Additional Requested Drugs
TO RE-ORDER CALL RITE-PRINT 718/384-4288 PART 1 o o o o o o o o o o o
ETHANOL DESIPRAMINE NORTRIPTYLINE IMIPRIMINE DOXEPIN AMITRIPTYLINE PREGABALIN GABAPENTIN METHYLPHENEDATE METHAMPHETAMINE AMPHETAMINE o o o o Additional RequestedDrugs: PATIENT PRESCRIBEDMEDICATIONS: CLONAZEPAM* BUTRANS BUPRENORPHINE BUPRENEX AVINZA ATIVAN AMITRIPTYLINE AMBIEN ALPRAZOLAM* ADDERALL ACTIQ
ALCOHOL ANTIDEPRESSANTS ANTICONVULSIVES AMPHETAMINES ALLIANCE DRUGPANEL(SEEBELOW) TRIAZOLAM* TEMAZEPAM OXAZEPAM LORAZEPAM FLURAZEPAM* FLUNITRAZEPAM* DIAZEPAM CLONAZEPAM* ALPRAZOLAM* BUTALBITAL PENTOBARBITAL SECOBARBITAL BUTABARBITAL PHENOBARBITAL o o
BENZODIAZEPINES BARBITURATES o o o o o o o o o o o
GRALISE GABAPENTIN FIORICET FENTANYL* ENDOCET EMBEDA ELAVIL DURAGESIC DILAUDID DIAZEPAM* DESIPRAMINE 6-MAM 25I-NBOMe THC* PCP METHYLONE METHCATHINONE MEPHEDRONE MDPV MDMA MDEA MDA LSD BENZOYLECGONINE a-PVP o
ILLICITS o o o o o o o o o o o °
CBD METHADONE LYRICA LORCET LORTAB LORAZEPAM KLONOPIN KETAMINE KADIAN IMIPRAMINE HYDROMORPHONE HYDROCODONE (HEROIN)* OXYMORPHONE OXYCODONE HYDROMORPHONE HYDROCODONE DESOMORPHINE DIHROCODEINE BUPRENORPHINE* MORPHINE CODEINE MEPROBAMATE CARISPRODOL o o o * FPO FOR AFFIXED LABEL
OPIODS (SEMI-SYN) OPIODS (NATURAL) MUSCLE RELAXANTS o o o o o o o o o o o 1001 1001
RESTORIL PERCOCET OXYCONTIN OXYCODONE OPANA NUCYNTA NORTRIPTYLINE NORCO NEURONTIN MS CONTIN MORPHINE 1001 1001 PHENTERMINE COTININE KETAMINE DEXTROMETHORPHAN ZOLPIDEM* HYPNOTIC TAPENTADOL TRAMADOL ANALGESICS METHADONE* NALOXONE MEPERIDINE FENTANYL* *Includes Metabolite o o o o o o o o o o o o o o
XANAX VICODIN VALIUM ULTRAM #3 TYLENOL TRAMADOL* TEMAZEPAM SUBOXONE SOMA ROXICODONE MISCELLANEOUS DRUGS NON-BENZODIAZEPINE NON-OPIOID OPIODS (SYN) 1001 1001 1001 PART 2 PART
PATIENT PRESCRIBED MEDICATIONS: o ACTIQ o DESIPRAMINE o HYDROCODONE o MORPHINE o ROXICODONE o ADDERALL o DIAZEPAM* o HYDROMORPHONE o MS CONTIN o SOMA o ALPRAZOLAM* o DILAUDID o IMIPRAMINE o NEURONTIN o SUBOXONE o AMBIEN o DURAGESIC o KADIAN o NORCO o TEMAZEPAM o AMITRIPTYLINE o ELAVIL o KETAMINE o NORTRIPTYLINE o TRAMADOL* o ATIVAN o EMBEDA o KLONOPIN o NUCYNTA o TYLENOL #3 o AVINZA o ENDOCET o LORAZEPAM o OPANA o ULTRAM o BUPRENEX o FENTANYL* o LORTAB o OXYCODONE o VALIUM o BUPRENORPHINE o FIORICET o LORCET o OXYCONTIN o VICODIN o BUTRANS o GABAPENTIN o LYRICA o PERCOCET o XANAX o CLONAZEPAM* o GRALISE o METHADONE o RESTORIL
TO RE-ORDER CALL RITE-PRINT 718/384-4288 RITE-PRINT CALL TO RE-ORDER ALLIANCE DRUG PANEL (SEE BELOW)
o ALCOHOL o BARBITURATES o ILLICITS o MUSCLE RELAXANTS o OPIODS (SYN) ETHANOL PHENOBARBITAL 6-MAM (HEROIN)* CARISPRODOL FENTANYL* BUTABARBITAL a-PVP MEPROBAMATE MEPERIDINE o AMPHETAMINES SECOBARBITAL BENZOYLECGONINE NALOXONE AMPHETAMINE PENTOBARBITAL LSD o OPIODS (NATURAL) METHADONE* METHAMPHETAMINE BUTALBITAL MDA CODEINE METHYLPHENEDATE MDEA MORPHINE o NON-OPIOID o BENZODIAZEPINES MDMA ANALGESICS o OPIODS (SEMI-SYN) o ANTICONVULSIVES ALPRAZOLAM* MDPV TRAMADOL BUPRENORPHINE* GABAPENTIN CLONAZEPAM* MEPHEDRONE TAPENTADOL DIHROCODEINE PREGABALIN DIAZEPAM METHCATHINONE DESOMORPHINE o NON-BENZODIAZEPINE FLUNITRAZEPAM* METHYLONE HYDROCODONE HYPNOTIC o ANTIDEPRESSANTS FLURAZEPAM* PCP HYDROMORPHONE ZOLPIDEM* AMITRIPTYLINE LORAZEPAM THC* OXYCODONE DOXEPIN OXAZEPAM CBD ° OXYMORPHONE o MISCELLANEOUS DRUGS IMIPRIMINE TEMAZEPAM 25I-NBOMe DEXTROMETHORPHAN NORTRIPTYLINE TRIAZOLAM* KETAMINE DESIPRAMINE COTININE PHENTERMINE
Additional Requested Drugs: *Includes Metabolite 1001 F10.1 - F10.99 Alcohol related disorders F11.10 - F11.99 Opioid related disorders F11.12 - F12.99 Cannabis related disorders F13.10 - F13.99 Sedative, hypnotic, anxiolytic related disorders F14.10 - F14.99 Cocaine related disorders BACKER ALL PARTS F15.10 - F15.99 Other stimulant related disorders F16.10 - F16.99 Hallucinogen related disorders F19.10 - F19.99 Other psychoactive substance related disorders G89.4 Chronic pain syndrome M54.5 Low back pain R30.20 Coma, unspecified R40.4 Transient alteration of awareness R40.3 Persistent vegetative state R40.0 Somnolence R40.1 Stupor R40.2 Dizziness and giddiness R26.0 - R26.9 Abnormalities of gait R27.0 - R27.9 Lack of coordination R00.0 Tachycardia, unspecified R06.4 Hyperventilation Z79.891 Long-term (current) use of other opiate analgesic Z79.899 Long-term (current) use of other medications