MDedge
Example: DISCHARGE MEDICATION LIST
Patient Name: XXXXX Date: 11/30/12
Northwestern Pharmacists: XXXX (312-926-5381)
Scheduled Medications:
|Medication (Generic/Brand) |
|Vancomycin |2 g |Infection |250 ml (1 bag) | | | |Infusion |
|Medications that have NOT changed |
|Aspirin |81 mg |Heart health |1 tab | | | | |
|Vitamin D3 |50,000 IU |Supplement | | | | |1 cap 2 times a week |
|Dutasteride-tamsulosin (Jalyn) |0.5/0.4 mg |Prostate |1 cap | | | |30 min after the same meal each |
| | | | | | | |day |
|Enalapril (Vasotec) |10 mg |Blood pressure |1 tab | | | | |
|Metoprolol succinate (Toprol XL) |25 mg |Blood pressure / Heart |½ tab | | | | |
|Multivitamin | |Supplement |1 tab | | | | |
|Niacin (Niaspan ER) |1000 mg |Cholesterol |1 tab | | | | |
|Omega 3 fish oil | |Supplement |1 cap | | | | |
|Rabeprazole (Aciphex) |20 mg |Stomach / Acid reflux |1 tab | | | | |
|Rosuvastatin (Crestor) |10 mg |Cholesterol |1 tab | | | | |
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As Needed Medications:
|Medication (Generic/Brand) |Strength |Directions |
|Medications that have NOT changed |
|Acetaminophen-hydrocodone (Norco) |10/325 mg |1 tablet every 3 hours as needed for pain |
|Naproxen (Aleve) |220 mg |1 tablet every 8 hours as needed for pain |
| | | |
| | | |
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