Medication Reconciliation Accuracy

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Ceptic Online - Medication Reconciliation Accuracy

Listen to the interview and complete the medication reconciliation form.

Home Medication List: to be completed by pharmacy upon admission (10/20/25)

First Name: Davis Last Name: Williams Date of Birth: 03/18/1978	Allergies: amoxicillin (rash, anaphylaxis occurred 5 years ago)	Immunization History: Influenza: November 2024 <br>COVID-19: 2023 <br>Tetanus: 2023 <br>Pneumococcal: PPSV23 2024 <br>Shingles: none
Community Rx Info: Rx Insurance:	Social History: Nicotine: current cigarette smoker, 1 ppd, 20 pack years <br>Alcohol: 2-3 beers/day x 20 years <br>Recreational Drugs: none currently, previous marijuana in college (25 years ago)
Additional Notes:

DRUG STRENGTH DF	DOSE ROUTE FREQ	PRN?	LAST DOSE (date/time)	ADVERSE EFFECTS	ADHERENCE	NOTES	MED REC ACTION	MED REC REASON
Glumetza 1,000 mg ER tablet	1 PO QD w/breakfast	no	10/20/25 06:00	stomach upset/diarrhea when taking IR tablets	misses 1 dose/month	takes for diabetes		formulary substitution to metformin IR 500 mg, 1 PO BID
Cymbalta 60 mg capsule	1 PO QD w/breakfast	no	10/20/25 06:00	none	misses 1 dose/month	takes for diabetic neuropathy
Lotensin 10 mg tablet	1 PO QD w/breakfast	no	10/20/25 06:00	dry cough for years	misses 1 dose/month	takes for nephropathy		formulary substitution to lisinopril 10 mg, 1 PO QD, consider ACEI alternative due to cough ADR
Salonpas (lidocaine) 4% topical patch	1 TOP 1-2x/day	yes, neuropathy	10/19/25 15:00	none	misses 1 dose/month	uses on back for neuropathy
Nephro-Vite multivitamin tablet	1 PO QD w/breakfast	no	10/20/25 06:00	none	misses 1 dose/month	takes for kidney health		formulary substitution to Complete Multivitamin, 1 tab PO QD
Chromium Picolinate 1,000 mcg tablet	1 PO QD w/breakfast	no	10/20/25 06:00	none	misses 1 dose/month	takes for diabetes		hold supplement until discharge

Helpful Links: Formulary Substitution List LexiDrugs							Action Key: C = Continue, D = Discontinue^, H = Hold^, M = Modify^* ^*must provide reason