Make your own free website on Tripod.com

Meds Administration Record

PATIENT NAME:   ARLIE GRIMES

Date:   From______________ to _____________   Year________
MED:
Time SUN MON TUE WED THR FRI SAT SUN MON TUE WED THR FRI SAT
Sinemet
(carbidopa/levadopa)
10 mg., 4 times a day
7am              
11a              
4pm              
7pm              
MED:
Time SUN MON TUE WED THR FRI SAT SUN MON TUE WED THR FRI SAT
Parlodel
(Bromocriptine)
2.5 mg., 2 times a day
7am              
xxx              
xxx              
7pm              
MED:
Time SUN MON TUE WED THR FRI SAT SUN MON TUE WED THR FRI SAT
Artane
(Trihexyphenidyl)
2 mg., 1/2 (HALF) tablet 1 time a day
7am              
xxx              
xxx              
xxx              
MED:
Time SUN MON TUE WED THR FRI SAT SUN MON TUE WED THR FRI SAT
Digoxin
0.25 mg., 1 time a day
7am              
xxx              
xxx              
xxx              
MED:
Time SUN MON TUE WED THR FRI SAT SUN MON TUE WED THR FRI SAT
Coumadin
(Warfarin)
6 mg., 1/2 tab on Sunday and
1 tab all other days
xxx              
xxx              
xxx              
7pm              
MED:
Time SUN MON TUE WED THR FRI SAT SUN MON TUE WED THR FRI SAT
Zyprexa
(Olanzapine)
7.5 mg., 1/2 (HALF) tab a.m. 2 tabs p.m.
7am              
xxx              
xxx              
7pm              
MED:
Time SUN MON TUE WED THR FRI SAT SUN MON TUE WED THR FRI SAT
AcipHex
(Raberrazole NA)
20 mg., 30 minutes before lunch
xxx              
11a              
xxx              
xxx