Drug Classification: __________________________________ ACTION:

USES:

GENERIC & TRADE names:

Specific Information Needed:

Dosage Range:

DATA THAT INDICATES DRUG IS EFFECTIVE:

COMMON SIDE EFFECTS:

ADVERSE AND LIFE THREATENTING SIDE EFFECTS-CONTRAINDICATIONS:

FOOD, DRUG, HERBAL INTERACTIONS:

ASSESSMENTS REQUIRED PRIOR TO ADMINISTRATION:

PATIENT TEACHING AT THE TIME OF ADMINISTRATION-INCLUDE SPECIAL TEACHING NEEDS

COMPATIBILITY