Free Discharge Medication List Template
Discharge Medication List
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Name patien |
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Date of birth |
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Transfer to |
This list contains a comprehensive record of a patient's discharge medication details, including medication names, dosages, frequencies, special instructions, and additional notes. It serves as a vital tool for transitioning patient care from the hospital to home or to another healthcare facility, ensuring the safety and continuity of the patient’s treatment regimen.
Patient Information
|
Patient Name |
Date of Birth |
Medical Record Number |
Discharge Date |
|---|---|---|---|
|
John Doe |
January 15, 1985 |
MRN789012 |
February 28, 2024 |
Medication Details:
|
Medication Name |
Dosage |
Frequency |
Special Instructions |
|---|---|---|---|
|
Acetaminophen |
500mg |
Every 6 hours |
Take with plenty of water |
|
Omeprazole |
20mg |
Once daily before breakfast |
Take on an empty stomach |
|
Levothyroxine |
100mcg |
Once daily before breakfast |
Take on an empty stomach |
|
Ibuprofen |
400mg |
Every 8 hours |
Take with food |
|
Metformin |
1000mg |
Twice daily with meals |
Monitor blood sugar levels |
Notes
List of additional reminders:
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Allergies, if any, must always be kept in mind before the administration of any medication.
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These are the default instructions, and deviations, if any, should be practiced under medical guidance only.
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It is essential to maintain the order of the medications, as detailed.
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Medications must be stored under recommended conditions to preserve their efficacy.
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In case of any health complications, immediately contact the healthcare provider.
