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On 8/30/03 I reinstated metformin into her medication regimen at a dose of 500 mgs in the morning, sometimes at noon and night as well. I'm splitting her 1000 mg pills to obtain the correct dosage. I have noted the change in the most recent A.M. and P.M. schedules below but have not created new schedules. I won't do this until I see metformin moving out of occasional usage.
Final Critical Update - 3/17/04:
New medication schedule here
My mother has been a supplement addict since I can remember. These are her current choices.
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Supplement
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Notes
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1 Vitamin E - 400 IU
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1 Vitamin C - 1000 mg
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*1 Multi-Vitamin for "Mature Adults"
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includes potassium and minerals
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1 Folic Acid - 400 mcg
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1 Garlic tablet - 1,250 mg
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* 1 One-A-Day brand Multi-vitamin for Women |
Used instead of the multi-vitamin for "mature adults" when we are controlling for potassium. This vitamin contains none. |
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Medication
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Rx Dose
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Adjusted Dose
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Notes
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65 mg Elemental Iron from 325 mg Ferrous Sulfate
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1 tablet
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for anemia control |
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Metformin HCL (Glucophage) 1000 mg
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1 tablet
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See Metformin (Glucophage) 850 mg under FLEXIBLY ADMINISTERED MEDS
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for blood glucose control
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Glipizide (Glucotrol) 10 mg
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1 tablet
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for blood glucose control
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Detrol (tolterodine tartrate) 2 mg
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1 tablet
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for bladder control
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Aspirin 81 mg
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1 tablet
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for stroke prevention
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Lisinopril (Zestril) 10 mg
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1 tablet
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This is adjusted by the doctor and me periodically.
Current dosage: 1/2 tablet |
to enhance kidney functions; also lowers blood pressure so must be administered to Mom with care
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Albuterol/Iprao mix 3 ml
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1 nebulized vial
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to enhance breathing; vials refrigerated
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Medication
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Rx Dose
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Adjusted Dose
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Notes
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65 mg Elemental Iron from 325 mg Ferrous Sulfate
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1 tablet
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I am no longer giving her this medication, since her bowel cleansing prior to her colonoscopy, as I am not at all sure she
needs it, anymore. |
for anemia control |
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Metformin HCL (Glucophage) 1000 mg
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1 tablet
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I am no longer giving her this medication, since her bowel cleansing prior to her colonoscopy, as I have observed that the absence of this medication does not affect her blood glucose level, obviously was having no effect on it and I further believe that it was suppressing a variety of other normal functions, behaviors and states. |
for blood glucose control
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Glipizide (Glucotrol) 10 mg
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1 tablet
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for blood glucose control
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Detrol (tolterodine tartrate) 2 mg
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1 tablet
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for bladder control
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Aspirin 81 mg
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1 tablet
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for stroke prevention
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Lisinopril (Zestril) 10 mg
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1 tablet
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This is adjusted by the doctor and me periodically.
Current dosage: 1/2 tablet |
to enhance kidney functions; also lowers blood pressure so must be administered to Mom with care
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Albuterol/Iprao mix 3 ml
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1 nebulized vial
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to enhance breathing; vials refrigerated
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Medication
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Rx Dose
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Adjusted Dose
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Notes
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65 mg Elemental Iron from 325 mg Ferrous Sulfate
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1 tablet
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This dose is the only iron she is taking since 8/14/03 |
for anemia control |
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Metformin HCL (Glucophage) 1000 mg
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½ tablet
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I am no longer giving her this medication, since her bowel cleansing prior to her colonoscopy, as I have observed that the
absence of this medication does not affect her blood glucose level, obviously was having no effect on it and I further believe
that it was suppressing a variety of other normal functions, behaviors and states.
AS OF 8/29/03: I'm administering this judiciously and with circumspection, again. Whether I continue and on what schedule
will depend on daily blood glucose readings. Look for updates on How Sweet It Is. |
for blood glucose control
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Glipizide (Glucotrol) 10 mg
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1 tablet
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I discovered last week, roaming around the web, that, for the best effect, Glucotrol should be taken
30 minutes before the meal, so I'm doing this now. I'm surprised I was never told this by Mom's PCP, the pharmacist or that
it was not written on the Rx bottle.
