Last Name First Name (Suffix, if any) Middle Name Health Record #

Tabudlo Zack

Age/Sex 1 year old/Male Date of Birth (mm/dd/yy) Ward COVID Ward Rm/Bed

MEDICATION AND TREATMENT SHEET

FREQUENCY
MEDICINE SHIFT MONTH/YEAR: April 2021

04/19
0 04/20

Piperacillin + Tazobactam 390mg IV Q6 11-7 12mn

6am

7-3

12nn

3-11 6pm

Baclufen 10mg/tab 1/2 tab TID p.o. 11-7 6am

7-3

12nn

3-11 6pm

Carbamazipine 100mg/5ml syrup 2.5ml 11-7

BID p.o.
 7-3 7am

3-11 7pm

To start Valproic Acid 250mg/5ml, 11-7

1.4ml BID

7-3 7am

3-11 7pm

Amikacin 105mg OD x 7days IVTT 11-7

(1-2-3-4-5-6-7)

7-3

3-11 6pm

Paracetamol 100mg IVTT now then Q4 11-7 12mn

PRN for fever
4am

7-3 8am

12nn

3-11 4pm
 Printed Name Initial Printed Name Initial Printed Name Initial

MARIELLE P. CHUA
NDU-BSN 2D

KATHLEYA GRACE PEGARRO, RN

NDU CI