Nombre Comercial (Si aplica) Analgsicos Acido Mefenamico Generico Anestenka Aspirina Beserol Forte B-Tres-Dolo Celeco Celecoxib

Complejo B- MEHECO CVS Extra Strength Pain Relief Diclofenac Diclowal 75 Dolomef Ergovidom Etigesic Impedil Migra Dorixina Politres Forte Sertal Compuesto Sertal Compuesto Tylenol Extra Fuerte Alergias Cetirizina Dimenin Dimenhidrinato Generico Fendramin Hidrocortisona Loratadina Meticorten Prednisona

Medicamento

Acido Mefenamico Lidocaina Acido Acetil Saliclico Paracetamol/Carisprodol Ibuprofeno/Complejo B Celecoxib Celecoxib Complejo B Acetaminofen Diclofenac Sodico Diclofenac Sodico Acido Mefenamico Maleato de Ergonovina Tramadol Clorhidrato Celecoxib Clonixinato de Lisina 125/Ergotamina Complejo B/Ibuprofen Propinox Clorhidrato/Clonixinato de Lisina Propinox Clorhidrato/Clonixinato de Lisina Acetaminofen

Cetirizina Dimenhidrinato Dimenhidrinato Difenhidramina Hidrocortisona Loratadina Prednisona Prednisona

Antibiticos/Antivirales

Aciclovir Albendazol Amplibiotic Amplibiotic-Uro Azitromicina Cepha Plus Ciprofloxacina Calox Ciproglen-500 Clavulin C/12 Doxiciclina Levo Levo Levobiotic Metronidazol Monodoxin Antigripales

Aciclovir Albendazol Ciprofloxacina Ciprofloxacina/Fenazopiridina Azitromicina Cefadroxilo/Ambroxol Ciprofloxacina Ciprofloxacina Amoxicilina/Acido Clavulanico Doxiciclina Levofloxacina Levofloxacina Levofloxacina Metronidazol Doxiciclina

Antiflu-Des Forte Sinutab NS Cardiovascular Atenolol DF Captoprilan Clopidogrel Furosemida Lasix Dermatolgico Clotrimazol ovulos Clozol Dermasten crema Fucidine Johnsons Baby Vaseline Lactibon Momet compuesto crema Nitrofurazona crema0.2% Secalia Thrombocid

Acetaminofen/Amantadina/Fenilefrina/Clorfeniramina Paracetamol/Pseudoefedrina

Atenolol Captopril Clopidogrel Bisulfato Furosemida Furosemida

Clotrimazol Clotrimazol Permetrina al 5% Acido Fusidico Vaselina Mometasona/Gentamicina Nitrofurazona Tolnaftato Pentosano/Timol

Gastrointestinal CVS Heartburn Relief Colofin Digestomen Famopep Gelnacid-SM Maalox Plus Pepto Bismol Primperan Ranicol Tums Omeprazol Generico Prodom Neuro/Psych Fenitoina Fluoxetina Relax Relax Otorrino/Oftalmo Oto-Furan Otofull Tobrimin Visfloxin Visimax Primeros Auxilios Nitrofurazona/Neomicina/Dexametasona NeomicinaPolimixinaB/Tetracaina/Clotrimazol Tobramicina Ciprofloxacina Tetrahidrozolina MgOH/AlOH Beclometasona/Clioquinol/Heparina/Lidocaina Enzimas Digestivas Famotidina MgOH/AlOH/Simeticona AlOH/MgOH/Simeticona Salicilato de Bismuto Metoclopramida Ranitidina Carbonato Calcio Omeprazol Loperamida

