West Visayas State University

COLLEGE OF NURSING
La Paz, Iloilo City

DRUG STUDY
Name of Patient:
Age:
Name of Drug
Generic:

Brand:

Classification

Attending Physician:
Impression/Diagnosis:

Ward/Bed Number:
Dosage,
Route,
Frequency
and Timing
Dosage:

Mechanisms of
Action

Indication

Adverse
Reactions

Contraindication
s

Side Effects

Route:

Frequency:

Functional:
Timing:

Chemical:

Students Name:
Clinical Instructor:

Special
Precautions

Nursing Responsibilities