OVER THE COUNTER (OTC)
OVER THE COUNTER (OTC)
MEDICATION RECORD
CHECK ONLY ONE BOX FOR EACH MEDICATION. ALL BLANKS MUST BE FILLED IN.
|(OTC) MEDICATION |CONDITION |YES |NO |
|Acetaminophen, Tylenol |Minor aches and pains | | |
|Aleve |Minor aches and pains | | |
|Aloe Vera Gel/Lotion |Sunburn | | |
|Ambesol |Toothache | | |
|Bactine |Cuts, abrasions, scratches | | |
|Benadryl, oral |Insect bites and stings | | |
|Benadryl, topical |Stings, bites, allergies | | |
|Betadine |Antiseptic | | |
|Caladryl/calamine lotion |Stings, bites, rashes | | |
|Capacol or generic throat lozenges |Sore throat | | |
|Chlorpheniramine-Chior-Trimetion |Allergies | | |
|Dimetapp, tablet or elixir |Colds, cough, allergies | | |
|Dramamine |Motion sickness | | |
|Gas-X |Gas | | |
|Hydrocortisone Cream – Cortaid |Itching | | |
|Hydrogen Peroxide |Antiseptic | | |
|Ibuprofen – Advil, Motrin |Minor aches, pains, cramps | | |
|Imodium A-D |Diarrhea | | |
|Kaopectate |Diarrhea | | |
|Midol |Menstrual cramps | | |
|Milk of Magnesia |Constipation | | |
|Neosporin |Minor scrapes, cuts | | |
|Mylanta |Upset stomach, gas | | |
|Pepto-Bismol |Upset stomach | | |
|Polysporin, or generic oint. |Minor scrapes, cuts | | |
|Robitussin Elixir |Colds, coughs | | |
|Sore throat spray-generic |Sore throat | | |
|Sudafed, tablets or elixir |Colds, allergies | | |
|Tenactin, Desenix or generic |Athlete’s foot | | |
|Tums |Indigestion, gas | | |
|Vicks Vaporub |Colds | | |
I give permission for my daughter ___________________________ to receive the following “Over the Counter” medications on an as needed basis. Unless otherwise directed, the medications will be administered as directed by package labeling.
______________________________ ______________
Parent or Guardian Signature Date
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- best over the counter erectile dysfunction medication
- pink eye over the counter medication
- over the counter erectile dysfunction pills
- over the counter pink eye drops
- best over the counter ed pills
- over the counter ed pills for men
- over the counter ed remedies
- over the counter erectile pills at walgreens
- conjunctivitis over the counter treatment
- best over the counter erectile pill
- over the counter conjunctivitis medication
- over the counter eye drops for conjunctivitis