLSALICYLIC ACID 81 MG PO QD, on order for COUMADIN PO (ref #55946845) to address a POTENTIALLY SERIOUS INTERACTION: ASPIRIN & WARFARIN, PHOSLO (CALCIUM ACETATE) 667 MG PO TID, FOLATE (FOLIC ACID) 1 MG PO QD, DIOVAN (VALSARTAN) 160 MG PO QD prescribed by his cardiologist, CARVEDILOL 6.25 MG PO BID HOLD IF: HR < 60, or SBP < 100, NEPHROCAPS (NEPHRO-VIT RX) 1 TAB PO QD, with an alert overridden: Override added on 4/7/05 by ALAMIN, NORMAN B., M.D. POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & NIACIN, VIT. B-3 Reason for override: MD Aware, LIPITOR (ATORVASTATIN) 20 MG PO QD with an alert overridden: Override added on 6/7/05 by: POTENTIALLY SERIOUS INTERACTION: NIACIN, VIT. B-3 & ATORVASTATIN CALCIUM Reason for override: home med, and LASIX (FUROSEMIDE) 80 MG PO BID, with a d/c JVP 10cm. He had not been taking his Lasix for 2d prior to d/c. Pt was instructed to diurese further at home on Lasix 80 BID and continue on Coumadin for his h/o recent DVT (4/30) and INR 2-3.

Has this patient ever tried simvastatin

This is a 46-year-old morbidly obese female with a history of insulin-dependent diabetes mellitus complicated by BKA on two prior occasions, who was admitted to the MICU with BKA, urosepsis, and a non-Q-wave MI. On presentation to the Emergency Department, her vital signs were notable for a blood pressure of 189/92, pulse rate of 120, respiratory rate of 20, and an O2 sat of 90%. She was given insulin, sublingual nitroglycerin x three, 4 mg of morphine, 5 mg of Lopressor, and started on a heparin drip and IV antibiotics, and admitted to the MICU for further management. Her past medical history included insulin-dependent diabetes mellitus for how many years, positive ethanol use, approximately one drink per week, and denied IV drug use or other illicit drug use. She was placed on an insulin drip and hydrated with intravenous fluids, with improvement, and eventually transitioned to NPH with insulin sliding scale coverage. Despite escalating her dose of NPH up to 65 U subcu b.i.d. on the day of discharge, she continued to have elevated blood sugars >200 and required coverage with insulin sliding scale. This issue will need to be addressed as an outpatient. She was also placed on cefotaxime for gram negative coverage, with both her blood cultures and urine cultures growing out E. coli which were sensitive to cefotaxime and gentamycin. As she initially continued to be febrile and continued to have positive blood cultures, one dose of gentamycin was given for synergy, and she was eventually transitioned to p.o. levofloxacin and will take 7 days of p.o. levofloxacin to complete a total 14-day course of antibiotics for urosepsis. She was initially placed on aspirin, heparin, and a beta blocker, and once her creatinine normalized, an ACE inhibitor was also added. Heparin was discontinued once the concern for PE was alleviated, and her beta blocker and ACE inhibitor were titrated up for a goal systolic blood pressure of <140 and a pulse of <70. On admission, the patient was on several pain medicines, including amitriptyline, Flexeril, and Valium for reported history of sciatica and low back pain, which were discontinued and she was placed on Neurontin for likely diabetic neuropathy. She was also placed on GI prophylaxis with Carafate and treated symptomatically with Imodium p.r.n. diarrhea. The patient was discharged with enteric coated aspirin 325 mg p.o. q.d., NPH Humulin insulin 65 U subcu b.i.d., human insulin sliding scale: for blood sugars 151-200 give 4 U, for blood sugars 201-250 give 6 U, for blood sugars 251-300 give 8 U, for blood sugars 301-350 give 10 U, Imodium 2 mg p.o. q. 6 hrs. p.r.n. diarrhea, Niferex 150 mg p.o. b.i.d., nitroglycerin 1/150 one tab sublingual q. 5 min. x 3 p.r.n. chest pain, multivitamin one tab p.o. q.d., simvastatin 10 mg p.o. q.h.s., Neurontin 600 mg p.o. t.i.d., levofloxacin 500 mg p.o. q.d. x 5 days, Toprol XL 400 mg p.o. q.d., lisinopril 40 mg p.o. q.d. The patient was evaluated by the physical therapist, who noted her to walk around the hospital without significant difficulty.

Has the patient ever taken human insulin for their blood sugars 301-350

The patient is a 33 year-old woman with diet controlled diabetes mellitus and morbid obesity who presents to the emergency department with periumbilical pain radiating to the right lower quadrant. After an abdominal CT revealing a 5x5 cm cecal thickening with extraluminal air, her white blood count was 19,000 and her urine HCG was negative. She was taken to the operating room by Dr. Jenovese and had a right colectomy due to gangrenous portions of the right colon. During her postoperative course she developed supraventricular tachycardia to a rate of 200 with hypotension, requiring beta blockade and adenosine. An echocardiogram was obtained which was normal and she was ruled out for myocardial infarction. She was kept on Zantac, ampicillin, levofloxacin, and Flagyl, and was weaned off her oxygen and her central line was discontinued. She was discharged to home on November, 2000 with Lopressor 50 mg p.o. t.i.d., Percocet 1-2 tabs p.o. q 3-4 hours p.r.n. pain, Colace 100 mg b.i.d. while on Percocet, and after completing a 5-day course of ampicillin, levofloxacin, and Flagyl. She is tolerating a regular diet, ambulating dependently, and requiring minimal amounts of oral analgesics. She received wet to dry dressing changes b.i.d. to her wounds.

has the patient had adenosine.

A 83-year-old male patient with a history of CAD, IMI, CABG (2000), HTN, and BPH presented with sore throat, cough, and weakness, and was admitted to a medical service with a diagnosis of viral syndrome. He had an EKG showing A-paced at 69, IMI, normal axis, and no acute ischemic changes, a MIBI showing an EF of 45% and multiple pulmonary nodules, a CXR was negative, and a CT Chest showed several pulmonary nodules in RUL inferiorly, the largest being 0.6cm, and other tiny nodules in the upper lobes bilaterally, 2-3mm, and several small nodes in the mediastinum with no LAD. CTAB, RRR were normal. He was given TYLENOL (Acetaminophen) 650 mg PO Q4H PRN Headache, CEPACOL 1-2 Lozenge PO Q4H PRN Other:sore throat, Vitamin B12 (Cyanocobalamin) 1,000 mcg IM QD x 3 doses, Dipyridamole 25 mg PO QPM, Lasix (Furosemide) 10 mg PO QD, Isordil (Isosorbide Dinitrate) 30 mg PO TID, Ativan (Lorazepam) 3.5 mg PO QHS PRN Insomnia, Inderal (Propranolol HCl) 10 mg PO QID, Norvasc (Amlodipine) 2.5 mg PO QD, Nitroglycerin 0.2% Topical TP BID Instructions: 1 inch, Zetia (Ezetimibe) 10 mg PO QD, Azithromycin 500 mg pack 500 mg PO QD x 4 doses, and Calcium Phosphate, Oral, Reason for override: aware. He had no significant fever or WBC and his symptoms improved on admission with no cough. He was observed O/N with IVF and improved in the morning and will be D/C'd on Azithromycin x 5 days. For the pulmonary nodules, he will follow-up with Dr. Muether as an outpatient for w/u. For Heme, he was given anemia, iron studies, B12, and folate sent and got B12 1000ug IM x 1 and was instructed to follow-up with the doctor's office to get injections for 2 more days, then monthly, likely due to a gastrectomy. He was given instructions to continue TYLENOL (Acetaminophen) 650 mg PO Q4H PRN Headache, CEPACOL 1-2 Lozenge PO Q4H PRN Other:sore throat, Ativan (Lorazepam) 3.5 mg PO QHS PRN Insomnia, Azithromycin 500 mg pack 500 mg PO QD x 4 days, B12 1000ug QD for 2 more days, then qmonth, and to call his doctor if he continues to feel unwell or returns to the hospital, and to go to the doctor's office on Thursday and Friday to receive the B12 injections. He was discharged in a stable condition.

Is there history of use of norvasc ( amlodipine )

This is a 66-year-old man with diabetes, hypertension, obesity and non-Hodgkin's lymphoma of the right hip on chemotherapy (R-CHOP) which began on 4/10/06 and will continue for 18 weeks, reporting no complications from ischemic chemotherapy. The patient presented to the emergency room with syncope and was hypotensive on arrival, receiving IV normal saline as volume resuscitation. The second set of cardiac enzymes was positive with a troponin of 2, and an echocardiogram the morning following admission showed a dilated right ventricle consistent with right ventricular strain. A PE protocol CT scan showed a large saddle embolus, and the patient was treated initially with IV heparin, transitioned to Coumadin and then the decision was made to try Lovenox therapy for long-term anticoagulation. Cardiac enzymes normalized and repeat echocardiogram showed mild improvement in right heart function. On admission, the patient's medications were Atenolol 50 daily, lisinopril 5 daily, Protonix 40 daily, metformin 1500 daily, Lantus 60 daily, Humalog 20 before meals, Byetta 5 mcg twice daily, levothyroxine (dose unknown), OxyContin 40 every eight hours, Percocet two tabs every 3 hours as needed for pain and gabapentin (dose unknown).

