Now · Medications

Medications

12 scheduled · ~25 PRN. Heavy regimen, but coherent once foundational history is folded in (AFib + Watchman, Tourette's, mini-stroke).

Source: Haven Doctor's Orders PDF, current as of 2026-05-27. Original PDF →

At a glance

🫀 Cardiovascular (5 scheduled)

Post-Watchman + post-stroke + CAD + HTN

  • Aspirin 81 mg AM
  • Clopidogrel 75 mg AM
  • Atorvastatin 40 mg HS
  • Metoprolol 50 mg BID
  • Amlodipine 5 mg AM
  • Clonidine 0.1 mg BID PRN — tapering 5/26–5/30

🧠 Psychiatric scheduled (3)

Mood, depression, tics

  • Olanzapine 10 mg HS — mood, post–Baker Act
  • Duloxetine 40 mg BID (80 mg/day) — depression
  • NAC 300 mg AM — tics; not fully covering per Dad (5/27). Push for dose escalation + neurology consult

😴 Sleep stack (6 agents)

Heavy — consolidation target for Phase 2

  • Melatonin 5 mg HS — scheduled
  • Olanzapine 10 mg HS
  • Trazodone 50 mg HS PRN
  • Vistaril 50 mg q6h PRN
  • Valerian 500 mg PRN
  • Passion flower 1500 mg PRN

Fall-risk cocktail on top of amlodipine.

🧴 GI (new today)

Pantoprazole + ~10 PRN agents

  • Pantoprazole 40 mg AM started 2026-05-27
  • PRN: Mylanta, Pepto, Miralax, Colace, Loperamide
  • PRN: Dicyclomine, Calcium carbonate, Milk of Magnesia
  • PRN: Ondansetron PO + IM

🤕 Pain

Non-opioid path

  • Lidocaine 4% patch nightly PRN — back pain
  • Acetaminophen 500 mg q6h PRN
  • Ibuprofen 200 mg PRN — bleed risk on DAPT, prefer acetaminophen

💊 Supplements

Standard substance-use protocol

  • Multivitamin
  • Thiamine 100 mg AM — Wernicke's prophylaxis
  • Vitamin C 500 mg PRN

Detailed breakdown

Per-drug concerns + monitoring asks live in the legacy detail page, kept for now while we polish the new template.

Full per-drug breakdown →

📋 Open questions for the care team

  1. Update charted allergies: aspirin = historical, currently tolerated; epinephrine = not actually allergic; shellfish remains anaphylactic with cardiac arrest history.
  2. Watchman implant date: Determines when DAPT steps down to aspirin alone.
  3. EKG on file? Likely from April ER admission. Confirm + repeat cadence on olanzapine.
  4. Kindling prophylaxis: No gabapentin (or other anticonvulsant) in regimen. Why not?
  5. NAC dose escalation: 300 mg/day is sub-research.
  6. MOUD path: No buprenorphine / naltrexone visible.
  7. CYP2C19 PGx for clopidogrel responsiveness.
  8. CYP2D6 PGx for duloxetine.
  9. Bipolar screen given Baker Act + SNRI start.
  10. Discontinuation roadmap for olanzapine + duloxetine.
  11. DEXA scan: baseline for osteoporosis vector.
  12. Lp(a) — missing from 2025 baseline.
  13. Vascepa (icosapent ethyl) evaluation.
  14. Quetiapine vs olanzapine trade given metabolic baseline.
  15. Sleep stack consolidation roadmap for Phase 2.
  16. Ketamine / Spravato if duloxetine doesn't land within 6–8 weeks.