UNIVERSITY OF SAN CARLOS

COLLEGE OF NURSING
CEBU CITY
DRUG STUDY
Name of Patient: _______________________________________
Age: _______________
Sex: _________________
Occupation:___________________________________________
Date of Admission: _____________________________________
Status: ______________________ Religion: _______________

Name of Drug:
Generic name
Brand name

Classification

Mechanism of Action

Patients Health Profile: ____________________________________________________________

_____________________________________________________
_____________________________________________________
_____________________________________________________
Initial Complaint: __________________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
Diagnosis/Impression: _____________________________________________________________

Contraindication

Route and Dosage

Side Effects

Nursing Responsibilities