Has a patient had normal saline

Patient Damion Prehn, a 60 year old male with coronary artery disease, hypertension, and hyperlipidemia, was admitted with increasing shortness of breath and intermediate MIBI as an outpatient in the setting of significant deconditioning and multiple cardiac risk factors. In the ED, his temperature was 98.6, his pulse was 70, his blood pressure was 141/69, and his saturation was 94% on room air. He was given ASA and Keflex for LE cellulitis, and his cardiac markers were negative. A cath revealed Subtotal RCA occlusion, 80% OM, and 50% mid LAD, and Cypher stents were placed in mid RCA to os and wedge elevated. EF 45% on stress echo and monitoring revealed 2 episodes of NSVT post-PCI. He was started on Atenolol 125 mg PO daily, Lipitor (Atorvastatin) 80 mg PO daily, Keflex (Cephalexin) 500 mg PO QID, Plavix (Clopidogrel) 75 mg PO daily, Enteric Coated ASA 325 mg PO daily, Lasix (Furosemide) 80 mg PO BID, Potassium Chloride Slow Rel. (KCL Slow Release) 10 MEQ PO daily, LISINOPRIL 5 MG PO DAILY, MICONAZOLE NITRATE 2% CREAM TP BID, MICONAZOLE NITRATE 2% POWDER TOPICAL TP BID, NIASPAN (NICOTINIC ACID SUSTAINED RELEASE) 0.5 GM PO QPM with instructions to take aspirin 30 minutes before-hand to prevent facial flushing. Alerts were overridden due to SERIOUS INTERACTION: MICONAZOLE NITRATE & ATORVASTATIN CALCIUM, POTENTIALLY SERIOUS INTERACTION: NIACIN, VIT. B-3 & ATORVASTATIN CALCIUM, POTENTIALLY SERIOUS INTERACTION: LISINOPRIL & POTASSIUM CHLORIDE, POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & MICONAZOLE NITRATE, POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & NIACIN, VIT. B-3 and POTENTIALLY SERIOUS INTERACTION: POTASSIUM CHLORIDE & LISINOPRIL. He was discharged on 9/23/06 with code status full code and disposition home, a diet of house/low chol/low sat. fat, and instructions to measure weight daily and resume regular exercise. Follow up appointments were scheduled with Dr. Weakland, Primary Care 1-2 weeks and Dr. Trouser, Cardiology 571-491-1951 Please call in 1-2 days if you do not hear from the office. You must be seen in 2-4 weeks. Allergy is to Shellfish. ASA/Plavix were continued at current doses x 1 year, increased lasix from 40 mg PO daily to 80 mg PO BID, increased b-blocker, continued norvasc, and stopped isordil. Low dose potassium 10mEq was started as increased lasix, and lisinopril 5mg PO daily was started to prevent facial flushing. Patient was instructed to take aspirin 30 minutes before hand to prevent serious interaction between miconazole nitrate and atorvastatin calcium/simvastatin, and potassium chloride immediate rel. PO was ordered. Instructions were given to continue toe cream, check lytes in 2 days, and come to the ER if any concerning symptoms such as trouble breathing, chest pain, or leg swelling. Do NOT discontinue these medications without speaking to your doctor.

aspirin

Patient Damion Prehn, a 60 year old male with coronary artery disease, hypertension, and hyperlipidemia, was admitted with increasing shortness of breath and intermediate MIBI as an outpatient in the setting of significant deconditioning and multiple cardiac risk factors. In the ED, his temperature was 98.6, his pulse was 70, his blood pressure was 141/69, and his saturation was 94% on room air. He was given ASA and Keflex for LE cellulitis, and his cardiac markers were negative. A cath revealed Subtotal RCA occlusion, 80% OM, and 50% mid LAD, and Cypher stents were placed in mid RCA to os and wedge elevated. EF 45% on stress echo and monitoring revealed 2 episodes of NSVT post-PCI. He was started on Atenolol 125 mg PO daily, Lipitor (Atorvastatin) 80 mg PO daily, Keflex (Cephalexin) 500 mg PO QID, Plavix (Clopidogrel) 75 mg PO daily, Enteric Coated ASA 325 mg PO daily, Lasix (Furosemide) 80 mg PO BID, Potassium Chloride Slow Rel. (KCL Slow Release) 10 MEQ PO daily, LISINOPRIL 5 MG PO DAILY, MICONAZOLE NITRATE 2% CREAM TP BID, MICONAZOLE NITRATE 2% POWDER TOPICAL TP BID, NIASPAN (NICOTINIC ACID SUSTAINED RELEASE) 0.5 GM PO QPM with instructions to take aspirin 30 minutes before-hand to prevent facial flushing. Alerts were overridden due to SERIOUS INTERACTION: MICONAZOLE NITRATE & ATORVASTATIN CALCIUM, POTENTIALLY SERIOUS INTERACTION: NIACIN, VIT. B-3 & ATORVASTATIN CALCIUM, POTENTIALLY SERIOUS INTERACTION: LISINOPRIL & POTASSIUM CHLORIDE, POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & MICONAZOLE NITRATE, POTENTIALLY SERIOUS INTERACTION: SIMVASTATIN & NIACIN, VIT. B-3 and POTENTIALLY SERIOUS INTERACTION: POTASSIUM CHLORIDE & LISINOPRIL. He was discharged on 9/23/06 with code status full code and disposition home, a diet of house/low chol/low sat. fat, and instructions to measure weight daily and resume regular exercise. Follow up appointments were scheduled with Dr. Weakland, Primary Care 1-2 weeks and Dr. Trouser, Cardiology 571-491-1951 Please call in 1-2 days if you do not hear from the office. You must be seen in 2-4 weeks. Allergy is to Shellfish. ASA/Plavix were continued at current doses x 1 year, increased lasix from 40 mg PO daily to 80 mg PO BID, increased b-blocker, continued norvasc, and stopped isordil. Low dose potassium 10mEq was started as increased lasix, and lisinopril 5mg PO daily was started to prevent facial flushing. Patient was instructed to take aspirin 30 minutes before hand to prevent serious interaction between miconazole nitrate and atorvastatin calcium/simvastatin, and potassium chloride immediate rel. PO was ordered. Instructions were given to continue toe cream, check lytes in 2 days, and come to the ER if any concerning symptoms such as trouble breathing, chest pain, or leg swelling. Do NOT discontinue these medications without speaking to your doctor.

Is there a mention of of lipitor ( atorvastatin ) usage/prescription in the record

Mrs. Wetterauer is a 54-year-old female with coronary artery disease status post inferior myocardial infarction in March of 1997, with sick sinus syndrome, status post permanent pacemaker placement, and paroxysmal atrial fibrillation controlled with amiodarone; also with history of diabetes mellitus and hypertension. On 1/11, she experienced severe respiratory distress and was unable to be intubated on the field. She was ultimately intubated at Sirose, and an echocardiogram showed an ejection fraction of 25 to 30 percent with flat CKs. She was diuresed six liters and a right heart catheterization showed a pulmonary artery pressure of 40/15, wedge of 12, and cardiac output of 5.2. Hemodynamics indicated her cardiac output was dependent on her SVR. At the outside hospital, a right upper lobe infiltrate was noted and she was given gentamicin 250 mg times one, and clindamycin 600 mg. She was diagnosed with pneumonia and treated with clindamycin, which caused resolution of her white count. She was also given Solu-Medrol 40 mg intravenous q.6 hours for possible asthma, and had an increase in her Lasix and lisinopril dose, as well as her amiodarone. Her last admission was on 10/6 for atypical chest pain, and she was placed on Bactrim Double Strength b.i.d. times a total of seven days, as well as Lovenox 60 mg b.i.d., aspirin 325 p.o. q.d., lisinopril 40 mg p.o. b.i.d., digoxin 0.25, Lopressor 100 mg b.i.d., Zantac, Albuterol, Flovent, Solu-Medrol, and amiodarone 300 mg once a day. Home medications include amiodarone 200 mg p.o. q.d., Glyburide 5 mg p.o. q.d., Lopressor 50 mg p.o. b.i.d., Prempro 0.625/2.5 p.o. q.d., lisinopril 40 mg p.o. q.d., Coumadin, nitroglycerin sublingual, Zantac, beclomethasone, and Ventolin. Medications on transfer, Lovenox 60 mg b.i.d., aspirin 325 p.o. q.8, digoxin 0.25, Lopressor 100 mg b.i.d., Zantac, Albuterol, Flovent, Solu-Medrol, and amiodarone 300 mg once a day. The patient was also placed on Tapazole 10 mg p.o. b.i.d., Zantac 150 mg p.o. b.i.d., Coumadin 5.0 mg p.o. q.p.m., Bactrim Double Strength one tablet p.o. b.i.d., Tapazole 10 mg p.o. b.i.d., Zantac 150 mg p.o. b.i.d., Coumadin 5.0 mg p.o. q.p.m., Bactrim Double Strength one tablet p.o. b.i.d., Glyburide 5 mg p.o. q.d., Lasix 20 mg p.o. q.d., atenolol 150 mg p.o. q.d., diltiazem CD 240 mg p.o. q.d., and resolved with 20 mg of Lasix p.o. q.d. Mrs. Wetterauer was admitted to the Aley Coness-o Meoak Medical Center for paroxysmal atrial fibrillation controlled with amiodarone, and had an increase in her Lasix and lisinopril dose, as well as her amiodarone. She was also given Solu-Medrol 40 mg intravenous q.6 hours for possible asthma. For her anxiety, the patient was treated acutely with Ativan and her problem resolved quite well, and she became more comfortable in the hospital. Diabetes Mellitus was managed with Glyburide held initially on admission, covered with insulin sliding scale, and restarted on discharge. Edema was managed with Lasix 20 mg p.o. q.d. and resolved with 20 mg of Lasix p.o. q.d. Urinary Tract Infection was managed with antibiotics. She was discharged with medications including amiodarone 200 mg p.o. q.d., lisinopril 40 mg p.o. b.i.d., Tapazole 10 mg

