Caregiver Interview Prep Guide

Appendix E.5 Caregiver Interview Prep Guide.doc

The National Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) Study

Caregiver Interview Prep Guide

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Appendix E.5 Caregiver Interview Prep Guide


Caregiver Interview

Participant Preparatory Guide


During the interview you will be asked questions about your health before, during, and after your pregnancy with your child, and about the health of your child after birth. For example, we will be asking you about some conditions you and your child might have had, medications you and your child might have taken, and other treatments and procedures you and your child might have undergone. We will also be asking a few questions about your child’s biological father.


Because we know that it might be hard to remember certain events and the names of certain medications and treatments that you and your child might have taken, we have made this Preparatory Guide to help you remember such things. The interviewer will ask you to look at the lists in this guide in case you cannot remember. The interviewer will tell you which list to look at to help you answer a question. The lists do not include all conditions, medications, and treatments. Please tell the interviewer if you or your child were diagnosed with a condition, took a medication, or had a treatment that is not on one of the lists.


Please try to have this guide handy during your interview. The interview will go much faster if you are able to refer to it during the interview. It may take as long as two hours to go through the interview if you do not have it handy.


Some of the questions in the interview refer to the time period three months before pregnancy through the end of breastfeeding (if you breastfed). On the next page is a Pregnancy Reference Form to help you remember the dates before, during, and after your pregnancy. Please try to remember your expected due date and the number of months you breastfed before the interview. You do not need to do anything with this form before the interview. The interviewer will talk with you about how to fill it out.



C HILD’S NAME: PREGNANCY REFERENCE FORM





START DATE








END DATE




LINE



Month

Day

Year

to

Month

Day

Year

-3

3 Months PRE-pregnancy (-3)








to




-2

2 Months PRE-pregnancy (-2)







to




-1

1 Month PRE-pregnancy (-1)







to




1

MONTH 1 of pregnancy (1)







to




2

MONTH 2 of pregnancy (2)







to




3

MONTH 3 of pregnancy (3)







to




4

MONTH 4 of pregnancy (4)







to




5

MONTH 5 of pregnancy (5)







to




6

MONTH 6 of pregnancy (6)







to




7

MONTH 7 of pregnancy (7)







to




8

MONTH 8 of pregnancy (8)







to




9

MONTH 9 of pregnancy (9)







to




10

MONTH 10 of pregnancy (EDC) (10)




to




DOB

Date of BIRTH









BF

# of days/ weeks/months breastfed








C HILD’S NAME: PREGNANCY REFERENCE FORM





START DATE








END DATE




LINE



Month

Day

Year

to

Month

Day

Year

-3

3 Months PRE-pregnancy (-3)








to




-2

2 Months PRE-pregnancy (-2)







to




-1

1 Month PRE-pregnancy (-1)







to




1

MONTH 1 of pregnancy (1)







to




2

MONTH 2 of pregnancy (2)







to




3

MONTH 3 of pregnancy (3)







to




4

MONTH 4 of pregnancy (4)







to




5

MONTH 5 of pregnancy (5)







to




6

MONTH 6 of pregnancy (6)







to




7

MONTH 7 of pregnancy (7)







to




8

MONTH 8 of pregnancy (8)







to




9

MONTH 9 of pregnancy (9)







to




10

MONTH 10 of pregnancy (EDC) (10)