Fenitoina Fluoxetina Buspirona Buspirona

Adhesive bandages Adhesive bandages Adrenalina Aid Zinc Agua Esteril Agua Oxigenada Alcohol Isopropilico Algodon Planchado Algodon Atropina Bajante de suero Bisturi con mango Cateter 18 Cateter 20 Cateter 22 Curitas Redondas Depresores Linguales Clorhexidina Dex-Litos Dexametasona Dextrosa al 50% Gasas Esteriles Gasas Esteriles Blue Cross Gasa No esteril Gasa No esteril Guantes Esteriles Nmero 8 Guantes No Esteriles Hilo Seda Hilo Seda Hilo Prolene Hilo Prolene Hilo Nylon Hilo Nylon Hilo Nylon Hilo Vicryl Hilo Vicryl Hilo Vicryl Hilo Vicryl Jeringas de 1 ml. Jeringas de 3 ml. Jeringas de 5 ml. Jeringas de 10 ml. Jeringas de 20 ml. Lidocaina al 2% sin epinefrina Lubrigel Maripositas 21 G Maripositas 25 G Roxicaina 2% con epinefrina Seda Adhesiva Solucin Harlac NF Solucin Indosal 0.9 Solucin Indosal 0.9 Solucin Indodexal 5-0.9 Sonda Foley 16 Sonda Nasogastrica

Long lasting bandages Sterile assorted size Adrenalina Oxido de Zinc Agua para inyeccin Peroxido de Hidrogeno Alcohol Isopropilico Algodon Algodon Atropina

Clorhexidina Sales Rehidratacin Oral Dexametasona

Gasa Gasa 2MM Guantes No Esteriles Seda Seda Polipropileno Polipropileno Nylon Nylon Nylon Poliglactina Poliglactina Poliglactina Poliglactina

Lidocaina Personal Lubricant

Roxicaina al 2% Seda Adhesiva Solucin lactato de ringer Solucin Salina 0.9% Solucin Salina 0.9% Dextrosa 5%/Sol. Salina 0.9%

Tweezers Vendajes Elasticos Vendajes Elasticos Respiratorio Ambroxol MK Jarabe Aminofilina Fluimucil Oral Mucosolvan Salbutamol Generico Salcrymol

Ambroxol Clorhidrato Aminofilina Acetilcisteina Ambroxol Clorhidrato Salbutamol Salbutamol

Dosis/Presentacin

Cantidad

Tabletas 500 mg Gotas Tabletas 500mg Tabletas 500/200 mg Tabletas 400/50/100/100 Capsulas 200 mg Capsulas 200 mg Solucion Inyectable 10 ml Capsulas 500 mg Tabletas 100 mg Ampollas Inyectables Tabletas 500 mg Tabletas 0.2 mg Tabletas 50 mg Capsulas 400 mg Tabletas 125/1mg Tabletas 1000/50/50/400 mg Comprimidos 10/125 mg Ampollas Inyectables Tabletas 500 mg

4 1 12 1 12 11 20 2 41 0 22 4 15 13 1 8 3 17 1 24

Tabletas 10 mg Tabletas 50 mg Tabletas 50 mg Ampolla inyectable 20 mg Ampolla inyectable 100 mg Tabletas 10 mg Tabletas 5 mg Tabletas 5 mg

40 17 90 3 5 0 0 0

Tabletas 400 mg Tabletas 400 mg Tabletas 500 mg Tabletas 500/100 mg Tabletas 500 mg Tabletas 500/30 mg Tabletas 500 mg Tabletas 500 mg Tabletas 875/125 mg Tabletas 100 mg Tabletas 750 mg Tabletas 500 mg Tabletas 750 mg Tabletas 500 mg Tabletas 100 mg

36 18 6 2 44 2 16 2 10 20 21 2 2 51 18

Tabletas 500/50/5//2 mg Tabletas 500/30 mg

0 126

Tabletas 100 mg Tabletas 50 mg Tabletas 75 mg Ampolla Inyectable Ampolla Inyectable

6 28 10 4 2

Ovulos Gotas Topicas Crema de 10 gramos Crema Jabon Antiseptico en Pasta crema topica 15 gramos Crema Polvo Pomada

10 1 1 0 0 2 0 2 1 1

Tabletas 105/160 mg Supositorios Capsulas Tabletas 20 mg Suspension 200/200/25 mg Suspension 360 ml Suspension 118 ml Tabletas 10 mg Tabletas 300 mg Tabletas 500 mg Capsulas 20 mg Tabletas 2 mg

