List Of Over The Counter Medications For School Protocol (Page 2 of 2) in pdf

List Of Over The Counter Medications For School Protocol Page 2

Hydrocortisone Cream

Itch relief for skin rashes, poison ivy, oak, or

sumac. Dosing per label.

Ibuprofen

Fever above 100, headache, toothache,

menstrual cramps, sore throat, muscle pain,

earache.

Note will be given to student to take home.

Dosing per label instructions and weight.

Menstrual Relief Tablets (Midol)

Temporary relief of cramping and bloating

associated with menstrual period.

Only given to menstruating females.

Dosing per label.

Orajel

Temporary relief of toothaches and other minor

irritation of mouth. Dosing per label.

Pepto-Bismol

Stomach upset, nausea. Dosing per label.

Thera Tears

Temporary relief of dryness and pain in eyes.

Dosing per label.

Throat lozenges/Cough drops

Temporary relief of cough, pain associated with

sore throat, sore mouth. Dosing per label.

I authorize the above medications to be administered to my

student _______________________________________ per the above protocols. I have drawn

a line through any medications that I do not wish to be given. This consent will be renewed

annually and may be modified/withdrawn at any time.

Parent/Guardian Signature

Date

School Nurse Signature

Date

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List Of Over The Counter Medications For School Protocol Page 2