to




DOB

Date of BIRTH









BF

# of days/ weeks/months breastfed








Table of Contents

LIST 1: Diagnosis from health care provider 6

LIST 2: Oral contraceptives 7

LIST 3: Other methods of contraception 7

LIST 4a: Fertility medications taken by men 8

LIST 4b: Medication taken for prevention of miscarriage 9

LIST 4c: Fertility medications taken by women 10

LIST 5: Fertility procedures 12

LIST 6: Major reproductive and perinatal infections 12

LIST 7a: Antibiotics/antiviral/antifungal medications 13

LIST 7b: Pain medications/fever reducers/muscle relaxants 14

LIST 7c: Over-the-counter cold/flu/allergy medications 15

LIST 7d: Other allergy medications 15

LIST 7e: Diabetes medications 16

LIST 7f: Seizure medications 16

LIST 7g: Anti-depressants/anti-anxiety/psychotropic medications 17

LIST 7h: High blood pressure medications 18

LIST 7i: Medications/treatments for thyroid disorders 18

LIST 7j: Asthma medications 19

LIST 7k: Weight Loss Pills / Medications 20

LIST 7l: Constipation medications 20

LIST 7m: Sleep medications 21

LIST 7n: Other medications 21

LIST 7o: Herbal Medications 22

LIST 7p: Alternative Treatments for child 23

LIST 8: Autoimmune Disorders 24

LIST 9: Pregnancy Conditions 24

LIST 10: Medical conditions of child 25

LIST 11a: Antibiotics/anti-viral/anti-fungal medications for child 25

LIST 11b: Pain relief/fever reduction/cold/flu/allergy medications for child 26

LIST 11c: Anti-seizure medications for child 26

LIST 11d: Constipation medications for child 27

LIST 11e: Other medications for child 27

LIST 11f: Herbal Medications for child 28

LIST 11g: Alternative Treatments for child 29

LIST 12: Chemicals and Substances 31



LIST 1

DIAGNOSIS FROM HEALTH CARE PROVIDER

MEDICAL DIAGNOSIS

Asperger’s Syndrome

Attention Deficit Hyperactivity Disorder (ADHD) or ADD

Autism

Behavioral Problem

Bipolar disorder

Birth Defects (specify)

Cerebral Palsy

Childhood Disintegrative Disorder

Childhood-onset schizophrenia

Developmental Delay

Down Syndrome

Fragile X Syndrome

Hearing Problems

Learning Disabilities

Mental Retardation

Movement or Coordination Problems

Neurofibromotosis

Obsessive compulsive disorder

Other Developmental Problem

Pervasive Developmental Disorder Not Otherwise Specified

Reactive attachment disorder of infancy or early childhood

Reading Difficulty

Rett’s Syndrome

Seizure Disorder / Epilepsy

Self-Injuring Behavior

Sensory integration disorder

Sleep Disorder

Speech Delays

Tourette’s Disorder / Tic Disorder

Tuberous Sclerosis

Vision Problems that cannot be corrected with glasses or contact lenses



LIST 2

ORAL CONTRACEPTIVES

(including morning after pill preparations)

BRAND AND GENERIC NAMES

Alesse

Norethindrone

Brevicon

Norinyl

Demulen

Nor-Q.D

Desogen

Ortho-Cept

Estrostep

OrthoCyclen

Levlen

Ortho-Novum

Levlite

Ortho Tri-Cyclen

Levora

Ovcon

Loestrin

Ovral

Lo/Ovral

Tri-Levlen

Micronor

Tri-Norinyl

Mircette

Triphasil

Modicon

Trivora

Necon

Zovia

Nordette




LIST 3

OTHER METHODS OF CONTRACEPTION

METHOD

Birth control patch (Ortho-Evra)

Rhythm / calendar method

Condoms (male or female)

Sponge

Depo-Provera

Tubal ligation

Diaphragm / cervical cap

Vaginal ring (NuvaRing)

Intrauterine device (IUD)

Vasectomy

Jelly, foam or suppositories, or other spermicide

Withdrawal method

Norplant




LIST 4a

FERTILITY MEDICATIONS TAKEN BY MEN

MEDICATION BY TYPE

MEDICATION BY NAME

Antibiotics

Other male infertility medication

Antibiotics

Novarel

Anti-estrogen medications

Cabergoline

Bravelle

Ovidrel

Clomid

Danazol

Bromocriptine

Parlodel

Clomiphene citrate

Donocrine

Cabergoline

Pergonal

Milophene

Dostinex

Chorionic Gonadotrophin hCG

Pregnyl

Serophene

Factrel

Clomid

Profasi

Tamoxifen

Gonadorelin

Clomiphene citrate

Repronex

Hormonal injections

Leuprolide

Danazol

Serophene

Bravelle

Lupron

Donocrine

Steroid medications

Chorionic Gonadotrophin hCG

Lutrepulse

Dostinex

Synarel

Fertinex

Synarel

Factrel

Tamoxifen

Follistim

Nafarelin

Fertinex

Testosterone pill, injections or transdermal gel or patch

Follitrophin Alpha

Medicine to reduce prolactin

Follistim

Urofollitrophin

Follitrophin Beta

Bromocriptine

Follitrophin Alpha


FSH

Parlodel

Follitrophin Beta


Gonal F

Steroid medications

FSH


HCG

Testosterone pill, injections or transdermal gel or patch

Gonadorelin


Humegon


Gonal F


Menotrophins: Follicle Stimulating Hormone + Luteinizing Hormone or Interstitial Cell Stimulating Hormone


HCG



Humegon



Leuprolide


Metrodin


Lupron


Novarel


Lutrepulse


Ovidrel


Menotrophins: Follicle Stimulating Hormone + Luteinizing Hormone or Interstitial Cell Stimulating Hormone


Pergonal


Pregnyl


Profasi


Metrodin


Repronex


Milophene


Urofollitrophin


Nafarelin



LIST 4b

MEDICATION TAKEN FOR PREVENTION OF MISCARRIAGE

MEDICATION

Baby aspirin

Crinone vaginal gel

Gamma globulin

Heparin

IVIg Therapy or Immunotherapy

Progesterone

Progesterone injection or implant 

Prometrium or other progesterone capsules

Steroid treatment (specify)