~90 7 2 6 1 1 1 9 13 75 20 10

Tabletas 100 mg Tabletas 20 mg Tabletas 5 mg Tabletas 10 mg

20 20 10 20

Gotas Oticas Gotas Oticas Gotas Oftalmicas Gotas Oftalmicas Gotas Oftalmicas

1 1 1 1 1

Caja de 100 curitas Caja Amp. 1ml. Ungento 30 g Ampolla 5ml Frasco 120 ml Alcohol Rollo Paquete Ampollas

Jabon Liquido Sobres Ampolla inyectable 4 mg Ampolla Paquete de 10 Sobre con una gaza Rollo 3 Pulgadas Rollo 2 Pulgadas Caja de 100 2-0 3-0 3-0 4-0 2-0 3-0 4-0 1-0 3-0 4-0 5-0

Ampolla de 50 ml. 1 Tubo 3 onzas

Ampollas de 1.8 ml. Rollo 1 litro 1 Litro 500 ml 1 Litro

54 26 10 1 10 4 1 1 0 2 4 1 5 4 6 22 6 1 18 2 13 0 0 0 0 4 1 1 1 1 3 1 2 1 1 2 1 1 2 1 8 7 2 1 1 3 1 7 2 2 1 1 1 1 1

Rollo 6 pulgadas 4 pulgadas

1 2 2

Jarabe 15mg/5 ml 100 ml Ampolla inyectable Comprimido Efervescente 600mg 15mg/2 ml Inyectable Jarabe 120 ml Aerosol 250 dosis

1 4 4 2 1 1

Nombre Comercial (Si aplica) Parche de Ojo Salcrymol Gentamicina Balsamin Momet Compuesto OFF Deep Woods Glucamina Harlac NF Caladryl Clear Caladryl Tylenol Fendramin Termometro

Medicamento

Dosis/Presentacin

Salbutamol Gentamicina Oxido de Zinc Mometasona/Gentamicina DEET Glibenclamida Solucin Lactato de Ringer

Acetaminofen Difenhidramina

Bomba Inhalatoria Gotas Oftalmicas Crema Crema Spray Tabletas 5 mg 1000 ml Locion Locion 1 frasco 24 tabletas Ampolla IV

Cantidad 2 2 2 2 1 2 20 2 1 1 1 4 4

Persona Luis Arias Soto Kelvinson Moreno Vierka Dr. Morel

Radio Asignado 81 83 77 82 78 84

Celular 8098506681 8294488383 8293445636 8093233304 8296051470 8096274892

Flota 8498752639

8498752646 8498752638

Para ordenar: Item Sam Splint 36" Beserol Forte Diclofenac Tabs Fendramin IV Fucidin o antibiotico topico Vaselina Epinefrina Alcohol Dexametasona Jeringas 10 ml Jeringas 3 ml Vendaje Elastico 3" Qty 2 10 10 2 1 1 2 1 2 5 10 2

Note http://www.amazon.com/SAM-Splint-36-Orange-Blue/dp/B001J5H92C/ref=pd_

Local: Note

Item Qty m/SAM-Splint-36-Orange-Blue/dp/B001J5H92C/ref=pd_sim_sg_2

MALARIA PREVENTION MEDICATION

Drug: Form: Dosage: Start date: End date: Number of days: Number of days to take before trip: Number of days to take after trip: Total tabs per person: Cost per 60 pills: One prescription required per person

Malarone Tablet 1 tab QD 2/8/2012 3/18/2012 40 2 7 49 471

(atovaquone/proguanil)

(Walgreens)

Drug: Form: Dosage: # weeks: Total tabs per person: Total cost:

Fosfato de cloroquina 250 mg Tablet 2 tab same day each week 17 34 406.3 DOP

$11.95

DOP

Chloroquine Dosage and Administration The dosage of Chloroquine phosphate is often expressed in terms of equivalent Chloroquine base. Each 250 mg tablet of Chloroquine phosphate contains the equivalent of 150 mg Chloroquine base. In infants and children the dosage is preferably calculated by body weight. Malaria: Suppression - Adult Dose: 500 mg (= 300 mg base) on exactly the same day of each week. Pediatric Dose: The weekly suppressive dosage is 5 mg calculated as base, per kg of body weight, but should not exceed the adult dose regardless of weight.

