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. 2013 Nov;146(6):335–341. doi: 10.1177/1715163513504529

Table 1.

History of medication experience

# Drug Reason for use (if known) Knowledge, efficacy, compliance, goals and safety assessment Duration (if known)
1 Ramipril 10 mg daily Hypertension BP at GDH initially ranging from 106/86-138/64 mmHg, most systolic <130 mmHg with occasional orthostatic hypotension Unclear
2 Amlodipine 10 mg daily Hypertension Some left ankle swelling, recently on right as well Unclear
3 Metoprolol 75 mg twice daily Hypertension FHT pharmacist states metoprolol was 25 mg twice daily prior to valve replacement, increased during hospitalization to 75 mg twice daily 2 years ago; no attempts to taper since; heart rate = 76 Several years
4 Furosemide 40 mg daily Unknown Using for ankle swelling? Unclear
5 ASA 81 mg daily Stroke prophylaxis (following bioprosthetic aortic valve replacement) No bruising or bleeding 3 years
6 Rosuvastatin 10 mg daily Hyperlipidemia LDL = 1.2 mmol/L (last summer; info from FHT) Many years
7 Metformin 500 mg, 2 tablets at breakfast, 1 at noon, 2 at supper Diabetes HbA1c = 7.9% (last summer; info from FHT) About 9 years
8 Loperamide as needed Diarrhea One helps for 2 to 3 weeks, then diarrhea restarts
9 Vitamin B12 1200 mcg daily B12 deficiency B12 = 879 pmol/L (last winter; info from FHT) Unclear
10 Ferrous fumarate 300 mg daily Ferritin deficiency Ferritin = 65 mcg/L (last winter; info from FHT) Unclear
11 Amitriptyline 10 mg 2 tablets at bedtime Sleep? Depression? Patient uncertain of reason; naps during the day, can fall asleep in the evening but has difficulty getting back to sleep if up during the night A long time
12 Rabeprazole 20 mg daily Heartburn Patient stated had not had heartburn in a long time (seems to have started in hospital after valve replacement) About 3 years ago

Allergies/intolerances: sulfonamides, tetracyclines, quinolones, sulfamethoxazole/trimethoprim, glyburide. ASA, acetylsalicylic acid; BP, blood pressure; FHT, Family Health Team; GDH, Geriatric Day Hospital; HbA1c, glycosylated hemoglobin; LDL, low-density lipoprotein.