Vaginal progesterone suppositories




LIST 4c

FERTILITY MEDICATIONS TAKEN BY WOMEN

MEDICATION BY TYPE

Same medications also presented in complete alphabetized list on following page

Injections or pills to stimulate your ovaries to produce eggs

Injection to trigger ovulation once your ovaries had produced eggs

Other medications

Bravelle

Chorionic Gonadotrophin hCG

Bromocriptine

Clomid

HCG

Cabaser

Clomiphene citrate

Novarel

Cabergoline

Fertinex

Ovidrel

Danazol 

Follistim

Pregnyl

Danocrine

Follitrophin Alpha

Profasi

Dostinex

Follitrophin Beta

Medication to supress your body's natural hormone production (injection or nasal spray)

Estradiol patches 

FSH

Estrace pills

Gonal F

Factrel

Humegon

Abarelix

Gonadorelin

Menotrophins: Follicle Stimulating Hormone + Luteinizing Hormone or Interstitial Cell Stimulating Hormone

Antagon

Lutrepulse

Buserelin

Parlodel

Metrodin

Cetrotide


Milophene

Deslorelin


Pergonal

Eligard


Repronex

Ganirelix


Serophene

Goserelin


Urofollitrophin

Historelin


Progesterone medication to prepare the uterine lining for pregnancy or help prevent an early pregnancy loss

Leuprolide


Lupron


Nafarelin


Crinone vaginal gel

Suprefact


Cyclogest cream

Suprecor


Microgest

Synarel


Progesterone implant

Tryptorelin 


Progesterone injection

Zoladex


Progesterone vaginal suppositories



Prometrium  



Utrogestan






LIST 4c

FERTILITY MEDICATIONS TAKEN BY WOMEN

MEDICATION BY NAME

Same medications also presented by type on previous page

Abarelix

HCG

Antagon

Historelin

Bravelle

Humegon

Bromocriptine

Leuprolide

Buserelin

Lupron

Cabaser

Lutrepulse

Cabergoline

Menotrophins: Follicle Stimulating Hormone + Luteinizing Hormone or Interstitial Cell Stimulating Hormone

Cetrotide

Metrodin

Chorionic Gonadotrophin hCG

Microgest

Clomid

Milophene

Clomiphene citrate

Nafarelin

Crinone vaginal gel

Novarel

Cyclogest cream

Ovidrel

Danazol 

Parlodel

Danocrine

Pergonal

Deslorelin

Pregnyl

Dostinex

Profasi

Eligard

Progesterone implant

Estradiol patches 

Progesterone injection

Estrace pills

Progesterone vaginal suppositories

Factrel

Prometrium  

Fertinex

Repronex

Follistim

Serophene

Follitrophin Alpha

Suprefact

Follitrophin Beta

Suprecor

FSH

Synarel

Ganirelix

Tryptorelin 

Gonadorelin

Urofollitrophin

Gonal F

Utrogestan

Goserelin

Zoladex


LIST 5

FERTILITY PROCEDURES

PROCEDURE

Artificial insemination or intrauterine insemination

Donor embryo transfer

Frozen or thawed embryo transfer

Gamete intrafallopian transfer or GIFT

In vitro fertilization or IVF with vaginal embryo transfer

Zygote intrafallopian transfer or ZIFT or pronuclear stage transfer or PROST or tubal embryo transfer or TET



LIST 6

MAJOR REPRODUCTIVE AND PERINATAL INFECTIONS

INFECTION

Bacterial vaginosis

Influenza (flu)

Candidiasis (yeast infection)

Meningitis

Chicken pox

Mononucleosis (mono)

Chlamydia

Myocarditis

Cystitis NOS

Parvovirus or Fifth disease

Cytomegalovirus

Pelvic inflammatory disease (PID)

Encephalitis

Pneumonia

Endocarditis

Pyelonephritis (kidney infection)

Endometriosis

Rubella or German measles

Fibroids

Septicemia (blood infection)

Genital herpes

Shingles

Group B streptococcal infection

Staphylococcal infection (cysts

Hepatitis A

Syphilis

Hepatitis B

Toxoplasmosis

Hepatitis C

Trichomoniasis (Trich)