If circumstances permit, suppressive therapy should begin two weeks prior to exposure. However, failing this in adults, an initial double (loading) dose of 1 g (= 600 mg base), or in children 10 mg base/kg may be taken in two divided doses, six hours apart. The suppressive therapy should be continued for eight weeks after leaving the endemic area.

Name R. Heath Luman Alicia Ralero Richard Weber Dan Barger Juan Francisco Perez Quirico Javier Cano Marina Capra Paula Chimicz Omar Reyes Joan Jos Gmez G. Kevin Hodder Juan Bobea Ionela Vasquez Michaela Machacex Carlos D. Martinez Yankeury Liriano Bernarda Morel Polanco Yessica Medina Vera de la Cruz Daysi K. Acosta Patricio Paris Elizabeth M. Gonzalez P

Date of Birth

Emergency Contact

Sex M F M M M M F F M M M M F F M M F F F F M F

Katrina Mills Roger Rojas Riley Crapper "Carolina" Lucia Gutierrez "Maga" Alberto Magallon

Jeremy Verhoest Moises Torres

Wilson Taveras

Rich Miller 849-8752591, Nick Mills 30/05/1973 +61403786691 Cristina Calvo +5068833544 Alix Crapper 21/01/1986 +6785528225 Romain Dalban 26/08/1986 8098825467 Esther Magallon 25/09/1966 8099048740 Caroline 8093873553, Luz 8298417872, 4/4/1980 Federico 8095432289 Elizabeth Torres 26/02/1981 8095335991 Juana Tavares 8298836262, 12/18/1983 8095710500

F M M F M

M M

Richard Miller Ricky Lough Rane Erken

Kirsten Miller 5/4/1971 +61438239952 11/17/1986 Mickey Lough Karin Erken 1/4/1980 +61754999499

M M M

Camilo Widmaier Jose Hidalgo Elisa Abreu DLS

Rodrigo Montealegre Victor Luis Grulln

Alberto Matos Yanina Beccaria Pascual Acosta Juan Donovan Irvin Bueno Ismael Herrera Contestants Aaron Michael Chase Aaron Twigg

Silvia Lissabeth Alonso 4/21/1960 movil: 829-885-3297 829-449-0085/ 809-5325/28/1982 6146 809.805.4139, Julizza 4/11/1984 Abreu (Sister) Father 809-980-8080, Mother 809-890-2790 8/3/1986 809-582-9506, 829-3406/21/1977 0045 Amado Matos 809-5456777 Laura Nuez 8099/5/1988 757-0525 5/16/1978

M M F

M M

2/10/1988

M F M M M M M M

10/16/1983 Karen Twigg 3/17/1982 302.898.4964

Don & Sophia Pucek 501.455.1372 (home) 501.993.1051 (moms mobile) Ali Leitza Anand Reddy Ben Clark Bryan Mckelvy 5/17/1978 Ravi Reddy 630-4561/29/1982 1831 11/10/1984 Lois Mckelvy 386-2162/12/1982 9168 F M M M

Christian Seklecki

Darwin Zook Eucina Luks Francisco Arriola

Jack McMahon 706-2844/24/1977 2624 M Douglas Zook- 617-5362955 Mary Zook- 857753-1295 M 11/4/1989 Kasey Luks 5109621172 F 10/3/1980 M Mela Hughes 925-4139/22/1986 5686 Robert Holmes (Dad) 12/2/1982 cell: 805-712-8527 Carol Gillund 251 232 10/13/1988 1683

