Inspection: No obvious erythema, swelling, or deformity of bilateral knees. Mild quadriceps atrophy noted bilaterally.
Hepatic Function Panel: No results found for: TP, ALKPHOS, AST, ALT, ALBUMIN, BILITOT, BILIDIR    Cultures:   Blood Cultures: Urine Culture: This component does not exist; URCXSCRN    C. DIFFICILE
Palpation: Tenderness to palpation over medial joint line of left knee. No warmth or effusions.
===>
Inspection: No obvious erythema, swelling, or deformity of bilateral knees. Mild quadriceps atrophy noted bilaterally.
No results found for: **, *******, AST, ALT, ALBUMIN, *******, *******    Cultures:   Blood Cultures:       Urine Culture: This component does not exist; ********    *. DIFFICILE
Palpation: Tenderness to palpation over medial joint line of left knee. No warmth or effusions.

Dexketoprofen 25 mg: Take 1 tablet by mouth every 8 hours as needed for pain. Dispense #20. Counseled on potential for GI upset and advised to take with food. Not available in all regions.
Tapentadol ER 50 mg: Take 1 tablet by mouth every 12 hours. Dispense #28. Counseled on potential for drowsiness, dizziness, and constipation. Advised against alcohol consumption and driving until effects are known.
Medications Adjusted/Discontinued:
Flupirtine 100 mg PO PRN (previously used for chronic pain, patient ran out): Discontinued due to liver toxicity concerns and initiation of Tapentadol ER.
Tizanidine 2 mg PO PRN (previously used for muscle spasms, patient found it too sedating): Not re-prescribed.
===>
Dexketoprofen 25 mg: Take 1 tablet by mouth every 8 hours as needed for pain. Dispense #20. Counseled on potential for GI upset and advised to take with food. Not available in all regions.
********** ** 50 mg: Take 1 tablet by mouth every 12 hours. Dispense #28. Counseled on potential for drowsiness, dizziness, and constipation. Advised against alcohol consumption and driving until effects are known.
Medications Adjusted/Discontinued:
********** 100 mg PO PRN (previously used for chronic pain, patient ran out): Discontinued due to liver toxicity concerns and initiation ** ********** **.
Tizanidine 2 mg PO PRN (previously used for muscle spasms, patient found it too sedating): Not re-prescribed.