Hepatitis NOS

Upper respiratory infection

HIV/AIDS

Urinary tract infection

Human papilloma virus (HPV) or genital warts or venereal warts

Vaginitis NOS



LIST 7a

MEDICATIONS: Antibiotics / Antiviral / Antifungal

MEDICATION


Achromycin

Levofloxacin

Acyclovir

Macrobid

Amoxicillin

Metronidazole

Amoxil

Minocin

Augmentin

Minocycline

Azithromycin

Mycostatin

Bactrim

Nilstat

Biaxin

Nitrofurantoin

Cefprozil

Novacet

Ceftin

Novo-Doxylin

Cefuroxime

Nystatin

Cefzil

Nystex

Cephalexin

Panmycin

Cipro

Penicillin

Ciprofloxacin

Penicillin VK

Clarithromycin

Penicillin V potassium

Cleocin

Protostat

Clindamycin

Quixin

Cofatrim

Septra

Cotrim

Sodium sulfacetamide-sulfur

Diflucan

Sulfatrim

Doxycin

Sumycin

Doxycycline

Tetracap

Doxytec

Tetracycline

Dynacin

Topicycline

EES

Trimox

E-Mycin

Valacyclovir

Erythrocin

Valtrex

Erythromycin

Veetids

Flagyl

Vibramycin

Fluconazole

Vibra-Tabs

Ilosone

Zithromax

Keflex

Zovirax

Levaquin



LIST 7b

MEDICATIONS: Pain Medications / Fever Reducers / Muscle Relaxants

MEDICATION


Acetaminophen

Motrin

Advil

Naprelan

Aleve

Naprosyn

Anaprox

Naproxen

Aspirin

Nuprin

Carisoprodol

Oxycontin

Celebrex

Oxycodone

Celecoxib

Pamprin

Cotanal

Propoxyphene

Cyclobenzaprine

Rofecoxib

Darvon

Roxicet

Excedrine Migraine

Roxycodone

Flexeril

Soma

Genpril

Tramadol

Haltran

Tylenol

Hydrocodone

Ultram

Ibuprofen

Vanadom

Medipren

Vioxx

Midol 200




LIST 7c

MEDICATIONS: Over-The-Counter Cold / Flu / Allergy Medication

MEDICATION

Afrin

Guaifenesin

Afrin original 12-hour nasal spray

Hexylresorcinol

Benadryl

Loratadine

Cepacol

Nasal Crom Allergy Prevention

Cepastat

Nyquil

Cetylpyridinium

Oxymetazoline

Chlorpheniramine maleate

Pertussin dm

Chlor-Trimeton

Pseudoephedrine HCl

Claritin

Robitussin

Clemastine fumarate

Sucrets

Cromolyn sodium

Sudafed

Dextromethorphan

Tavist-1

Dimetapp

Tylenol Flu

Diphenhydramine HCl

Vicks Sinex 12-hour nasal spray

Dristan 12-hour nasal spray




LIST 7d

MEDICATIONS: Other Allergy Medications

MEDICATION

Allegra

Cetirizine

Fexofenadine

Flonase

Fluticasone

Mometasone

Montelukast

Nasonex

Singulair

Zyrtec



LIST 7e

MEDICATIONS: Diabetes Medications

MEDICATION

Acarbose

Glucovance

Actos

Glyburide

Amaryl

Glynase

Avandia

Glyset

Chlorpropamide

Metformin hydrochloride

Diabeta

Micronase

Diabinese

Pioglitazone hydrochloride

Glimepiride

Miglitol

Glipizide

Prandin

Glucophage

Precose

Glucophage XR

Repaglinide

Glucotrol

Rosiglitazone maleate

Glucotrol XL




LIST 7f

MEDICATIONS: Seizure Medications

MEDICATION

Barbita

Luminal

Carbamazepine

Mebaral

Clonazepam

Mephobarbital

Depakene capsules

Mysoline

Depakote Tabs

Neurontin

Diazepam

Phenobarbital

Dilantin

Phenytoin

Divalproex

Primidone

Ethosuximide

Solfoton

Felbamate

Tegretol

Felbatol

Tiagabine

Gabapentin

Topamax

Gabatril

Topiramate

Klonopin

Valium

Lamictal

Valproic acid

Lamotrigine

Zarontin


LIST 7g

MEDICATIONS: Anti-Depressants / Anti-Anxiety / Psychotropic Medications

MEDICATION

Adapin

Dextrostat

Molindone

Adderall

Diazepam

Nefazodone

Alprazolam

Doxepin

Norpramin

Amitriptyline

