Patient Medication List
Prepared by: [Your Name]
Hospital: [Your Company Name]
Introduction:
A Patient Medication List is a critical tool for healthcare providers to ensure safe and effective management of a patient's medications. It includes detailed information about each medication prescribed, facilitating communication and reducing the risk of medication errors.
Patient Information:
Medication Details:
Medication Name | Dosage (Strength) | Frequency | Route |
|---|
Lisinopril | 10 mg | Once daily | Oral |
Metformin | 500 mg | Twice daily with meals | Oral |
Atorvastatin | 20 mg | Once daily at bedtime | Oral |
Aspirin | 81 mg | Once daily | Oral |
Levothyroxine | 75 mcg | Once daily on empty stomach | Oral |
Vitamin D | 1000 IU | Once daily | Oral |
Prescribing Doctor:
Start Date:
Medication Name | Start Date |
|---|
Lisinopril | January 1, 2020 |
Metformin | March 15, 2010 |
Atorvastatin | October 5, 2015 |
Aspirin | February 20, 2018 |
Levothyroxine | May 10, 2012 |
Vitamin D | Ongoing |
Purpose/Indication:
Medication Name | Purpose/Indication |
|---|
Lisinopril | Hypertension |
Metformin | Type 2 diabetes |
Atorvastatin | Hyperlipidemia |
Aspirin | Cardiovascular protection |
Levothyroxine | Hypothyroidism |
Vitamin D | Vitamin D deficiency |
Special Instructions:
Pharmacy Information:
Pharmacy Name | Contact Information |
|---|
Maplewood Pharmacy | Phone: 555-987-6543 Address: 456 Oak Avenue, Maplewood, USA |
Allergies/Side Effects:
Additional Notes:
List Templates @ Template.net