What is the dosage of the medication the patient was prescribed for severe anxiety

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 the patient had multiple insulin prescriptions

An 81-year-old woman with Atrial Fibrillation (AF) on Fondaparinux, no Coumadin secondary to prior epistaxis, Non-small Cell Lung Cancer (NSC Lung Ca), and Pernicious Anemia (Pernicious Anemia) presents with three days of constant chest pain, pleuritic, not exertional, and mostly related to arm movement. Treatment included ACEBUTOLOL HCL 400 MG PO DAILY Starting IN AM ( 8/10 ), ALLOPURINOL 100 MG PO DAILY, VITAMIN C (ASCORBIC ACID) 500 MG PO BID, CALCIUM CARBONATE (500 MG ELEMENTAL CA++) 500 MG PO BID, CIPROFLOXACIN 250 MG PO Q12H X 4 doses (Administer iron products a minimum of 2 hours before or after a Levofloxacin or Ciprofloxacin dose dose), DIGOXIN 0.125 MG PO DAILY, COLACE (DOCUSATE SODIUM) 100 MG PO BID, LOVENOX (ENOXAPARIN) 120 MG SC BEDTIME, TARCEVA (ERLOTINIB) 100 mg PO DAILY, FOLIC ACID 1 MG PO DAILY, FUROSEMIDE 40 MG PO DAILY Starting IN AM ( 4/9 ), DILAUDID (HYDROMORPHONE HCL) 0.5 MG PO Q4H PRN Pain (on order for DILAUDID PO, ref# 925975305, POTENTIALLY SERIOUS INTERACTION: TRAMADOL HCL & HYDROMORPHONE HCL, Reason for override: aware), LIDODERM 5% PATCH (LIDOCAINE 5% PATCH) 1 EA TP DAILY, PRAVACHOL (PRAVASTATIN) 20 MG PO BEDTIME, VITAMIN B6 (PYRIDOXINE HCL) 50 MG PO DAILY, ULTRAM (TRAMADOL) 50 MG PO Q6H PRN Pain (on order for ULTRAM PO, ref# 417339527, POTENTIALLY SERIOUS INTERACTION: MORPHINE & TRAMADOL HCL). CT-PE showed no evidence of PE or Deep Venous Thrombosis (DVT) and post Right Lower Lobe Resection changes, with interval resolution of Left Upper Lobe Nodule without new nodules, and possible chronic subsegmental PE. CXR showed no acute process. Factor Xa level was checked to insure Lovenox dosing was therapeutic. Discharge plan included mammogram next week for evaluation, continue pain control with Lidoderm patch, Ultram and low dose Dilaudid as needed for severe pain, continue Tarceva as per outpatient oncologist, continue Lovenox as outpt, continue Lasix at 40mg daily, complete course of Cipro 250mg BID x 3 days, follow up with cardiologist for continued management of heart conditions, and follow up with rehabilitation specialists to try to regain strength and function. Discharge condition was stable.

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

The patient is a 33 year-old woman with diet controlled diabetes mellitus and morbid obesity who presents to the emergency department with periumbilical pain radiating to the right lower quadrant. After an abdominal CT revealing a 5x5 cm cecal thickening with extraluminal air, her white blood count was 19,000 and her urine HCG was negative. She was taken to the operating room by Dr. Jenovese and had a right colectomy due to gangrenous portions of the right colon. During her postoperative course she developed supraventricular tachycardia to a rate of 200 with hypotension, requiring beta blockade and adenosine. An echocardiogram was obtained which was normal and she was ruled out for myocardial infarction. She was kept on Zantac, ampicillin, levofloxacin, and Flagyl, and was weaned off her oxygen and her central line was discontinued. She was discharged to home on November, 2000 with Lopressor 50 mg p.o. t.i.d., Percocet 1-2 tabs p.o. q 3-4 hours p.r.n. pain, Colace 100 mg b.i.d. while on Percocet, and after completing a 5-day course of ampicillin, levofloxacin, and Flagyl. She is tolerating a regular diet, ambulating dependently, and requiring minimal amounts of oral analgesics. She received wet to dry dressing changes b.i.d. to her wounds.

Has the patient ever had lopressor

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.

What is the reason this patient is on albuterol inhaler

This 90+-year-old male with a complex past medical history including CAD, CHF, AF and diabetes mellitus presented to the SICU for removal of chronically MRSA-infected mesh from prior abdominal surgery. He was intubated with etomidate, succinylcholine and kept sedated with Versed and fentanyl. He received intraoperative vancomycin and levofloxacin as well as 2200 mL of lactated Ringer's. In an attempt to reverse anticoagulation, one unit of FFP was begun but then aborted due to hypotension, which resolved with epinephrine injection, likely due to transfusion reaction. Another unit of FFP was administered, with platelets also given at the request of the Plastic Surgery Team in light of aspirin and Plavix, which were continued due to the patient's cardiac stents. Despite bolus Lasix, the patient did develop CHF with symptomatic pulmonary edema and increased oxygen requirement, concomitantly becoming delirious. He developed hypertension refractory to beta-blockade, calcium channel blockers and IV ACE inhibitors, and was thus placed on a nitroglycerin drip, a furosemide drip with ginger blood product resuscitation to address bleeding and an elevated INR, responding well to this regimen and aggressive pulmonary toilet. The patient was advanced to clear liquids, on medications including Amiodarone 200 mg p.o. daily, Calcium, Colace 100 mg by mouth t.i.d., Coumadin alternating doses of 4 mg and 3 mg, Diltiazem CD 360 mg p.o. daily, Aspirin 81 mg p.o. daily, Folate 1 mg p.o. daily, Lisinopril 10 mg p.o. daily, Metamucil p.r.n., Clopidogrel 75 mg p.o. daily, Potassium, Protonix 40 mg p.o. daily, Simvastatin 80 mg p.o. daily, Synthroid 25 mcg p.o. daily, Thiamine 100 mg p.o. daily, Metoprolol SR 100 mg p.o. b.i.d., Zyprexa 2.5 mg at bedtime p.r.n., and Vancomycin for MRSA-infected mesh. He does experience more significant delirium with morphine and less so with sparing Dilaudid p.r.n., and Haldol is written p.r.n. as needed. Weaning off nitroglycerin drip, nitro paste added, hematocrit 25%, one unit of packed red blood cells with Lasix and potassium to be given, RISS, and PICC line consult ordered for anticipated long-term vancomycin. Services following the patient include Medicine, Dr. Harcar, patient's PCP, Cardiology, Dr. Pagliari, and Plastic Surgery, Dr. Dunshie. Patient anticipated to be transferred to the floor on 9/28/06.

Has this patient ever been treated with zyprexa

Mr. Quigg is a 42-year-old man with history of diabetes, end-stage renal disease on hemodialysis, left Charcot foot complicated by recurrent cellulitis who presented with left lower leg swelling, erythema, and pain. On admission, his temperature was 100.8, heart rate was 111, and blood pressure was 140/70. His left lower extremity had 1+ pitting edema with erythema on the anterior shin and foot. He was uptitrated to 5mg and also lopressor, started on Lyrica and oxycodone for breakthrough pain, and received Fentanyl PCA. His home medications included Colace 100 mg b.i.d., folate 1 mg p.o. daily, gemfibrozil 600 mg b.i.d., Lantus 30 mg subcu q.p.m., Lipitor 80 mg nightly, Nephrocaps, Neurontin 300 mg daily, PhosLo 2001 mg t.i.d., Protonix 40 mg daily, Renagel 3200 mg t.i.d., Requip 2 mg p.o. b.i.d., and Coumadin. His Lipitor was decreased to 20mg due to rhabdomylosis risk, and he was also started on low dose b-blocker to reduce perioperative MI risk prior to his surgery. His Vancomycin was continued given his history of MRSA cellulitis, with a goal of a level less than 20, and he was bridged with heparin with a goal PTT of 60-80. He was restarted on his Lantus and Aspart doses with meals, and his Coumadin was held prior to surgery and decreased to 20mg with a repeat lipid panel in 4-6 weeks. He required antibiotics which were discontinued at this time and he was discharged with dry sterile dressing changes to his residual limb daily, PTT goal 60-80, INR goal 2-3 until stable off of levofloxacin, monitoring of FS and adjustment of DM regimen, monitoring pain scale and decreasing pain medications as pain improves, hemodialysis M/W/F, and follow up with Dr. Carpino voice message left on his medical assistant's voice mail and Dr. Lynes 6/10/06 at 9:30am. Psychiatry service was consulted who recommended low dose Ativan prior to him going for dialysis. He was initially placed on a ketamine drip and given IV Levofloxacin and IV Flagyl to cover gram negatives and anaerobes respectively, and started on oxycontin 80mg tid with oxycodone for breakthrough pain and Lyrica for neuropathic pain. He was comfortable prior to discharge on this current regimen.