Doxypin

Nortriptyline

Amoxapine

Effexor

Pamelor

Amphetamine

Elavil

Paroxetine

Amphetamines NOS

Endep

Paxil

Anafranil

Escitalopram oxalate

Pemoline

Asendin

Fluoxetine

Remeron

Ativan

Fluvoxamine

Ritalin

Atomoxetine

Focalin

Sertraline

Aventyl

Halcion

Serzone

Bupropion

Haldol

Sinequan

Celexa

Haloperidol

Sinequan

Chlordiazepoxide

Imipramine

Strattera

Chlorpromazine

Klonopin

Thorazine

Citalopram

Lexapro

Tofranil

Clomipramine

Librium

Trazodone

Clonazepam

Lithium

Triazolam

Concerta

Lorazepam

Valium

Cylert

Luvox

Venlafaxine

Desipramine

Metadate

Wellbutrin

Desoxyn

Methamphetamine

Xanax

Desyrel

Methylin

Zoloft

Dexedrine

Methylphenidate

Zyban

Dexmethylphenidate HCl

Mirtazapine


Dextroamphetamine

Moban




LIST 7h

MEDICATIONS: High Blood Pressure Medications

MEDICATION

Ace Inhibitor NOS

Inderal

Acupril

Isoptin

Adalat

Lisinopril

Aldomet Tablet

Lopressor

Altace

Methyldopa

Antihypertensive NOS

Metoprolol

Apresazide

Nifedipine

Apresoline

Prinivil

Atenolol

Procardia

Beta blocker NOS

Propranolol

Calan

Quinapril HC

Capoten

Ramipril

Captopril

Tenormin

Cardizem

Toprol XL

Covera

Vasotec

Dilacor

Veralan

Diltiazem HCL

Verapamil

Enalapril Maleate

Zestril

Hydralazine




LIST 7i

MEDICATIONS: Medications / Treatments For Thyroid Disorders

MEDICATION

Armour Thyroid

Liotrix

Cytomel

Radioactive iodine

I131

Synthroid

Levothroid

Surgery

Levothyroxine

Thyrolar

Levoxyl

Triostat

Liothyronine




LIST 7j

MEDICATIONS: Asthma Medications

MEDICATION

Accolate


Albuterol

Methylprednisolone

Alupent

Mometasone

Aminophylline

Montelukast

Atrovent

Nasal Crom Allergy Prevention

Beclomethasone

Nasalcrom

Beclovent

Nasonex

Beconase

Nedercromin sodium

Brethine

Oxtriphylline

Brethine

Phyllocontin

Bricanyl

Pirbuterol

Bronkometer

Prednisone

Choledyl

Primatene

Cromolyn sodium

Salmeterol

Cromolyn sodium nasal

Serevent

Deltasone

Singulair

Epinephrine

Slo-Phyllin

Flovent

Tedral

Intal

Terbutaline

Ipratropium

Theophylline

Isoetharine

Tilade

Isoproterenol

Truphylline

Isuprel

Vancenase

Levalbuterol

Vanceril

Marax

Ventolin

Maxair

Xopenex

Medrol

Zafirlukast

Metaprel

Zileuton

Metaproterenol

Zyflo



LIST 7k

MEDICATIONS: Weight-Loss Pills / Medications

MEDICATION

Acutrim

Mazindol

Phentermine

Adipex

Meridia

Phentermine resin SA

Adipost

Melfiat

Phentride

Benzphetamine

Metabolife

Phenylpropanolamine

Bontril

Obenix

Plegine

Dexatrim

Obezine

Sanorex

Didrex

Orlistat

Sibutramine

Diethylpropion

Pentercot

Tenuate

Fastin

Phendiet

Teramine

Ionanine

Phendimetrazine

Xenical

Mazanor

Phendimetrazine tartrate

Zantryl



LIST 7l

MEDICATIONS: Constipation Medications

MEDICATION: Bulk-Forming (Psyllium)

MEDICATION: Stimulants

Citrucel Metamucil

Carter’s

Fiber Choice

Correctol Magnesium Citrate

Fibercon

Doxidan

Metamucil

Dulcolax

Ultra-Fiber

Ex-Lax

MEDICATION: Herbals (Stimulants)

Fleet Laxative

Nature’s Resource

Freelax

Nature’s Way

Glycerin Suppositories

Senna

Magnesium Citrate Phillips’ Milk of Magnesia

Senokot

Phillips’ Milk of Magnesia

MEDICATION: Stool Softeners (Emollients)

