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Drug Information Sheet

May use alternate format but must include all information


Name of medication
Generic

Classification

Indications for use

Side effects / Most common

Contraindications

Trade
Mechanism of action

Safe for breastfeeding?

Nursing Implications

Patient Education

Notes

Antedote / Tx for overdo


Can it be crushed?

Patient Diagnosis
#1
#2
#3
#4
#5
#6

For what reason is the patient taking


this drug?

What is the dosage, freq


route for this patie

ons for use

dications

breastfeeding?

e / Tx for overdose

he dosage, frequency and


oute for this patient?