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for blood glucose control
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Aspirin 81 mg
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1 tablet
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for stroke prevention
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Lisinopril (Zestril) 10 mg
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½ tablet
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to enhance kidney functions; also lowers blood pressure so must be administered to Mom with care
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Albuterol/Iprao mix 3 ml
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1 nebulized vial
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to enhance breathing; vials refrigerated
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Medication
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Rx Dose
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Adjusted Dose
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Notes
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65 mg Elemental Iron from 325 mg Ferrous Sulfate
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1 tablet
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If Mom eats only two meals a day (which often happens when it's a sleep day), this dose is skipped, unless she is looking
extraordinarily pale; then I insist she eat "a little something" and take an iron pill.
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for anemia control |
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Albuterol/Iprao mix 3 ml
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1 nebulized vial
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Rarely agrees to this dose, unless she is experiencing pleural distress (usually excessive coughing or breathlessness) and
I insist.
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to enhance breathing; vials refrigerated
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Medication
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Rx Dose
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Adjusted Dose
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Notes
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65 mg Elemental Iron from 325 mg Ferrous Sulfate
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1 tablet
|
If Mom eats only two meals a day (which often happens when it's a sleep day), this dose is skipped, unless she is looking
extraordinarily pale; then I insist she eat "a little something" and take an iron pill.
I am no longer giving her this medication, since her bowel cleansing prior to her colonoscopy, as I am not at all sure she
needs it, anymore.
|
for anemia control |
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Albuterol/Iprao mix 3 ml
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1 nebulized vial
|
Rarely agrees to this dose, unless she is experiencing pleural distress (usually excessive coughing or breathlessness) and
I insist.
|
to enhance breathing; vials refrigerated
|
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Medication
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Rx Dose
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Adjusted Dose
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Notes
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65 mg Elemental Iron from 325 mg Ferrous Sulfate
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1 tablet
|
If Mom eats only two meals a day (which often happens when it's a sleep day), this dose is skipped, unless she is looking
extraordinarily pale; then I insist she eat "a little something" and take an iron pill.
I am no longer giving her this medication, since her bowel cleansing prior to her colonoscopy, as I am not at all sure she
needs it, anymore.
|
for anemia control |
|
Albuterol/Iprao mix 3 ml
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1 nebulized vial
|
Rarely agrees to this dose, unless she is experiencing pleural distress (usually excessive coughing or breathlessness) and
I insist.
|
to enhance breathing; vials refrigerated
|
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Medication
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Rx Dose
|
Adjusted Dose
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Notes
|
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65 mg Elemental Iron from 325 mg Ferrous Sulfate
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1 tablet
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for anemia control |
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Metformin HCL (Glucophage) 1000 mg
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1 tablet
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See Metformin (Glucophage) 850 mg under FLEXIBLY ADMINISTERED MEDS
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for blood glucose control
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Glipizide (Glucotrol) 10 mg
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1 tablet
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for blood glucose control
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Albuterol/Iprao mix 3 ml
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1 nebulized vial
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Rarely agrees to this dose, unless she is experiencing pleural distress (usually excessive coughing or breathlessness) and
I insist.