MEDICATION: Lubricants

Colace

Castor Oil Mineral Oil

Peri-Colace Sof-Lax

Mineral Oil

Phillips’ Stool Softener Laxative Softgels


Sof-Lax




LIST 7m

MEDICATIONS: Sleep Medications

MEDICATION

Ambien

Dalmane

Flurazepam

Restoril

Temazepam

Zolpidem


LIST 7n

MEDICATIONS: Other Medications

MEDICATION

Accutane

Finevin

Protonix

Aciphex

Imitrex

Rabeprazole sodium

Adapalene

Isotretinoin

Ranitidine

Axelex

Lansopraxole SR

Retin-A

Axid

Maalox

Rolaids

Azelaic acid

Methotrexate

Sumatriptan

Bupropion

Misoprostol

Tagamet

Calcium carbonate

Nexium

Tazorac

Cimetidine

Nicotine Patch NOS

Tazarotene

Coumadin

Nizatidine

Treretinoin

Cytotec

Omeprazole SA

Tums

Depakene

Pantoprazole

Valproic acid

Differin

Pepcid

Warfarin

Esomeprazole magnesium

Prevacid

Zantac

Famotidine

Prilosec

Zyban



LIST 7o

MEDICATIONS: Herbal Medications

MEDICATION

Absinthe

Echinacea

Milk Thistle

Aloe

Eucalyptus

Noni

Angelica

Ephedra

Red Clover

Arnica

Feverwort

Rooibos

Belladonna

Frankincense

Saw Palmetto

Black Cohosh

Gingko

St. John’s Wort

Birch

Ginseng

Senna

Borage

Glucosamine

Southernwood

Chamomile

Horse Chestnut

Valerian

Chicory

Kava

Wormwood

Chondroitin

Licorice

Yarrow

Dong Quai

Ma Huang




LIST 7p

ALTERNATIVE TREATMENTS

TREATMENT BY TYPE Same treatments also presented by name on following page

Diets

Gastrointestinal treatments

Gluten free/casein free

Acidophilus/ mixed probiotics

Specific Carbohydrate Free

Alkaline Salts

Yeast Free

Bethanecol/ urocholine

Other elimination diet (e.g., Finegold, sugar free, others)

Epsom Salt baths

Natural and/or vitamin supplements

Enzyme aide

B6 and Magnesium (SuperNuThera)

Histamine 2 blockers – Cimetadine (Zantac)

Carnosine

Pepcid

Cod Liver Oil

Secretin

D-Cycloserine

Oxidative stress

DMG (Dimethylglycine)

Glutathione (oral, transdermal, or IV)

Fatty acids (EFA) or Omega 3 Fatty Acids

Thiamine tetrahydrofurfuryl (TTFD); Allithiamine (Transdermal TTFD)

Folic acid

Anti-infectives or immune

Grapefruit seed extract

Antibiotic therapy

Melatonin

Antifungal (anti-yeast) agents (Nystatin, Diflucan)

Methyl-B12 (oral or shot)/ Methylcobalamin (concentrated Vitamin B12) injections

Antiviral: Valtrex (for herpes); Acyclovir, Famvir, Immunovir

Tryptophan

Aqua Flora (anti yeast)

Tyrosine

Colustrum

Vitamin A (as cod liver oil)

Immunoglobulins Intravenous or Oral, BayGam

Vitamin B12

Natural anti-virals: Lauricidin, Larch araginogalactins, IP-6 (Inositol hexaphosphate), Myco-Immune

Vitamin C

Transfer factor

Vitamin Supplements (other)

Vancomycin

Chelation (for mercury)

Withhold immunization(s)

Chelators: DMSA

Antibiotic therapy

Natural chelators: alpha lipoic acid

Other


Oxytocin


Hyperbaric Oxygen (HBOT)


Chiropractic Care


Massage


Meditation


Deep breathing exercises


LIST 8

Autoimmune Disorders

DISORDER

Addison’s Disease

Hyperthyroidism

Aplastic Anemia

Irritable bowel syndrome

Ankylosing Spondylitis

Migraine Headaches

Asthma

Mixed connective tissue disease

Autoimmune hepatitis

Multiple sclerosis

Celiac Disease

Myasthenia Gravis

Crohn’s Disease

Narcolepsy

Dermatitis herpetiformis

Optic neuritis

Diabetes

Pemphigus

Use insulin

Reiter’s Syndrome

Not on insulin

Rheumatoid Arthritis

Gestational diabetes only

Scleroderma (progressive systemic sclerosis, CREST)

Eczema / Psoriasis

Sjogren’s syndrome

Giant cell arteritis

Stevens-Johnson syndrome

Graves Disease

Sydenham’s chorea

Guillain-Barre Syndrome

Systemic lupus erythematosus (SLE)

Hashimoto thyroiditis

Thrombocytopenia (immune, idiopathic)

Hemolytic Anemia

Tourette’s syndrome

Hypothyroidism

Ulcerative colitis



LIST 9

PREGNANCY CONDITIONS


CONDITION


Anemia

Incompetent cervix

Chorioamnionitis

Low blood pressure that required medical treatment

Eclampsia

Pregnancy-induced hypertension or preeclampsia

Gestational diabetes

Premature rupture of your membranes

HELLP syndrome

Pre-term or early labor

Hyperemesis

Vaginal bleeding



LIST 10

MEDICAL CONDITIONS OF CHILD

CONDITION


Chicken pox

Bacterial Meningitis

Cytomegalovirus

Viral Meningitis

Diphtheria

Mumps

Ear infection, recurrent

Parvovirus or Fifth Disease

Eczema/ Psoriasis

Pneumonia

German measles or rubella

Respiratory Syncytial Virus (RSV)

