Ms. Pall is a 72-year-old female patient with multiple chronic medical problems, including Coronary Artery Disease, CHF, Hypertension, Diabetes Mellitus Type 2, Chronic Kidney Disease, Hypocalcemia, Colon Cancer, Osteoarthritis, and Chronic Anemia. She recently sustained a tib/fib fracture due to a scooter accident in 2006 and is being treated with Tylenol and Aspirin 81 mg PO qd for her left midleg pain. Her medications include Acetylsalicylic Acid 81mg PO daily, Calcium Carbonate 1,500mg (600mg elem Ca)/Vit D 200 IU 1 tab PO bid, Calcitriol 0.5mcg PO daily, Phoslo (Calcium Acetate 1 GELCAP=667 mg) 1,334mg PO tid, Nexium (Esomeprazole) 40mg PO daily, Lasix (Furosemide) 40mg PO daily, Toprol XL (Metoprolol Succinate Extended Release) 25mg PO daily Food/Drug Interaction Instruction, Nephrocaps (Nephro-Vit RX) 1 TAB PO daily, and Simvastatin 10mg PO bedtime. Her diet is a House diet and she needs nutritional supplements/boost. She was discussed two options for management, casting with a patellar tendon bearing cast or surgery, and the patient declined surgery due to her high risk surgical status. She will follow-up in the Orthopedics clinic on Wednesday for casting. Her chronic kidney disease and electrolyte abnormalities have been monitored and her TSH was recently elevated and T3/T4 are pending at discharge. She has a history of diabetes but does not require insulin and has a normal A1C. Her EF is 30% and she was not in CHF on admission. She has been instructed to take her medications with meals or on an empty stomach, and to avoid grapefruit unless MD instructs otherwise. A screen for assisted living, PT consult, and SW consult were also ordered. She is DNR/DNI and her daughter will discuss her status further with her tomorrow. She has been advised to follow-up with her primary provider in 1-2 weeks after discharge and to monitor renal function and lytes. She is taking Calcium Carbonate 1,500 mg (600 mg ELEM CA) / Vit D 200 IU 1 TAB PO BID, Acetylsalicylic Acid 81 MG PO DAILY, Calcitriol 0.5 MCG PO DAILY, Phoslo (Calcium Acetate (1 GELCAP=667 MG)) 1,334 MG PO TID, Nexium (Esomeprazole) 40 MG PO DAILY, Lasix (Furosemide) 40 MG PO DAILY, Toprol XL (Metoprolol Succinate Extended Release) 25 MG PO DAILY Food/Drug Interaction Instruction, Nephrocaps (Nephro-Vit RX) 1 TAB PO DAILY, and Simvastatin 10 MG PO BEDTIME with the potential for a serious interaction between Niacin, Vit. B-3, and Simvastatin. Number of doses required (approximate): 4.
What pain meds has vet tried in past
is being treated with Tylenol and Aspirin 81 mg PO qd for her left midleg pain.