phoslo

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 the patient had previous isordil ( isosorbide dinitrate )

Patient Emilio R. Strausberg was admitted on 5/26/2004 with atrial fibrillation and calcaneous fracture and was discharged on 7/18/2004 with discharge orders including ECASA (Aspirin Enteric Coated) 325 MG PO QD, with a potentially serious interaction with Warfarin, Vitamin B12 (Cyanocobalamin) 1,000 MCG PO QD, Digoxin 0.25 MG PO QD, Colace (Docusate Sodium) 100 MG PO BID, Lasix (Furosemide) 60 MG PO BID, Oxycodone 5 MG PO Q6H PRN Pain, Coumadin (Warfarin Sodium) 5 MG PO QPM, with a potentially serious interaction with Atorvastatin, Metoprolol (Sust. Rel.) 300 MG PO QD, Accupril (Quinapril) 20 MG PO QD, Tiazac (Diltiazem Extended Release) 240 MG PO QAM, Lipitor (Atorvastatin) 80 MG PO QD, with a potentially serious interaction with Niacin, Vit. B-3 and Calcium, Niaspan (Nicotinic Acid Sustained Release) 1 GM PO QHS, Lantus (Insulin Glargine) 66 UNITS SC QPM, Insulin Lispro Mix 75/25 74 UNITS SC QAM, Glucometer 1 EA SC x1, Maalox-Tablets Quick Dissolve/Chewable 1-2 TAB PO Q6H PRN Upset Stomach, and Insulin Lispro Mix 75/25 54 UNITS SC QPM. Override notices were added on 6/9/04 with reasons such as heart, home med, and home emd. The patient was rate controlled with IV metoprolol and diltiazem, instructed to continue ASA, continue rate control with home meds, continue lipitor/niacin (incr lipitor 40--->80), continue lasix, 60 bid (was 40po TID at start of hospitalization), and to continue home insulin. Diabetes education was provided. Mr. Schmider was given ECASA (ASPIRIN ENTERIC COATED) 325 MG PO QD, with a POTENTIALLY SERIOUS INTERACTION: WARFARIN & ASPIRIN, VITAMIN B12 (CYANOCOBALAMIN) 1,000 MCG PO QD, DIGOXIN 0.25 MG PO QD, COLACE (DOCUSATE SODIUM) 100 MG PO BID, LASIX (FUROSEMIDE) 60 MG PO BID, OXYCODONE 5 MG PO Q6H PRN Pain, COUMADIN (WARFARIN SODIUM) 5 MG PO QPM, on order for ECASA PO (ref # 23344198), on order for LIPITOR PO (ref # 90217884), POTENTIALLY SERIOUS INTERACTION: WARFARIN & ATORVASTATIN CALCIUM Reason for override: home 40mg, METOPROLOL (SUST. REL.) 300 MG PO QD, on order for DILTIAZEM PO (ref # 68655693), POTENTIALLY SERIOUS INTERACTION: METOPROLOL TARTRATE & DILTIAZEM HCL Reason for override: home med, on order for TIAZAC PO (ref # 86614276), on order for DILTIAZEM SUSTAINED RELEASE PO (ref #, ACCUPRIL (QUINAPRIL) 20 MG PO QD, TIAZAC (DILTIAZEM EXTENDED RELEASE) 240 MG PO QAM, LIPITOR (ATORVASTATIN) 80 MG PO QD, POTENTIALLY SERIOUS INTERACTION: NIACIN, VIT. B-3 & NIASPAN (NICOTINIC ACID SUSTAINED RELEASE) 1 GM PO QHS, LANTUS (INSULIN GLARGINE) 66 UNITS SC QPM, INSULIN LISPRO MIX 75/25 74 UNITS SC QAM, GLUCOMETER 1 EA SC x1, MAALOX-TABLETS QUICK DISSOLVE/CHEWABLE 1-2 TAB PO Q6H PRN Upset Stomach, and Insulin Lispro Mix 75/25 54 UNITS SC QPM, as well as continue rate control with home meds, continue lipitor/niacin (incr lipitor 40--->

has the patient had diltiazem

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 had prozac

Mrs. Wetterauer is a 54-year-old female with coronary artery disease status post inferior myocardial infarction in March of 1997, with sick sinus syndrome, status post permanent pacemaker placement, and paroxysmal atrial fibrillation controlled with amiodarone; also with history of diabetes mellitus and hypertension. On 1/11, she experienced severe respiratory distress and was unable to be intubated on the field. She was ultimately intubated at Sirose, and an echocardiogram showed an ejection fraction of 25 to 30 percent with flat CKs. She was diuresed six liters and a right heart catheterization showed a pulmonary artery pressure of 40/15, wedge of 12, and cardiac output of 5.2. Hemodynamics indicated her cardiac output was dependent on her SVR. At the outside hospital, a right upper lobe infiltrate was noted and she was given gentamicin 250 mg times one, and clindamycin 600 mg. She was diagnosed with pneumonia and treated with clindamycin, which caused resolution of her white count. She was also given Solu-Medrol 40 mg intravenous q.6 hours for possible asthma, and had an increase in her Lasix and lisinopril dose, as well as her amiodarone. Her last admission was on 10/6 for atypical chest pain, and she was placed on Bactrim Double Strength b.i.d. times a total of seven days, as well as Lovenox 60 mg b.i.d., aspirin 325 p.o. q.d., lisinopril 40 mg p.o. b.i.d., digoxin 0.25, Lopressor 100 mg b.i.d., Zantac, Albuterol, Flovent, Solu-Medrol, and amiodarone 300 mg once a day. Home medications include amiodarone 200 mg p.o. q.d., Glyburide 5 mg p.o. q.d., Lopressor 50 mg p.o. b.i.d., Prempro 0.625/2.5 p.o. q.d., lisinopril 40 mg p.o. q.d., Coumadin, nitroglycerin sublingual, Zantac, beclomethasone, and Ventolin. Medications on transfer, Lovenox 60 mg b.i.d., aspirin 325 p.o. q.8, digoxin 0.25, Lopressor 100 mg b.i.d., Zantac, Albuterol, Flovent, Solu-Medrol, and amiodarone 300 mg once a day. The patient was also placed on Tapazole 10 mg p.o. b.i.d., Zantac 150 mg p.o. b.i.d., Coumadin 5.0 mg p.o. q.p.m., Bactrim Double Strength one tablet p.o. b.i.d., Tapazole 10 mg p.o. b.i.d., Zantac 150 mg p.o. b.i.d., Coumadin 5.0 mg p.o. q.p.m., Bactrim Double Strength one tablet p.o. b.i.d., Glyburide 5 mg p.o. q.d., Lasix 20 mg p.o. q.d., atenolol 150 mg p.o. q.d., diltiazem CD 240 mg p.o. q.d., and resolved with 20 mg of Lasix p.o. q.d. Mrs. Wetterauer was admitted to the Aley Coness-o Meoak Medical Center for paroxysmal atrial fibrillation controlled with amiodarone, and had an increase in her Lasix and lisinopril dose, as well as her amiodarone. She was also given Solu-Medrol 40 mg intravenous q.6 hours for possible asthma. For her anxiety, the patient was treated acutely with Ativan and her problem resolved quite well, and she became more comfortable in the hospital. Diabetes Mellitus was managed with Glyburide held initially on admission, covered with insulin sliding scale, and restarted on discharge. Edema was managed with Lasix 20 mg p.o. q.d. and resolved with 20 mg of Lasix p.o. q.d. Urinary Tract Infection was managed with antibiotics. She was discharged with medications including amiodarone 200 mg p.o. q.d., lisinopril 40 mg p.o. b.i.d., Tapazole 10 mg

has there been a prior prempro

A 79-year-old female with a history of diabetes mellitus, congestive heart failure, coronary artery disease, chronic renal insufficiency, and anemia, status post five years of TAMOXIFEN TREATMENT, was admitted to Darnbo Hospital on 7/29/97 after sudden onset of shortness of breath unrelieved by one sublingual nitroglycerin. This shortness of breath was managed with IV Lasix and IV nitroglycerin, saturating at 99% on 100% oxygen, and IV heparin at 1,300 units per hour. Her blood pressure was stabilized on IV nitroglycerin with TRANSFER MEDICATIONS: Lopressor 25 mg PO BID started three weeks ago, Axid 150 mg PO BID, enteric coated aspirin 325 mg PO QD, Isordil 30 mg PO QID, hydralazine 50 mg PO QID, Lasix 40 mg PO QD, Timoptic 0.25% one GTT OU BID, Serax 30 mg PO QHS PRN insomnia, and nitroglycerin 1/150 one tablet sublingual Q 5 minutes times three PRN chest pain. She underwent cardiac catheterization on 11/4/97 with PTCA plus stent placement to her RCA with a good result and is on Ticlid for two weeks. Her blood pressure was well controlled in her target range of 140-160 systolic blood pressure on hydralazine, Lasix, and Lopressor. She was found to have an iron deficiency anemia treated with Niferex 150 mg PO BID and may benefit from Epogen as an outpatient. She was discharged to home in stable condition to follow up with her cardiologist and primary care physician based on previously scheduled appointments. Discharge medications included enteric coated aspirin 325 mg PO QD, Lasix 40 mg PO QD, hydralazine 50 mg PO QID, Isordil 30 mg PO TID, Lopressor 25 mg PO BID, nitroglycerin 1/150 one tablet sublingual Q 5 minutes times three PRN chest pain, Timoptic 0.25% one drop OU BID, Axid 150 mg PO QD, and Ticlid 250 mg PO BID for two weeks. Also, Niferex tablet 150 mg PO BID. Discharge instructions included that the patient have her CBC checked at two weeks and four weeks given her Ticlid therapy.

