URDANETA CITY UNIVERSITY

San Vicente West, Urdaneta City, Pangasinan 2428

COLLEGE OF HEALTH SCIENCES

Bachelor of Science in Nursing

DRUG STUDY
Name of Student:_________________________________________________ Year Level and Group: _______________

Affiliating Agency/Area: ___________________________________________ Month/Year of Exposure: ________________________

DRUG CLASSIFICATION INDICATION SIDE EFFECTS ADVERSE EFFECTS NURSING RESPONSIBILITIES

Generic Name:

Brand Name:

Dosage:

MECHANISM OF CONTRAINDICATIONS
ACTION
Route::

Frequency:
 
Checked by: _________________________________ Date: ____________________
Clinical Instructor’s Name and Signature