Prescription Medications Current

Generic name Brand name Strength Instructions Monthly co-pay

Metformin ER Glimepiride Gabapentin Tramadol HCL Meloxicam Lorazepam

Glucophage ER 500 mg Amaryl Neurontin Ultram Mobic Ativan Lexapro Lexapro 4 mg tab 600 mg tab 50 mg tab 15 mg 1 mg tab 20 mg tab 10 mg 10 mg 2.5 mg tab 1 mg Prilosec Synthroid Norvasc 20 mg cap 125 mcg. 10 mg 40 mg tab Cozaar Dyazide Zocor 100 mg 37.5-25 cap 20 mg

2 tab 2x day 1 tab am, tab pm 1 tab 2x day 1 tab every 6 hrs as needed for pain 1 tab daily 1 tab daily as needed 1 tab daily w/ 10 mg for 30 mg total 1 tab daily w/ 20 mg for 30 mg total 1 tab twice daily 8 tab 1x per week (Saturday evening) 2 tab daily 1 tab daily 1 tab daily 1 tab once or twice daily as instructed by dr 2 tab daily in AM 1 tab daily 1 tab daily 1 tab at bedtime Monthly Co-pay Total

$10.00 $10.00 $10.00 (Not filled every month) $25/every 3 months $10.00 (Not filled every month) $25/every 3 months $25.00 $25.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $190.00

Ampheta S/ Combo Methotrexate Folic Acid Omeprazole Levothyroxin Amlodipine Lisinopril Losartan Pot Triam/HCTZ Simvastatin

Adderall

Davette Diane Smith SSN 480-56-8741

DOB 10/31/1951

Non-Prescription Medications - Current

Generic name Brand name Strength Instructions Cost/Frequency

Cetirizine

Zyrtec

10 mg 30 mg 81 mg

1 tab daily prn 1 2 tabs prn 1 tab daily 1 tab daily 1 tab 2x day 1 tab 2x day $4.00/year

Pseudophredrine HCL Sudafed Natures Bounty ABC Plus Senior Aspirin

Members Mark Glucosamine HCL 1500 mg and Chondroitin Sulfate 1200 Natural Vitamin C with Rose Hips Glucose Tablets Aceteminophen Loperamide HCL Dex Tylenol Immodium 1000 mg

4 grams carb PRN for low sugar 500 mg 2 mg tab Per label as needed
2 w/methotrexate, 2 next am, 1 with ea diahrrea episode

Calcium Citrate w/ Vit D (400 iu D; 630 mg Calcium) 1 tab three times day

Soothe XP Zaditor

Emollient eye drops Antihistamine drops

Daily per label Daily per label

Drug Allergies: Penicillin; Sulfa Drugs; Erythromycin (EES); Tetracycline; Keflex; Ceclor; Tetanus Antitoxin

Davette Diane Smith Pharmacy: Kilgores Pharmacy Physicians: University of Missouri Hospitals & Clinics 1502 Fir Pl, Apt B Fairview Internal Medicine Clinic 573-882-4464 (Dr. Gill) Columbia, MO 65201 Adult Psych @ Green Meadows 573-882-2511 (Maggie Yoest/Dr. Hommus) SSN: 480-56-8741 Universitys Diabetic Clinic 573-882-3818 (Dr. Manrique) DOB: 10/31/1951 Rheumatology 573-882-7411 (Dr. Wilson)