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to enhance breathing; vials refrigerated
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Medication
|
Rx Dose
|
Adjusted Dose
|
Notes
|
|
65 mg Elemental Iron from 325 mg Ferrous Sulfate
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1 tablet
|
I am no longer giving her this medication, since her bowel cleansing prior to her colonoscopy, as I am not at all sure she
needs it, anymore. |
for anemia control |
|
Metformin HCL (Glucophage) 1000 mg
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1 tablet
|
I am no longer giving her this medication, since her bowel cleansing prior to her colonoscopy, as I have observed that the absence of this medication does not affect her blood glucose level, obviously was having no effect on it and I further believe that it was suppressing a variety of other normal functions, behaviors and states. |
for blood glucose control
|
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Glipizide (Glucotrol) 10 mg
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1 tablet
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for blood glucose control
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Detrol (tolterodine tartrate) 2 mg
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1 tablet
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UPDATE 8/11/03: For a few days, now, I've been giving her a tablet at night, to get a little control over night water shed. I'm hoping that, as we bring her blood glucose levels under better control, we'll be able to drop this medication at night, again, but, for now, the little bit that it helps is appreciated. Unfortunately, it also tends to increase her dehydration quotient during the day, but I keep an eye on her and ply her with lots of water (much to her annoyance). |
for bladder control
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Albuterol/Iprao mix 3 ml
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1 nebulized vial
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Rarely agrees to this dose, unless she is experiencing pleural distress (usually excessive coughing or breathlessness) and
I insist.
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to enhance breathing; vials refrigerated
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Medication
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Rx Dose
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Adjusted Dose
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Notes
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Glipizide (Glucotrol) 10 mg
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1 tablet
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given 30 minutes prior to meal
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for blood glucose control
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Metformin HCL (Glucophage) 1000 mg
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½ tablet
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I am no longer giving her this medication, since her bowel cleansing prior to her colonoscopy, as I have observed that the
absence of this medication does not affect her blood glucose level, obviously was having no effect on it and I further believe
that it was suppressing a variety of other normal functions, behaviors and states. |
for blood glucose control
|
|
Detrol (tolterodine tartrate) 2 mg
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1 tablet
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This evening dose is the only dose I am giving her, now. |
for bladder control
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Albuterol/Iprao mix 3 ml
|
1 nebulized vial
|
Rarely agrees to this dose, unless she is experiencing pleural distress (usually excessive coughing or breathlessness) and
I insist.
|
to enhance breathing; vials refrigerated
|
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Medication
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Rx Dose
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Adjusted Dose
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Notes
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Concentrated oxygen
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Concentration 2 liters; canulized from a concentrator or tanks 24/7
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Only recently got her to use it every night and almost every nap time; still having aesthetic trouble with her using the portable
tanks. Both her doctor and I think that she'll find reason to get used to the portables in Prescott, and will, thus, begin
using oxygen when she is awake.
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for COPD |
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Metformin HCL (Glucophage) 850 mg
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1 tablet
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Administered instead of 1000 mg dose if her blood sugar begins to slip below 100, per doctor's orders. Her blood glucose
level zig-zags throughout the day, depending on how much she's eating and moving. If lethargy leads you to believe that it's
getting too low, it is always safe, for Mom, to err on the side of less, rather than more.
UPDATE 7/24/03: I am no longer giving her this medication, since her bowel cleansing prior to her colonoscopy, as I have observed
that the absence of this medication does not affect her blood glucose level, obviously was having no effect on it and I further
believe that it was suppressing a variety of other normal functions, behaviors and states.
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for blood glucose control
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Furosemide (Lasix) 40 mg
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1/4 tablet/day
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This one is tricky and must be administered with care. If, through observation, you detect slight swelling in her feet and/or
belly and/or face, first try a vigorous foot and calf rub. If that doesn't alleviate the condition within 6 hours (or overnight),
administer 5 mgs (at present, this is 1/4 tablet). Harsh water shedding leads to blood pressure crashes in Mom. As well,
she tends to "run" a little underhydrated, so it's easy for her to slip into severe dehydration. Always monitor her
liquid intake and get her to consume them any way you can.
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for edema control
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Albuterol/Iprao mix 3 ml
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1 nebulized vial 3/day
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Rarely agrees to this dose, unless she is experiencing pleural distress (usually excessive coughing or breathlessness) and
I insist.
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to enhance breathing; vials refrigerated
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KLOR-CON M (Potassium) 20 MEQ
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1 tablet
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When she is on Furosemide
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See notes on the importance of potassium
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Levaquin 500 mg
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As physician prescribed
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Doctor stopped her intake at half the prescription and cautioned us to keep the remaining 5 pills "just in case".
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Prescribed when she was having trouble breathing and her doctor was concerned about plueral infection.