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

This 74-year-old gentleman with insulin-dependent diabetes mellitus, hypertension, and coronary artery disease presented with substernal chest pain on exertion and was admitted with T wave inversions in leads V3 and V4. Cardiac cath showed a 95% ostial LAD lesion, a 60% mid LAD lesion, an 80% distal LAD lesion, a 70% proximal D1 lesion, a 40% proximal circumflex lesion, a 90% ostial OM1 lesion, and a 100% proximal RCA lesion; he underwent CABG x3 with a Y graft, SVG1 connecting SVG2 to the LAD, SVG2 connecting the aorta to OM1, and SVG3 connecting to PDA. The patient is a Spanish-speaking only male who is neurologically intact, moving all extremities, getting in and out of bed, and very independent. He had a ventricular fibrillation arrest in the operating room due to an aprotinin reaction, necessitating open cardiac massage and requiring lidocaine and amiodarone use during the code. Medication on admission included Lopressor 50 mg p.o. t.i.d., Lisinopril 40 mg p.o. daily, Aspirin 325 mg p.o. daily, Hydrochlorothiazide/triamterene one tablet daily, Atorvastatin 80 mg p.o. daily, and Lantus 50 cc daily. The patient developed a deep sternal infection with E. coli and was started on Flagyl and Vancomycin for presumed aspiration pneumonia, Imipenem for ID's recommendation, and Nitrofurantoin and Ceftazidime for UTI. He is on Lopressor 25 mg q.6h, Amlodipine 5 mg b.i.d., Lasix 20 mg p.o. b.i.d., Aspirin, Atorvastatin, Lantus, NovoLog, and Diabetes Management. Imipenem and Vancomycin need to be continued for six weeks. He had a small area of erythema on his chest wound, but it is intact and he is being followed by Plastics. He had one brief episode of atrial fibrillation during a coughing spell, but it resolved and he is on antihypertensive medication. He was deemed fit for transfer back to the Step-Down Unit on postoperative day #18.

Has the patient ever been on amlodipine

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.

has there been a prior diltiazem

This is a 69 year-old woman with a history of congestive heart failure and hypertension who presented with a productive cough which was worsening over the past 3-4 days and fever to 101 with chills and shakes and increasing shortness of breath. She had a white blood cell count of 9.3 with 54% polys and 9.6 % eosinophils, a glucose of 377, and a chest x-ray without evidence of congestive heart failure or infiltrate. She was treated in the emergency room with Albuterol nebulizer and plans were to discharge her to home, however, her saturations dropped to 89% on room air with exercise in the emergency room and was admitted for further observation. She was started on intravenous Cefuroxime, and initially improved with decrease in cough and shortness of breath; however, the patient continued to desat with exercise. A repeat chest x-ray was performed which showed no change when compared to the admission film. Her sputum culture grew out Pen-sensitive E-coli and she was continued on her intravenous and then PO antibiotics. She continued to desat with exercise, however, and her cough persisted although she remained afebrile with a slightly elevated white count and moderate peripheral eosinophilia. Her chest exam remained rancorous and the reason for this remained unclear. Given the finding of E-coli in the sputum sample, in addition to the elevated eosinophilia and lack of finding on chest x-ray despite significant findings on chest exam, the possibility of a worm or parasitic disease was raised. She had a Persantine MIBI in March of 1996, on which she had no fixed or reversible defects, and was on nitroglycerin for stable angina - "chest heaviness" after climbing one flight of stairs, relieved by rest and one sublingual nitroglycerin. Her medications on admission included Lasix 40 mg. per day, Insulin 70/30 28 units q a.m. and 5 units q p.m., Verapamil SR 120 mg PO b.i.d., Enteric coated aspirin 325 mg q day, KCL 10 mEq PO q day, Premarin 0.625 mg PO q day, Zestril 20 mg b.i.d., Atenolol, recently discontinued, Tofranil 75 mg PO q HS, Albuterol inhaler two puffs inhaled q.i.d., and Potassium slow release 10 mEq PO q day. She was discharged to home with Albuterol inhaler and instructions to follow up with her primary physician in clinic for further evaluation including PFTs and possible chest CT if symptoms did not abate, and to finish a full ten day course of antibiotics for presumed bronchitis. At the time of discharge the patient's saturation was 92 to 93% on room air and dropping slightly to 90 to 91% with exercise, however she was tolerating this well and was getting relief from her Albuterol inhaler.

Has patient ever been prescribed potassium slow release

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.

Has this patient ever tried plavix ( clopidogrel )

A 79-year-old female with a history of diabetes mellitus, congestive heart failure, coronary artery disease, chronic renal insufficiency, and anemia, status post five years of TAMOXIFEN TREATMENT, was admitted to Darnbo Hospital on 7/29/97 after sudden onset of shortness of breath unrelieved by one sublingual nitroglycerin. This shortness of breath was managed with IV Lasix and IV nitroglycerin, saturating at 99% on 100% oxygen, and IV heparin at 1,300 units per hour. Her blood pressure was stabilized on IV nitroglycerin with TRANSFER MEDICATIONS: Lopressor 25 mg PO BID started three weeks ago, Axid 150 mg PO BID, enteric coated aspirin 325 mg PO QD, Isordil 30 mg PO QID, hydralazine 50 mg PO QID, Lasix 40 mg PO QD, Timoptic 0.25% one GTT OU BID, Serax 30 mg PO QHS PRN insomnia, and nitroglycerin 1/150 one tablet sublingual Q 5 minutes times three PRN chest pain. She underwent cardiac catheterization on 11/4/97 with PTCA plus stent placement to her RCA with a good result and is on Ticlid for two weeks. Her blood pressure was well controlled in her target range of 140-160 systolic blood pressure on hydralazine, Lasix, and Lopressor. She was found to have an iron deficiency anemia treated with Niferex 150 mg PO BID and may benefit from Epogen as an outpatient. She was discharged to home in stable condition to follow up with her cardiologist and primary care physician based on previously scheduled appointments. Discharge medications included enteric coated aspirin 325 mg PO QD, Lasix 40 mg PO QD, hydralazine 50 mg PO QID, Isordil 30 mg PO TID, Lopressor 25 mg PO BID, nitroglycerin 1/150 one tablet sublingual Q 5 minutes times three PRN chest pain, Timoptic 0.25% one drop OU BID, Axid 150 mg PO QD, and Ticlid 250 mg PO BID for two weeks. Also, Niferex tablet 150 mg PO BID. Discharge instructions included that the patient have her CBC checked at two weeks and four weeks given her Ticlid therapy.

Has patient ever been prescribed ticlid

Mr. Serafine is a 78-year-old gentleman with class III heart failure and aortic stenosis. He was admitted to the Intensive Care Unit on 3 mcg of epinephrine and insulin and Precedex. He was prescribed Atenolol 12.5 mg daily, aspirin 325 mg daily, metformin 500 mg b.i.d., and Humalog insulin 12 units q.i.d., intravenous Lasix but had weaned Lasix drip and had intermittent boluses of 40 mg IV to promote diuresis with good result. He was also found to have a positive urinary tract infection and was started on ciprofloxacin for a total of five days. The patient at one point required 5 liters of nasal cannula to get his saturations in the 90s. He was prescribed three days, Motrin 400 mg q.8h. p.r.n. pain, NovoLog 24 units subq q.a.c., Lantus 60 units subcutaneous q.10 p.m., Toprol-XL 300 mg daily, patient was also discharged on NovoLog sliding scale subcutaneous q.a.c. with doses of Lasix 40 mg b.i.d., baby aspirin 81 mg daily, and potassium chloride slow release 20 mEq b.i.d. for three days. He was then discharged to home in stable condition with visiting nurse and medications including Atenolol 12.5 mg daily, aspirin 325 mg daily, metformin 500 mg b.i.d., and Humalog insulin 12 units q.i.d., Ciprofloxacin 500 mg q.6h. for remaining four doses, baby aspirin 81 mg daily, Lasix 40 mg b.i.d., for three days along with potassium chloride slow release 20 mEq b.i.d. for three days, Motrin 400 mg q.8h. p.r.n. pain, NovoLog 24 units subq q.a.c., Lantus 60 units subcutaneous q.10 p.m., Toprol-XL 300 mg daily, and NovoLog sliding scale subcutaneous q.a.c. His beta-blocker was increased with good result and he underwent a minimally invasive aortic valve replacement with a 25-mm Carpentier-Edwards pericardial valve. He was then to follow up with Dr. Collin Hyman in six weeks and his cardiologist Dr. Louie W Eilders in one week.