Hepatitis A

Seizure disorder/Epilepsy

Hepatitis B

Skin condition (Specify type)

Hepatitis C

Streptococcus, Group B or Group B Strep

Hepatitis NOS

Tetanus

Herpes infection

Tonsillitis

HIV

Toxoplasmosis

Lyme Disease

Tuberculosis

Measles

Urinary tract infection (UTI)




LIST 11a

MEDICATIONS FOR CHILD: Antibiotics / Anti-Viral / Anti-Fungals

MEDICATION

Acyclovir

Cotrim

Quixin

Amoxicillin/ Amoxil/ Augmentin

Diflucan

Septra/ Sulfatrim

Azithromycin

Doxycin/ Doxytec/ Doxycline

Valacyclovir

Bactrim

Fluconazole

Valtrex

Cipro / Ciprofloxacin

Levaquin

Vibramycin

Cleocin

Levofloxacin

Vibra-Tabs

Clarithromycin

Novo-Doxylin

Zithromax

Clindamycin

Penicillin

Zovirax

Cofatrim






LIST 11b

MEDICATIONS FOR CHILD: Pain Relief / Fever Reduction / Cold / Flu / Allergy Medications

MEDICATION

Acetaminophen

Dimetapp

Oxymetazoline

Advil, Children’s

Diphenhydramine HCl

Pseudoephedrine HCl

Afrin

Dristan 12-hour nasal spray

Robitussin

Benadryl

Guaifenesin

Sudafed

Chlorpheniramine maleate

Ibuprofen

Triaminic

Chlor-Trimeton

Motrin, Children’s

Tylenol, Children’s

Cromolyn sodium

Nasal Crom Allergy Prevention

Vicks Sinex 12-hour nasal spray




LIST 11c

MEDICATIONS FOR CHILD: Anti-Seizure Medications

MEDICATION

Benzodiazepine (valium)

Gabatril

Phenytoin

Carbamazepine/ Carbetrol

Ketogenic Diet

Primidone

Clonazepam

Klonopin

Solfoton

Depakene capsules

Lamictal

Tegretol

Depakote Tabs

Lamotrigine

Tiagabine

Dilantin

Luminal

Topamax

Diazepam

Mebaral

Topiramate

Divalproex

Mephobarbital

Valium

Ethosuximide

Mysoline

Valproic acid

Felbamate

Neurontin

Zonisamide

Felbatol

Phenobarbital Barbita

Zarontin

Gabapentin





LIST 11d

MEDICATIONS FOR CHILD: Medications for Constipation

MEDICATION

STIMULANT

ORAL

Fleet Suppositories

Magnesium Citrate

Dulcolax suppositories

Magnesium Hydroxide (Phillips’ Milk of Magnesia)

Senna (Senkot)

OTHER

STOOL SOFTENER (Emollient)

Glycerine Suppositories

Children’s Colace

Lactulose

Mineral oil





LIST 11e

MEDICATIONS FOR CHILD: Other Medications


Adderall/ Adderall XR

Methylin

Atomoxetine

Methylphenidate

Buproprion/ Buspar

Pemoline

Concerta

Ritalin/ Ritalin LA

Cylert

Strattera

Dexedrine/ dextroamphetamine salts

Ventolin

Dextrostat

Wellbutrin

Focalin/ Focalin XR

Xopenex

Levalbuterol

Zileuton

Metadate/ Metadate CD

Zyflo




LIST 11f

MEDICATIONS: Herbal Medications for Child

MEDICATION

Absinthe

Echinacea

Milk Thistle

Aloe

Eucalyptus

Noni

Angelica

Ephedra

Red Clover

Arnica

Feverwort

Rooibos

Belladonna

Frankincense

Saw Palmetto

Black Cohosh

Gingko

St. John’s Wort

Birch

Ginseng

Senna

Borage

Glucosamine

Southernwood

Chamomile

Horse Chestnut

Valerian

Chicory

Kava

Wormwood

Chondroitin

Licorice

Yarrow

Dong Quai

Ma Huang



LIST 11g

ALTERNATIVE TREATMENTS FOR CHILD

TREATMENT BY TYPE Same treatments also presented by name on following page

Diets

Gastrointestinal treatments

Gluten free/casein free

Acidophilus/ mixed probiotics

Specific Carbohydrate Free

Alkaline Salts

Yeast Free

Bethanecol/ urocholine

Other elimination diet (e.g., Finegold, sugar free, others)

