This is a 47-year-old female with a history of HIV, diabetes, questionable cerebral aneurysm, and seizure disorder who recently had two syncopal events without prodrome and without postictal state, who presented for evaluation of left arm paresthesias and chest pain, with associated diaphoresis, shortness of breath and nausea. Of note, the patient recently started Flexeril to treat chronic low back pain, was not receiving her Keppra for approximately a year, as her prescription had ran out, and was instead taking Ecotrin 81 mg daily, clonazepam 1 mg q.6 h. p.r.n., Imodium one to two tablets q.i.d. p.r.n. for diarrhea, and low-dose aspirin. The patient was started on low-dose beta-blocker and aspirin, metoprolol 12.5 b.i.d. with occasional bradycardia to the high 40's, and was treated with the Ryo Hospital Medical Center insulin protocol. The patient was restarted on Keppra 250 mg b.i.d. with a goal to increase to 500 mg b.i.d. after 7 days and to 750 mg after another week, and was given Keppra 500 mg b.i.d. for 14 doses and then 750 mg b.i.d., Flexeril 5 mg daily, clonazepam 1 mg q.i.d., Truvada one tablet p.o. daily, Norvir 1400 mg b.i.d., glyburide 5 mg q.a.m. and 2.5 mg q.p.m., Lomotil one tablet q.i.d. p.r.n., methadone 150 mg daily, Zofran 4 mg daily p.r.n., Percocet 325 mg/5 mg tablets one tablet q.6 h. p.r.n., Zantac 150 mg b.i.d., Zoloft 100 mg q.a.m., and trazodone 100 mg nightly. Labs revealed a low reticulocyte index consistent with anemia of chronic disease, and the methadone dose of 155 mg was confirmed with the outpatient clinic. The patient was also given three doses of Klonopin over a six-day period, instructed to take medications as listed, clarify discrepancies with her PCP, return to the ER for evaluation if she faints again, call her PCP and/or return to the ER if her chest pain symptoms recur and persist, make an appointment with the Smill Memorial Hospital to evaluate the cause of her left arm symptoms, and check her blood sugars before meals and at bedtime. Additionally, her PCP was instructed to arrange for a loop monitor, follow up on a 24-hour urine studies assessing for pheochromocytoma, and adjust the patient's diabetes management as needed.
What is her current dose of klonopin
The patient was also given three doses of Klonopin over a six-day period,