Procedure Logs

C3.2 R5: Perform and document a Best Possible Medication History (BPMH)

In our oncology patients it is very important to have a best possible medication history as their medications are constantly changing as their chemotherapy progresses.

EH is a new diagnosis acute lymphoblastic leukemia who was being discharged after her first cycle of induction. I conducted a BPMH, provided a medication calendar and discharge counselling for EH’s mother.

Drug Used for Dose (mg) Dose (mL) Morning Lunch Evening Bedtime
Dexamethasone

(until Feb 8)

Leukemia 2.5 mg 2.5 mL X X
Ranitidine

(only while on dexamethasone)

Acid reflux/stomach irritation 45 mg 3 mL X X
Co-trimoxazole (Septra) Prevention of lung infections 6 mL X(sat & sun only) X(sat & sun only)
Morphine Pain 4 mg 4 mL Every 4 hours as needed for pain
Pegalex Constipation 17 g Once daily as needed for constipation *take with at least 250 mL water with each dose*
Ondansetron Nausea 4 mg 2 mL Every 8 hours as needed for nausea or vomiting

This was an enjoyable interaction with EH’s mom to ensure she was aware of all of EH’s medications  especially given that this was a new diagnosis with a great deal of psychosocial burden.

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