Jason Ewell Jason Holmes Jenna Gillund

M M F

Jennifer Blatt Jesse Wilson Ken Barrington Leo Borriello

Tobi Blatt ( Mother) 2158/23/1984 605-2809 / 484-784-5415 3/2/1979 AR Barrington (786)4177/11/1978 7999 1/21/1985

F M M M

Melissa Alatorre Michelle Sacco

4/22/1989 Jennifer Ehmann 70610/17/1985 346-1708

F F

Michael Sweet

Mom Patricia Sweet 714-916-7679 sweetpsalm1835@aol.co m, Dad John Sweet 714-916-7671 Johnsweet4031@gmail.c om, Sister Tricia Sweet 310-409-9904 jayde.donovan@me.com M

Natalie Korzon

Madelynn Korzon 7349/25/1987 646-3196

Quaison Dodd Ryan Smith Shauna Leann Tackett 3/18/1985 3/21/1983

Stephanie Turek Summer Mack Tara Locke Tim Parrish

10/26/1988 7/22/1979 2/21/1986 10/21/1979

Dinella Dodd (Mom) 203627-0293 Horace Dodd (Dadd) 804-349-1458 M Prescott Smith 530-5197025 M Kathy Biggs 559-7907706 F Susan Turek (mother) 216-408-7282 or 440-8711469 F Sallie Mack 321-7202221 F Susan Locke (847) 8008344 F Sherry Parrish 608-8374502 M

Vanessa F. Ramirez Yanina Beccaria

Belinda Ramirez 602-2955/10/1981 1475 F 5/16/1978 F

Blood Type Unknown O+ O+ A O+ BA+ O+ A+ B+ Unknown B+ A+ Unknown O+ O+ Unknown Unknown A+ O+ AB + Unknown

Medical Condition Allergy None None None None None None None None None None None Asma Controlada Operacion hace 2 meses None None None None None Asma Controlada None None None Pregnant 27 weeks EDD 28/04/2012; Varicosity of Round Ligament None Previous Malaria None None Grass/Pollen/Etc. None Fine Red Wine None Dust Lactose/ Coliflower None None None Bee/Wasp Stings None None None None None None None Penicilina Animales/Levofloxacina Crustceos None None

Reaction Itchy/Swollen Eyes, etc. None Hives, Respiratory Difficulty None Runny Nose/Congestion Diarrea/Colitis None None None Rash/Dizziness None None None None None None None Not described Alergia en Piel, Ojos, ataque de asma Not described None None

O+ Unknown Unknown AO+

None None None Camarones y Mariscos, Picaduras de Avispas None

None None None None Described None

B+ O+

None None

None None

None None

O+

O+ A+ Unknown

None None Dextrocardia, Harrington Rods (for scoliosis), Had dengue twice None None None None Penicilina

None

None None Mild Rash

A+ B+ A+

None None None

None None None

None None None

B+ O-

None None

None Penicilina

None None Described

B+ A+ A+ A+ Unknown O+ A+ Unknown

None None None None None None None None

None None None None None None None None

None None None None None None None

Unknown Unknown Unknown O+

Anemic None None None

Mosquitoes None None None

(On occasion) my bites seem to look a little larger than normalThis is not a diagnosed allergy but rather an awareness. None None None

B+

Sleepiness sometimes, slight anxiety

Swelling of the skin, need epiI might be allergic to bees pen

Unknown A+ Unknown

None None None

None None None

None None None Throat tightens, will vomit if enough is ingested. Only an issue if ingested. None None Adverse, hyperactivity, hallucinations/Scratchy throat/Hives for weeks/No reaction, does not work. Advil only./Hives None None None

O+ Unknown Unknown

Asthma None None

Peanut None None

O+ Unknown Unknown A

None None None None

Codeine; Calamari; Eggplant; Tylenol; Dove Deodorant None None None

Unknown Unknown

tendonitis None

None Bacitracin (found in triple antibiotic ointment)

