Kingdom of Saudi Arabia ‫المملكة العربية السعودية‬

Ministry of Higher Education ‫وزارة التعليم العالي‬

University of Tabuk ‫جامعة تبوك‬
Faculty of Applied Medical Sciences ‫كلية العلوم الطبية التطبيقية‬
Department of Nursing ‫قسم التمريض‬

DRUG STUDY

Name of Student: _____________________________________ Student Number: ________________________________

Name of Patient: _______________________ Age:______ Medical Diagnosis: ________________________________
Ward/Unit :________________________Room/ Bed No.:__________ Date of Assessment: ______________________________
DRUG NAME MECHANISM OF ACTION CONTRAINDICATIONS SIDE EFFECTS NURSING RESPONSIBILITIES
AND
INDICATION
GENERIC NAME: MECHANISM OF ACTION:

BRAND NAME:

CLASSIFICATION:

DOSAGE:

INDICATION:

ROUTE:

FREQUENCY:

Date Submitted: __________________________ Faculty Name & Signature: ______________________________

CTC_Revised summer 2016