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o Ethanol Level, Blood Therapeutic Drug Monitoring Dose route o Oral o IV o Other Dose Regimen ____________________________ How Long on Current Regimen?______________ Date of Last Dose or IV Complete _____________ Time of Last Dose or IV Complete _____________ Date of Next Dose or IV Start ________________ Time of Next Dose or IV Start ________________ o Carbamazepine o Phenytoin, Total o Cyclosporine pre dose o Sirolimus o Cyclosporine 2 h post o Tacrolimus o Digoxin o Theophylline o丙戊酸锂o苯巴比妥o其他________抗生素gentamicin o to o per o of tof of to o o o o o o tobramycin o pre o per o of of of to o o o o o其他万古霉素o其他
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