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Guaifenex DM (Humibid DM)
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As physician prescribed
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Used only twice, for very short periods.
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On hand in case she experiences severe lung congestion. Can cause dehydration.
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Albuterol Sulfate 0.083%
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1 nebulized vial
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as physician directed
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for severe, acute respiratory distress
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Cranberry Extract
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1 tablet every meal
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given w/1 glass water in addition to whatever other liquids Mom is consuming
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Used when her kidney functions went slightly out of whack, as per blood work
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Albuterol Inhaler - 17 g
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as physician prescribed
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Only used twice because she has trouble understanding them mechanics of it's usage.
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If she needs it, we more often use Nebulized dose of Albuterol
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Philips Milk of Magnesia liquid
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As directed for strong laxative effect
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usually at my discretion
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doctor recommended; works especially well on patients taking iron supplements; may provoke a fecal accident or two so be prepared;
do not use as an antacid
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Tums or generic equivalent
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at Mom's discretion
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antacid effect
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Mom has had adverse reactions to these medications, but I've kept them on hand in case we ever want these reactions.
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Medication
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Rx Dose
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Reactions
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Notes
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Prednizone
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See Rx bottle
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First time: alleviated swelling too quickly when taken in combination with Furosemide.
Second time: increased, instead of alleviated, swelling in Mom; common allergic reaction to Prednizone. |
for alleviation of edema
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Naproxen Sodium
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Any dose, any method
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She swells when she takes it and becomes more lethargic than usual.
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anti-inflammatory for arthritis
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Furosemide (Lasix)
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Doses above 5 mg
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Dehydrates her all at once, causing her to sweat and leak uncomfortably, and exhausts her.
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See Adjusted Dose for Furosemide under FLEXIBLY ADMINISTERED MEDS
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65 mg Elemental Iron from 325 mg Ferrous Sulfate
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1 tablet x3
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I am no longer giving her this medication, since her bowel cleansing prior to her colonoscopy, as I am not at all sure she needs it, anymore. |
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Metformin HCL (Glucophage) any mg dosage
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1 tablet x2
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Since Mom's bowel cleansing prior to her colonoscopy I have observed that the absence of this medication does not affect her blood glucose level, obviously was having no effect on it and I further believe that it was suppressing a variety of other normal functions, behaviors and states. |
I am no longer giving my mother this medication and keeping her under close observation for indications that other medications might need to be substituted for this. I am hoping that lifestyle may take care of the need for any blood glucose control medication except for Glucotrol. |
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Subject
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Information/Explanation
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How medications are listed in above grids
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Whichever name is not in parentheses is the form in which we obtain each medication. We use generic exclusively unless it
is not available.
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Doctor cooperation
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Her attending physician (primary care provider) is as interested in observation as he is in prescribing treatment. He is
interested in the caretaker's observations and suggestions and has often agreed with my advice and treatment determinations.
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Lisinopril (Zestril)
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She originally took 10 mg/day but this dropped her blood pressure too low. Since she isn't taking it for Congestive Heart
Failure, the dose was cut back. The reason this medication is given to promote kidney health as well as CHF is that it affects
(opens up) the artery that leads directly from the heart to the kidneys.
Recent edemic episodes have caused both her doctor and me to observe and treat her more closely for signs of developing CHF, but, so far, this is not critical. |
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Emergency Prescribing
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Be very vigilant of medications prescribed by all doctors under emergent and hospitalized situations. Every
time Mom has had an opposite or "bad" reaction to a medication, it has been administered under emergent situations. Do not
be afraid to question and refuse any doctor's prescriptions at any time, including prescriptions for tests, procedures and
therapies, if you have any doubts.
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Mom's hostility to medication
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Worry if she ever too easily and readily accepts medication.
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Mom's current medication profile
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Overall, my mother is, at this time, on the low end of the medication scale for people her age in her physical condition.
She does not enjoy adding medications to her list, questions any additions rigorously and we joke frequently about the number
of pills she does take. I am pleased that this is true, as I think it is a good sign that she resists medication and would
prefer less than more.
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