tokens: 638157550 SC 97308722 6261929 1/22/2005 12:00:00 AM gastritis DIS Admission Date : 01/22/2005 Report Status : Discharge Date : 01/24/2005 ****** DISCHARGE ORDERS ****** AKOTE , NAO 630-65-64-5 Q39 Room : 70B-157 Service : GGI DISCHARGE PATIENT ON : 01/24/05 AT 07:00 PM CONTINGENT UPON Not Applicable WILL D / C ORDER BE USED AS THE D / C SUMMARY : YES Attending : GAETZFREIERM , DENA DA , M.D. CODE STATUS : Full code DISPOSITION : Home DISCHARGE MEDICATIONS : AMOXICILLIN 1,000 MG PO BID X 28 doses Instructions : for H.Pylori . Food / Drug Interaction Instruction May be taken without regard to meals CLARITHROMYCIN 500 MG PO BID X 28 doses Instructions : h.pylori tx . Food / Drug Interaction Instruction Take with food Alert overridden : Override added on 01/23/05 by DAINSAYLESNOORT , AGER , M.D. , PH.D. SERIOUS INTERACTION : SIMVASTATIN and CLARITHROMYCIN POTENTIALLY SERIOUS INTERACTION : SIMVASTATIN and CLARITHROMYCIN Reason for override : will monitor . HYDROCHLOROTHIAZIDE 25 MG PO QD ZOCOR ( SIMVASTATIN ) 40 MG PO QHS Food / Drug Interaction Instruction Avoid grapefruit unless MD instructs otherwise . Override Notice : Override added on 01/23/05 by DAINSAYLESNOORT , AGER , M.D. , PH.D. on order for CLARITHROMYCIN PO ( ref # 99052380 ) SERIOUS INTERACTION : SIMVASTATIN and CLARITHROMYCIN POTENTIALLY SERIOUS INTERACTION : SIMVASTATIN and CLARITHROMYCIN Reason for override : will monitor . POTASSIUM CHLORIDE SLOW REL. ( KCL SLOW RELEASE ) 40 MEQ PO QD As per SC Potassium Chloride Policy : each 20 mEq dose to be given with 4 oz of fluid COZAAR ( LOSARTAN ) 50 MG PO QD Number of Doses Required ( approximate ) : 2 LAMICTAL ( LAMOTRIGINE ) 150 MG PO BID Number of Doses Required ( approximate ) : 5 WELLBUTRIN SR ( BUPROPION HCL SUSTAINED RELEASE ) 200 MG PO BID Number of Doses Required ( approximate ) : 4 ESOMEPRAZOLE 20 MG PO BID X 28 doses Instructions : H. Pylori tx . DIET : No Restrictions ACTIVITY : Resume regular exercise FOLLOW UP APPOINTMENT ( S ) : Dr. Gaetzfreierm 1-2 weeks , ALLERGY : PERCOCET , IV Contrast , LISINOPRIL , ATENOLOL ADMIT DIAGNOSIS : Gastritis PRINCIPAL DISCHARGE DIAGNOSIS ; Responsible After Study for Causing Admission ) gastritis OTHER DIAGNOSIS ; Conditions , Infections , Complications , affecting Treatment / Stay Obesity HTN High Cholesterol Tobacco Fhx of CAD ETT 12/94 ( - ) ischemia ECHO 02/89 nl ETT 03/89 , 07/90 c / w ND ische Takes hubby &apos;s sl ntg Barium Swallow 04/89 ( - ) UGI 06/91 ( - ) OPERATIONS AND PROCEDURES : OTHER TREATMENTS / PROCEDURES ( NOT IN O.R. ) MRI HIDA CT BRIEF RESUME OF HOSPITAL COURSE : The pt is a 55yo F s / p Roux en Y GBP in 12/20 presenting to the ED this AM c / o mod severe midepigastric pain . She notes that she has had this pain since Thursday , and that it becomes much worse within 15 min of consuming a meal . She has also had intermittent post-prandial nausea / satiety for which she had been scheduled for an outpt EGD with GI on 2/8 . She describes the pain as band-like / radiating to both sides but not the back . Her pain currently is 5/10 . ROS ( - ) emesis / BRBPR/melena / fever/chills / sob . Pt was seen by GI on 13 EGD was performed HD2 which was negative for gastritis , stricture or ulcer . Pt was found to be H. Pylori positive and therefore was started on empiric treatment . Afferent limb of the roux en y anastamosis was visualized however the efferent limb could not be explored . Pt had HIDA scan which was negative for obstruction , and CT was unremarkable . Pt was tolerating regular diet by HD4 , and GI felt that further workup could be continued as an outpatient . Pt was therefore discharged home in stable condition , voiding , ambulating and eating without difficulty . Plans to follow up with outpatient MRA to rule out ischemic causes of post prandial pain , as well as HIDA with CK challenge to evaluate for biliary dyskinesia without stasis . Pt will finish course of H. pylori treatment as well . ADDITIONAL COMMENTS : If fevers , chills , nausea , vomiting , diarrhea , increasing pain with food please call Dr. Gaetzfreierm &apos;s office or PCP . If severe , then proceed to ER for evaluation . Will need to call for outpatient MRA and HIDA with CCK challenge to evaluate biliary system and mesenteric vasculature . Please continue taking the antibiotics for H. Pylori for full course ( 26 more days ) . DISCHARGE CONDITION : Stable TO DO / PLAN : No dictated summary ENTERED BY : DOUETSHUFF , DE CLEEE , M.D. ( CP85 ) 01/24/05 06:53 PM ****** END OF DISCHARGE ORDERS ******