Why was nasal cannula originally prescribed

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 on diflucan

The patient is a 58-year-old female with chronic renal insufficiency, diabetes mellitus, hypertension, and anemia who presented with two weeks of diffuse abdominal pain that acutely worsened one day prior to admission with associated nausea, nonbloody emesis, and chills. She was initially given a seven-day course of ciprofloxacin and oxycodone for pain, but stopped taking them after developing constipation. She currently presents with complaints of diarrhea and was given ampicillin 2 g IV, gentamicin 80 mg IV, Flagyl 500 mg IV and 8 units of insulin. She was put on levofloxacin, vancomycin, and Flagyl as her left foot had been encasted with evidence of underlying infection, and her blood cultures grew MRSA, which is presumed to need eight weeks of vancomycin. She was put on erythromycin with a change to Reglan on 8/6/06 per renal or liver disease and kept on Compazine for nausea. Later, it was determined that the patient was iron deficient and she was put on iron supplementation and darbepoetin initially and changed to erythropoietin later during dialysis. She was maintained on aspirin, a statin, and calcium channel blocker, and started on prophylactic beta-blocker during her hospital course. Her insulin regimen was titrated to good glycemic response, and she was kept on heparin and Nexium. Other medications included Tylenol 650 mg p.o. q.4. p.r.n. headache, Colace 100 mg p.o. b.i.d., Dilaudid 0.4-0.8 mg p.o. q.4. p.r.n. pain, Insulin NPH human 20 units subq b.i.d., Lopressor 50 mg p.o. q.i.d., Senna tablets two tabs p.o. b.i.d., Norvasc 10 mg p.o. daily, Nephrocaps one tab p.o. daily, Insulin Aspart sliding scale subq a.c., Lipitor 80 mg p.o. daily, Protonix 40 mg p.o. daily, Vancomycin 1 g IV three times a week, Reglan 5 mg p.o. q.a.c., Reglan 5 mg p.o. q.h.s., Compazine 5-10 mg p.o. q.6h. p.r.n. nausea, Ergocalciferol 50,000 units p.o. q. week for six weeks, Aspirin 81 mg p.o. daily, Heparin 5000 units subq t.i.d., and Lactulose 30 mL p.o. q.i.d. p.r.n. constipation.

Why does the patient take compazine

Gregory Goodness, a 79-year-old man, was admitted to Sachua Oaks De on 5/18/2003 and discharged on 3/24/2003 with a disposition of home with services. The patient was put on a full code status and the attending physician was Gene R. Kos, M.D. The main diagnoses included Hypercalcemia, Hyperkalemia, CHF, NIDDM, AI/AS, bicuspid aortic valve, LVH, HTN, s/p thyroglossal duct cyst excision, h/o, and CAD. The discharge medications included ECASA (Aspirin Enteric Coated) 325 mg PO QD, Enalapril Maleate 7.5 mg PO BID, hold if b/p<100 systolic, ACE for heart, NPH Humulin Insulin (Insulin NPH Human) 2 units SC QAM, NPH Humulin Insulin (Insulin NPH Human) 3 units SC QPM, Nitroglycerin 1/150 (0.4 mg) 1 tab SL q5min x 3 PRN chest pain, Imdur (Isosorbide Mononit. (SR)) 30 mg PO QD, Nephrocaps (Nephro-Vit Rx) 1 tab PO QD, Nexium (Esomeprazole) 20 mg PO QD, and Toprol XL (Metoprolol (Sust. Rel.)) 200 mg PO QD. The patient was also put on a renal diet with 2000 calories/day, low saturated fat, low cholesterol, and instructions to walk as tolerated. The patient was also instructed to take some medications with meals or on an empty stomach. Hypercalcemia 15 on admission was treated with 50mg of Calcitonin SC and Kayexelate given with Lactulose with good results and repeat K improved with dialysis MWF. SOB with hypoxia on admission from CHF, no clear infiltrates and doing well on NC O2. Pt was also given Nitroglycerin 1/150 (0.4 mg) 1 tab SL q5min x 3 PRN chest pain and adenosine mibi on 9/10 which showed minimal ischemia, and had Hyper PTH and Hyperkalemia without T wave peaking. The patient was switched to Toprol XL 200 QD 7/24 p.anterior wall, and was prescribed ECASA (Aspirin Enteric Coated) 325 mg PO QD, Enalapril Maleate 7.5 mg PO BID, Nitroglycerin 1/150 (0.4 mg) 1 tab SL q5min x 3 PRN chest pain, Imdur (Isosorbide Mononit. (SR)) 30 mg PO QD, Nephrocaps (Nephro-Vit Rx) 1 tab PO QD, Nexium (Esomeprazole) 20 mg PO QD, and Toprol XL (Metoprolol (Sust. Rel.)) 200 mg PO QD. The patient was also on ASA, Lopressor which was increased over 2 days, Nitrates, and ACE-inh, and received Vit D which may have contributed to the hypercalcemia. Pt was put on decreased NPH regimen with BS of 56 on 4/22 and given D50x1 and NPH decreased further to try to maintain tight glycemic control. The patient was discharged in stable condition with follow up chest CT, check SPEP and PTH labs, and call the doctor for any chest pains, dizziness, trouble breathing, fevers >100.4, or any other concerns.

Has the patient ever been on nephrocaps ( nephro-vit rx )

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 colace ( docusate sodium )

Jonas G Fosselman was admitted from office on 4/1/01 for infected L THR. Aspiration demonstrated purulent material, and he was started on Ceftriaxone per ID consult recs. with MIC to both PCN and Ceftriaxone pending. MRI of pelvis completed 10/10/01 as pre-op eval. TU Cardiology was consulted for pre-op clearance given extensive H/O cardiomyopathy and unstentable CAD per last cardiac cath 8/7. On further d/w PT, he was adament about being allowed to be D/C home on Abx for August holiday. Given that his clinical picture was much improved on antibiotics, both Dr Salkeld and ID MD agreed to this on provision that he return immediately for any evidence of progressing infection. His R hip pain and exam were much improved by time of discharge. Will plan for IV lon line to be placed prior to D/C for home dosing of QD Ceftriaxone. ID to be re-consulted on admission post-op 10/5 for re-eval of abx choice. By that time it is presumed that the MIC for PCN/CTX will be available for ascertation of proper long-term Abx care. Discharge medications included TYLENOL (ACETAMINOPHEN) 650 MG PO Q4H PRN headache, VENTOLIN (ALBUTEROL INHALER) 1-2 PUFF INH QID PRN sob/wheeze, ECASA (ASPIRIN ENTERIC COATED) 325 MG PO QD, ATENOLOL 25 MG PO QD Food/Drug Interaction Instruction Take consistently with meals or on empty stomach., CEFTRIAXONE 2,000 MG IV QD (Number of Doses Required (approximate): 2), COLACE (DOCUSATE SODIUM) 100 MG PO BID, ENALAPRIL (ENALAPRIL MALEATE) 2.5 MG PO QD, PERCOCET 1-2 TAB PO Q4H PRN pain, ZOCOR (SIMVASTATIN) 5 MG PO QHS Food/Drug Interaction Instruction Avoid grapefruit unless MD instructs otherwise., ISOSORBIDE MONONITRATE 30 MG PO QD Food/Drug Interaction Instruction Give on an empty stomach (give 1hr before or 2hr after food) (Number of Doses Required (approximate): 15), and NEXIUM (ESOMEPRAZOLE) 20 MG PO QD. Discharge instructions included IV Abx, D/C home with services for QD CTX dosing, IV long line placement, re-admission for removal of infected hardware and spacer placement 9/24/01, and IV Ceftriaxone per VNA 2 Gr IV QD for 10/9/01. Return immediately for increasing temps/shaking chills/pain at R hip. Discharge condition was stable. Follow-up appointment(s) included Dr Lobato 9/24/01, VH pre-admit for OR I&D/removal hardware. 9/24/01 scheduled, and Return to Work after eval by Dr Ashurst. Allergy: Shellfish, Morph

Has the patient ever been on isosorbide mononitrate

Ms. Dube is a 58-year-old female with non-insulin dependent diabetes mellitus, hyperlipidemia, hypertension, and a history of a left circumflex coronary artery stent placed three months prior to admission. She presented to the emergency room with left jaw pain, which was relieved with three sublingual nitroglycerin and later with Percocet to which she got some relief. She was started on Lovenox 1 mg per kg subcutaneously b.i.d., beta-blocker, Zocor and ACE inhibitor, t.i.d., glucophage 500 mg b.i.d., Celexa 40 mg p.o. q.d., Zestril 2.5 mg q.d., atenolol 25 mg p.o. q.d., Lipitor 20 mg p.o. q.h.s., Plavix. The patient's Lovenox was reversed with protamine and her hematoma continued to expand overnight, so she received one unit of fresh frozen plasma as well as a third unit of packed red blood cells, resulting in a total of five units of packed red blood cells due to blood loss secondary to her anticoagulation with Lovenox, Plavix, aspirin and a possible STONDE MEDICAL CENTER trial drug. Her headache was treated with Tylenol to which it did not respond and her discharge medications included aspirin 81 mg p.o. q day, Klonopin 0.5 mg p.o. q.h.s., and her home medications of Zocor, Lopressor, captopril, Celexa, Klonopin. Vascular surgery was consulted due to concern for developing compartment syndrome and she was restarted on aspirin. Her head CT was negative for bleeding and she was discharged home on March, 2003 with instructions to follow up with her primary care physician.

