Name | Age | Gender | Emergency Contact |
---|---|---|---|
Roland Grant | 75 | Male | Carol Grant (spouse) - 222 555 7777 |
Name | Specialty | Email Address |
---|---|---|
[Your Name] | Primary Care | [Your Email] |
Dr. Wilson Cook | Cardiologist | wilson@email.com |
Medication | Dosage | Frequency | Purpose | Special Instructions |
---|---|---|---|---|
Lisinopril | 10 mg | Once daily | Hypertension | Take with water |
Metformin | 500 mg | Twice daily | Diabetes | Take with meals |
Atorvastatin | 20 mg | Once daily | High Cholesterol | Take at bedtime |
Warfarin | 5 mg | Once daily | Blood Thinner | Monitor INR regularly |
Levothyroxine | 75 mcg | Once daily | Hypothyroidism | Take on an empty stomach |
Medication/Supplement | Dosage | Frequency | Purpose | Special Instructions |
---|---|---|---|---|
Aspirin | 81 mg | Once daily | Blood Thinner | Take with food |
Vitamin D | 1000 IU | Once daily | Bone Health | Take with water |
Calcium | 500 mg | Twice daily | Bone Health | Take with meals |
Medication/Substance | Reaction Type | Notes |
---|---|---|
Penicillin | Rash, Swelling | Avoid all penicillin derivatives |
Ibuprofen | Stomach Upset | Prefer acetaminophen for pain relief |
Consistency in Medication Schedule: Ensure medications are taken at the same time each day to maintain effectiveness and minimize the risk of missed doses.
Regular Medication Review: Schedule periodic reviews with the healthcare provider to reassess the necessity, dosage, and interactions of medications, especially if new conditions arise or existing ones change.
Monitoring for Side Effects: Keep an eye out for any adverse reactions or side effects from medications and promptly report them to the healthcare provider for appropriate adjustments or interventions.
Templates
Templates