None Rash

A+

None

Penicillin, Seasonal allergies

Bad reaction as a child

O+

Knee Tendonitis

Straight Milk

Can have some dairy but drinking milk just makes me feel nauseas

AB Unknown Unknown

None None None

None Pollen and Grass Sephora Lip gloss

None Stuffy Noise and Itchy eyes Swelling, bleeding

O+ OO+ Unknown

None

None

None None Short of breath None

None None Hypothyroid/Rosace a Penicillin None None Collapsed lung in 2000, Asthma (as a child) Cant take Vicodin None None

Unknown A+

Vomits shortly after taking None

Meds Zyrtec None None None None None None None None Antiallergy meds None None None None None None None None Buventol None None None

Dose 1 Pill/Day None None None None None None None None 2 pills None None None None None None None None

Frequency PRN None None None None None None None None PRN None None None None None None None None Hasta 2x8

None None

None None

None None None None None

None None None None None

None None None None None

None None

None None

None None

None

None

None

None None None

None None None

None None None

None None None

None None None

None None None

None None

None None

None None

None None None None None None None B12 shots - 1 syringe (not sure of the amount) - 1 2 weekly - Anemia Informed by the doctor/nurse associated with this showhave received a B12 shot since and was told that these shots can be administered up to 2 times a week if desired. Still deciding how often I will self-medicate.

None None None None None None None None

None None None None None None None None

None None None

None None None

None None None

Citalopram 20mg 1/day (I can go for several days without any medicine); Alprazolam 1mg 1 every 3 days; Trazadone 100mg nightly; Nasal Decongestant 60mg/day during allergies; benadryl 1 per day during allergies None

None

None None None

None None None

None None None

Inhaler - rare, asthma a non issue None None None None None

None None None

Nuvaring/Advil None None None Ortho Tri-Cyclen Lo 1pill/daily; Ibuprofen 600mg 1 pill 3x daily when pain occurs

0.120mg/4 Monthly/As 00mg needed None None None none None None

None None None

None None

Tylenol PM, Benadryl

3x-5x week

Levofloxacin/Flucon 500mg/100 1 Daily/10 azole mg days

None

None

None when needed 1 daily/2 daily

Zyrtec 1 pill Phentermine/Aciclo 1pill/1 vir tablet

None None Armour/Adoxa None

None

None

None None 0.5gr(30M G)/150MG 1 daily None None

Birth control None

one pill None

once a day None

Notes

En caso de picada, debo tomar 2 pastillas antialergicas de inmediato. Siempre trato de andar con pastillas encimas.

Operacin Hernia Inguinal, ninguna medicacin

No soy muy buena nadando, puedo bollar mucho, es un poco de fobia a profundidades. En otro aspecto puedo manejar cualquier vehculo y montar caballos :-)

Swimming: 14 small laps in 5 min ? (Thats what I did during swim test)

Strong swimming level Good swimming level

Swimming Proficient maybe not the best swimmer but can breaststroke for long periods of time if I become tired during freestyle/front crawl. Swimming: Probably like 4 on 1-10 scale. I can swim but I get tired and have to back stroke after a little bit

Contacts:Yes (BC8.8,DIA14.0,D-1.00) both eyes ; Swimming: Strong

Can swim 1/2 mile in 24 minutes.

Not filled out Swimming: Good Swimming: Decent

Strong swimmer, freestyle. Some difficulty treading water for long periods of time. "Sink if not moving around." Swimming: Strong Not filled out

Swimming: A step up from begginer Swimming: Short Distance Good, long distance Below average Swimming: Good Swimming: Medium High.I swim 500 yards 5 days out of the week (Free, Breast, Butterfly)

Eye glasses :Only worn at home; contacts: Yes, left eye -1.75 and right eye -1.00, Acuvue Oasys; swimming: average Strong swimmer

Not filled out

Antibiotics for strep. Will be done by 2/17 ; Strong Swimmer

Not filled out Swimming: Excellent Not filled out

Swimming: Very strong Swimming: Expert Swimming: Intermediate Swimming: Pretty decent

Not filled out 14 small laps in 5 min ? (Thats what I did during swim test)