Has the patient had previous plavix

A 63-year-old male with a history of CAD (Coronary Artery Disease) and two prior MIs (Myocardial Infarctions) presented with atypical chest pain and was admitted with a 100% LCx lesion unable to be stented. He was on medical management with Atenolol, Ace-I, and Aspirin (ECASA) 325 mg PO QD until the day of admission when he woke up with left arm and shoulder pain reminiscent of an old MI. Attempts at relief with nitroglycerin 1/150 (0.4 mg) 1 TAB SL q5min x 3 were unsuccessful, so he called EMS. In the ED, EKG and TnI were flat and he was started on heparin for unstable angina. Serial CKs were flat and he had no recurrence of chest pain in the hospital. He is to follow-up with Dr. Tollner with the possibility of ETT-MIBI as an outpatient. Discharge medications included Wellbutrin (Bupropion HCl) 200 mg PO QD, Colace (Docusate Sodium) 100 mg PO BID, FESO4 (Ferrous Sulfate) 300 mg PO BID, and Zocor (Simvastatin) 40 mg PO QHS. Additional instructions included taking the increased dose of Zestril 10 mg PO QD, making a follow-up appointment with Dr. Cyrus in the next week or two, and returning to the hospital if experiencing an increase in chest pain or shortness of breath at rest. The discharge condition was stable and he was discharged home with instructions to do an ETT-MIBI as an outpatient, check K and Cr within 1-2 weeks, and get a referral to GI and EGD as an outpatient.

Has this patient ever been on nitroglycerin 1/150 ( 0.4 mg )

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 had previous insulin

A 58 year old woman with a history of CABG times three, inferior myocardial infarction, peptic ulcer disease, anemia, and cholelithiasis was admitted with substernal chest pain at rest, dysphagia, light-headedness, coughing, and nocturia. On admission, her blood pressure was 110/68 lying and 90/palp sitting, O2 sat was 97% on room air, JVP was 9 cm with crackles at the right base, and her hematocrit was 20.8. She was given three sublingual nitroglycerins and Maalox, 10 mg of IV Lopressor from which she became hypotensive, two units of packed red blood cells, Lasix, and IV H2 blockers, 20 mEq of Kay Ciel, and IV nitroglycerin 50 units which was increased to 100 units. EKG changes were noted with a flattening in V4 through V6 with no ST depressions and a T wave down in V3. An endoscopy was done which revealed a large hiatal hernia with no evidence of GI bleeding. On discharge, she was given Pepcid 20 mg p.o. b.i.d., metoprolol 50 mg p.o. b.i.d., and nitroglycerin 1/150 0.4 mg sublingual p.r.n. Follow up was recommended with Dr. Pichard and the GI service.

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

This 63 year-old male with a history of peripheral vascular disease, hypertension, non-insulin dependent diabetes mellitus, coronary artery disease, aortic stenosis, and status post bilateral lower extremity bypass grafts presented to the hospital with increasing left lower extremity pain. At which time tPA infusion was commenced and an occlusion of the left lower extremity vein graft was found in the area of the mid-thigh with no passage of contrast and minimal reconstitution of collaterals to his foot. He was managed medically for a few days and underwent catheterization which revealed a right dominant system, a discreet 40% lesion in the proximal left main, a discreet 30% lesion in the proximal left anterior descending artery, 100% lesion in the first marginal branch of the left circumflex artery, as well as 100% lesion in the second marginal branch of the left circumflex artery. He was taken to the operating room on 0/27/02 for an aortic valve replacement with a #23 Carpentier-Edwards pericardial valve and mitral valvuloplasty with an Alfieri suture repair, as well as coronary artery bypass graft times three with left internal mammary artery to the left anterior descending artery, left radial to obtuse marginal one, and left radial to posterior descending artery. During his hospital course he was on MEDICATIONS: Glipizide 5 mg b.i.d., Hydrochlorothiazide 50 mg q.d., Lisinopril 20 mg q.d., Simvastatin 20 mg q.d., Amlodipine 5 mg q.d., Imdur 30 mg q.d., and Toprol 100 mg q.d. and enteric coated aspirin, and he remained on his aspirin and Lopressor, as well as Coumadin. He was placed on the Portland protocol and remained on a full ten-day course of Flagyl and Cefotaxime for his preoperative pneumonia. On his pre-discharge examination he was discharged to rehabilitation with DISCHARGE MEDICATIONS: Coumadin 4 mg p.o. q.hs to maintain INR between 2 and 3, aspirin, Diltiazem 30 mg t.i.d., Simvastatin 20 mg q.d., Colace 100 mg t.i.d., Nexium 20 mg q.d., Niferex-150 b.i.d., Glipizide 5 mg b.i.d., Lasix 40 mg b.i.d., and Lopressor 50 mg b.i.d. with CZI sliding scale.

What treatments has patient been on for his preoperative pneumonia. in the past

The patient is a 55 year old male with a history of noninsulin dependent diabetes mellitus, a significant heavy smoking history, and a family history of cardiac disease who was admitted with chest pain and worsening right great toe ulceration with lymphangitis. He had completed a course of Cipro and was given a dose of oxacillin before being sent to Sidecrestso Community Hospital for IV antibiotics and work-up. MEDICATIONS ON ADMISSION included Tylenol #3 and glyburide 10 mg p.o. q. day. No known drug allergies. He was then treated for the right toe cellulitis with IV antibiotics of gentamicin and Clindamycin, and was placed on atenolol with the dose increased to 75 mg p.o. q. day. On discharge, the patient was switched from Nitropaste to Isordil 10 mg p.o. t.i.d., and his glyburide was increased to 20 mg p.o. q. day. MEDICATIONS ON DISCHARGE included atenolol, aspirin, 325 mg po q day, Glyburide, 20 mg po q day, Tylenol #3, two tablets po x one p.r.n. for pain, and sublingual nitroglycerin, p.r.n. The patient was discharged to home and was to follow-up with Dr. Netti as an outpatient and with Dr. Frasso of AMH Cardiology.

Was the patient ever given antibiotics for right toe cellulitis

A 57 year old woman with multiple cardiac risk factors presented with substernal chest pain relieved by two sublingual nitroglycerins, nausea, and an acid taste. She was ruled out for myocardial infarction by enzyme sets respectively, with no change in EKGs. Her physical examination was afebrile with a blood pressure of 132/96, pulse 95, on one liter of oxygen, saturation of 97%, and respiratory rate of 20. She was treated with aspirin, beta blockers, and nitroglycerin and was started on Axid for possibility of gastroesophageal reflux disease, as well as provided with Maalox and told to keep the head of the bed elevated. She was continued on Glucotrol for diabetes mellitus and was instructed on risk factor modifications, including diabetes mellitus control, controlling cholesterol and hypertension. Upon discharge she was prescribed Atenolol 100 mg p.o. q.d., Ecasa 325 mg q.d., Glucotrol 20 mg b.i.d., Hydrochlorothiazide 12.5 mg q.d., Trazadone 50 mg q.h.s., aspirin 1 q.d., Lopressor 75 mg q.d., nitroglycerin sublingual p.r.n., Ambien 5 mg q.h.s., and was instructed on the possibility of gastroesophageal reflux disease, as well as to follow-up with Dr. Jonker as an outpatient for further workup and management of gastroesophageal reflux disease, as well as following her for her cardiac disease via the risk factor modification.

Has the patient had previous lopressor

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.

Previous albuterol

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 patient ever been prescribed beta blocker

A 59 year-old woman with metastatic breast cancer and a history of pulmonary embolism presented with symptoms of fatigue, lethargy, tachycardia and fever. CXR showed LLL opacity, LUL opacity and hilar fullness on the right with prominent bronchi (?cuffing) and vertebral fractures. She was admitted with bacteremia on 7/0/2006 and treated with whole brain radiotherapy in March 2006 and with weekly Taxol. Restaging studies showed stable visceral disease but progression of bony metastatic disease, so in January 2006, she initiated a second-line Navelbine therapy. At the ER, she was administered 1UPRBC, 1L NS, Levofloxacin 500 mg IV, and placed CVP~20. Her blood pressure systolic initially 120s but decreased to 90s (MAPS>70), and norepinephrine was administered. She was given TYLENOL (ACETAMINOPHEN) 650 MG PO Q6H PRN Pain, Temperature greater than:101, Other:transfusion premedication, ALBUTEROL NEBULIZER 2.5 MG INH Q4H PRN Wheezing, TESSALON PERLES (BENZONATATE) 100 MG PO TID PRN Other:congestion, BENADRYL (DIPHENHYDRAMINE) 12.5 MG PO x1 PRN Other:pre-transfusion, COLACE (DOCUSATE SODIUM) 100 MG PO BID PRN Constipation, ENOXAPARIN 40 MG SC DAILY, NEXIUM (ESOMEPRAZOLE) 40 MG PO DAILY, FLOVENT HFA (FLUTICASONE PROPIONATE) 110 MCG INH BID, INSULIN ASPART Sliding Scale.

