CGI Prep Guide Appendix E. 5

Appendix E.5 Caregiver Interview Prep Guide

S tudy to Explore Early Development

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 1b: Diagnosis from health care provider 7

LIST 2: Oral contraceptives 8

LIST 3: Other methods of contraception 8

LIST 4a: Fertility medications taken by men 9

LIST 4b: Medication taken for prevention of miscarriage 10

LIST 4c: Fertility medications taken by women 11

LIST 5: Fertility procedures 13

LIST 6: Major reproductive and perinatal infections 13

LIST 7a: Antibiotics/antiviral/antifungal medications 14

LIST 7b: Pain medications/fever reducers/muscle relaxants 15

LIST 7c: Over-the-counter cold/flu/allergy medications 16

LIST 7d: Other allergy medications 16

LIST 7e: Diabetes medications 17

LIST 7f: Seizure medications 17

LIST 7g: Anti-depressants/anti-anxiety/psychotropic medications 18

LIST 7h: High blood pressure medications 19

LIST 7i: Medications/treatments for thyroid disorders 19

LIST 7j: Asthma medications 20

LIST 7k: Weight Loss Pills / Medications 21

LIST 7l: Constipation medications 21

LIST 7m: Sleep medications 22

LIST 7n: Other medications 22

LIST 7o: Herbal Medications 23

LIST 11f: Alternative Treatments for child 24

LIST 8: Autoimmune Disorders 25

LIST 9: Pregnancy Conditions 25

LIST 10: Medical conditions of child 26

LIST 11a: Antibiotics/anti-viral/anti-fungal medications for child 26

LIST 11b: Pain relief/fever reduction/cold/flu/allergy medications for child 27

LIST 11c: Anti-seizure medications for child 27

LIST 11d: Constipation medications for child 28

LIST 11e: Other medications for child 28

LIST 7o: Herbal Medications 29

LIST 11f: Alternative Treatments for child 30

LIST 12: Chemicals and Substances 32

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 1b

DIAGNOSIS FROM HEALTH CARE PROVIDER

MEDICAL DIAGNOSIS

Birth Defects (specify)

Down Syndrome

Fragile X Syndrome

Neurofibromotosis

Tuberous Sclerosis

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