Epsom Salt baths

Natural and/or vitamin supplements

Enzyme aide

B6 and Magnesium (SuperNuThera)

Histamine 2 blockers – Cimetadine (Zantac)

Carnosine

Pepcid

Cod Liver Oil

Secretin

D-Cycloserine

Oxidative stress

DMG (Dimethylglycine)

Glutathione (oral, transdermal, or IV)

Fatty acids (EFA) or Omega 3 Fatty Acids

Thiamine tetrahydrofurfuryl (TTFD); Allithiamine (Transdermal TTFD)

Folic acid

Anti-infectives or immune

Grapefruit seed extract

Antibiotic therapy

Melatonin

Antifungal (anti-yeast) agents (Nystatin, Diflucan)

Methyl-B12 (oral or shot)/ Methylcobalamin (concentrated Vitamin B12) injections

Antiviral: Valtrex (for herpes); Acyclovir, Famvir, Immunovir

Tryptophan

Aqua Flora (anti yeast)

Tyrosine

Colustrum

Vitamin A (as cod liver oil)

Immunoglobulins Intravenous or Oral, BayGam

Vitamin B12

Natural anti-virals: Lauricidin, Larch araginogalactins, IP-6 (Inositol hexaphosphate), Myco-Immune

Vitamin C

Transfer factor

Vitamin Supplements (other)

Vancomycin

Chelation (for mercury)

Withhold immunization(s)

Chelators: DMSA

Antibiotic therapy

Natural chelators: alpha lipoic acid

Other


Oxytocin


Hyperbaric Oxygen (HBOT)


Chiropractic Care




LIST 11g

ALTERNATIVE TREATMENTS FOR CHILD

TREATMENT BY NAME Same treatments also presented by type on previous page

Acidophilus/ mixed probiotics

Histamine 2 blockers – Cimetadine (Zantac)

Alkaline Salts

Hyperbaric Oxygen (HBOT)

Antibiotic therapy

Immunoglobulins Intravenous or Oral, BayGam

Antifungal agents (Nystatin, Diflucan)

Melatonin

Antiviral: Valtrex (for herpes); Acyclovir, Famvir, Immunovir

Methyl-B12 (oral or shot)/ Methylcobalamin (concentrated Vitamin B12) injections

Aqua Flora

Natural anti-virals: Lauricidin, Larch araginogalactins, IP-6 (Inositol hexaphosphate), Myco-Immune

B6 and Magnesium (SuperNuThera)

Natural chelators: alpha lipoic acid, vitamin C, glutathione

Bethanecol/ urocholine

Oxytocin

Carnosine

Pepcid

Chelators: DMSA, DMPS, EDTA

Secretin

Cod Liver Oil

Super-Nu Thera (see B6/mg++)

Colustrum

Transfer factor

D-Cycloserine

Thiamine tetrahydrofurfuryl (TTFD); Allithiamine (Transdermal TTFD)

Diet: Gluten free/ casein free diet; Specific Carbohydrate Diet; Yeast-free diet or other elimination diet

Tryptophan

DMG (Dimethylglycine)

Tyrosine

Enzyme aide

Vancomycin

Epsom Salt baths

Vitamin A (as cod liver oil)

Fatty acids (EFA) or Omega 3 Fatty Acids

Vitamin C

Folic acid

Vitamin Supplements (other)

Glutathione (oral, transdermal, or IV)

Withhold immunization(s)

Grapefruit seed extract



LIST 12

CHEMICALS AND SUBSTANCES


CHEMICAL/SUBSTANCE



Adhesives or glues, like rubber cement

Glycol ethers

Pesticides or herbicides

Alcohols, such as methanol or ethanol

Lacquers

Fungicides

Anesthetic gases

Metals

Herbicides

Automotive fluids

Chromium

Insecticides

Antifreeze

Lead

Rat poison

Brake fluid

Manganese

Pharmaceuticals or drugs

Degreasers

Mercury

Phthalates

Freon

Metal dust or fumes

Styrene

Gasoline

Nickel

Toluene

Benzene

Oil-based paints

Trichloroethylene or TCE or trichlorethane or TCA

Carbon disulfide

Paint strippers

Varnishes

Carbon tetrachloride

Paint thinners

Vinyl chloride

Diesel fumes

Perchlorethylene or perc

X-ray or radioactive materials

Ethylene oxide


Xylene







Appendix E5

File Typeapplication/msword
File TitleCaregiver Interview Prep Guide
Authorcdc
Last Modified Bypax1
File Modified2006-12-29
File Created2006-12-29

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