What wheezing medications have ever been prescribed for pt. in the VA or mentioned in the record

The patient had been taking Ativan of 3-4 mg q.d. for anxiety for the past two months and abruptly stopped taking it on March 1995 after which she started to have feelings of disorientation, and had been taking chloral hydrate 500 to 1000 mg q.h.s. for five days and Compazine with one dose. CURRENT MEDICATIONS: At home, patient took insulin NPH 25 units in the morning with Regular 10 units in the morning, aspirin 81 mg q.d., Lopressor 25 mg b.i.d., Compazine 5 mg q.6h. p.r.n. anxiety of which she took only one dose, and chloral hydrate 500 to 1000 mg q.h.s. for five days. On admission, her laboratory examination was significant for BUN of 17, creatinine of 1.0, glucose was 364, liver function tests were within normal limits, white count was 7.2, hematocrit was 36, and platelet count was 266. Neurology consultation was obtained who felt that patient's peripheral neuropathy was probably secondary to longstanding diabetes but felt that some of her symptomatology could be consistent with porphyria. Psychiatry felt that this episode was consistent with generalized anxiety disorder separated by post dysthymia and suggested phenothiazines which are proven to be safe in porphyria for treatment. She was started on Trilafon 2 to 4 mg p.o. p.r.n. q.6h. for anxiety and Keflex 500 mg p.o. t.i.d. for treatment. The patient was also seen to be orthostatic which was felt to be secondary to dehydration secondary to poor p.o. intake prior to admission and was treated with normal saline boluses and her orthostasis improved. Her Lopressor was also held with this episode of orthostasis. The Watson-Schwartz test done by Dr. Mohar on patient very early in the admission was negative which made an acute porphyria attack very unlikely. These episodes were felt to be secondary to a combination of anxiety attack and rapid taper of Ativan which she had been taking at moderately high doses for the last two months. Patient also developed urinary tract infection symptoms and her urine culture showed greater than 100,000 colonies of E. coli which were pansensitive. She was discharged to home on August in good condition on medications Aspirin 81 mg p.o. q.d., insulin NPH 25 units subcutaneously q.a.m., insulin regular 10 units subcutaneously q.a.m., Trilafon 2 mg p.o. q.6h., and Keflex 500 mg p.o. t.i.d. Follow-up will be with Dr. Dario Rodriquz.

What medications has patient been on for E. coli in the past

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.

Has the patient ever been on aspirin

The patient is a 64-year-old woman with a history of chest pain and an intraventricular conduction delay, QRS interval of 0.10. In February 1988, an exercise tolerance test showed a left bundle branch block with exercise, and a thallium scan showed no evidence of ischemia. In July 1992, an exercise tolerance test with a maximum heart rate of 167 and maximum blood pressure of 138/60 showed a moderate fixed defect in the apicolateral wall. A cardiac catheterization in 1995 showed no coronary disease, but the patient was told she had cardiomyopathy. On the day of admission, the patient was watching television when she suddenly lost consciousness until she awoke with her grandchildren on top of her. Admission medications included Vasotec 10 mg p.o. q.day, Digoxin 0.25 mg p.o. q.day, and Lasix 20 mg q.day. Discharge medications included Enteric coated aspirin 325 mg p.o., Vasotec 15 mg p.o. q.day, Lasix 20 mg p.o. q.day, and Atenolol 12.5 mg p.o. q.day. Laboratory results revealed a CK of 119, magnesium 2.2, digoxin level 0.7, troponin I 0, electrolytes within normal limits, white blood cell count 10.3, hematocrit 36.5, and platelet count 298, urinalysis 0-1 white cells, 0-1 red cells, 1+ bacteria, and 1+ epithelial cells, chest x-ray revealed no evidence of congestive heart failure or infiltrate, EKG showed normal sinus rhythm at a rate of 93 with intervals of 0.183, 0.15, and 0.417, left bundle branch block, no arrhythmias triggered by exercise, carotid noninvasive studies revealed minimal disease bilaterally, tilt table study was entirely normal, no suggestion of a vasovagal response, ejection fraction 30%-35%, anterolateral wall motion abnormalities, right sided heart catheterization revealed coronary arteries completely clean, EP study was entirely normal, and MRA/MRI of her brain and ECG loop recorder were ordered as outpatient follow up.

Has a patient had atenolol

Mr. Faiella is a 78 year old man who presented with two episodes of chest pain and had recently undergone a MV and TV repair with SVG to OM1. An EKG showed pacing and a CK revealed a TnI elevated at 0.17, while Adenosine MIBI revealed a fixed inf/lat defect, consistent with LCX disease. He was sent home with Nitroglycerin, and the pain recurred while watching TV, resolving with one Nitroglycerin tablet. CV: Ischemia was ruled out for MI, added Isordil to regimen, ASA, and continue Carvedilol, Captopril. Likely to have CAD, Adenosine MIBI origin, will stop nitrates. Pt was able to amubulate w/o SOB or CP, CHF: euvolemic, continue Lasix, Aldactone, Digoxin. Neuro: recent history of TIA, on Coumadin, may not want to reverse. On order, he was prescribed ECASA (Aspirin Enteric Coated) 325 mg PO QD, Coumadin PO (ref # 44750239), Captopril 12.5 mg PO TID, Aldactone PO (ref # 94240639), Digoxin 0.125 mg PO QOD, Lasix (Furosemide) 80 mg PO BID, Niferex-150 150 mg PO BID, Nitroglycerin 1/150 (0.4 mg) 1 tab SL q5min x 3 PRN chest pain HOLD IF: SBP < 100, Aldactone (Spironolactone) 25 mg PO QD, Coumadin (Warfarin Sodium) 6 mg PO QD, Carvedilol 3.125 mg PO BID HOLD IF: SBP < 100, and Celexa (Citalopram) 20 mg PO QD, with potential serious interactions between Aspirin & Warfarin, Captopril & Spironolactone, and Potassium Chloride & Digoxin. He was instructed to call his cardiologist and return to the emergency department if his chest pain recurs, worsens, or he becomes short of breath, and to make an appointment with Dr. Moxness within the next 1-2 weeks. VNA was asked to oversee medications, check vitals, and draw PT/INR once a week, while PT was asked to help Mr. Muskett regain strength, flexibility, and range of motion. Number of Doses Required (approximate): 5. There were overrides on orders for COUMADIN PO (ref # 44750239) and ALDACTONE PO (ref # 94240639) due to Potentially Serious Interactions: ASPIRIN & WARFARIN, CAPTOPRIL & SPIRONOLACTONE, and POTASSIUM CHLORIDE & SPIRONOLACTONE.

Has this patient ever been treated with carvedilol

Mr. Heldman is a 69-year-old male with end-stage renal disease on hemodialysis who presented to the emergency department prior to admission with shortness of breath and chest x-ray revealed pulmonary edema. On physical examination, vital signs were temperature 95.8, heart rate 74, and blood pressure in the right arm 134/62, HEENT was dentition without evidence of infection, no carotid bruit, cardiovascular was regular rate and rhythm, peripheral pulses were 2+the carotid, radial, and femoral and dorsalis pedis and posterior tibial were present bilaterally, respiratory rales present bilaterally, and neuro was cool extremities with monophasic pulse. An echocardiogram was done and it showed evidence of dehiscence of the bioprosthetic aortic valve with prolapse into the left ventricular outflow tract and at least moderate perivalvular aortic regurgitation as well as moderate to severe mitral regurgitation. Preoperative labs showed sodium 141, potassium 4.4, chloride 102, carbon dioxide 29, BUN 26, creatinine 5.8, glucose 195, magnesium 1.9, white blood cells 6.11, hematocrit 28, hemoglobin 9.5, and platelets 98,000. He was put on preoperative medications which included Labetalol, 100 mg p.o. t.i.d., amlodipine 10 mg p.o. daily, lisinopril, 20 mg p.o. day, Zocor 40 mg p.o. daily, PhosLo 1334 mg p.o. a.c. The patient underwent a replacement of #24 homograph, MVP with Alfieri suture, bypass time of 355 minutes and crossclamp time of 265 minutes. During the operation, one ventricular wire, one pericardial tube, one retrosternal tube, two left pleural tubes and two right pleural tubes were placed. He was discharged home on the following medications aspirin 325 mg p.o. daily, hydralazine 100 mg p.o. q.i.d., labetalol 100 mg p.o. t.i.d., lisinopril 40 mg p.o. b.i.d., oxycodone 5 mg p.o. q.h.s., losartan 100 mg p.o. daily and he will continue to be on both vancomycin and rifampin until 1/3/04, with the rifampin taken orally and the vancomycin after dialysis three times a week. His postoperative course was complicated by infectious disease and cardiovascular issues and he will follow up with the cardiac surgeon in six weeks, cardiologist in three to four weeks, primary care physician in one to two weeks, and cardiologist in two weeks.

What was the dosage prescribed of aspirin