Name of Patient: ______________________ Room/BedNo:_______________________

Age: ________________________________ Physician: ___________________________

Gender: _____________________________ Admitting Diagnosis: ___________________
Chief Complaints: _____________________ Student’s Name and Group_______________

Date Name Drawing Classification Dosage/ Indication Mechanis Side Effects Nursing Responsibilities
of Drug Time/Rout m of
e Action
11- Generic Therapeutic Dosage:  Lower Amoxicilli CNS:  Culture the
23- name: class: -200 mg/5 respiratory n agitation, infected area
2021 Amoxicil Antibiotics mL tract infections prevents anxiety, prior to
lin- -125 mg/5  Otitis media bacterial behavioral treatment; re-
Clavulan Pharmacolog mL  Sinusitis cell-wall changes, culture the area if
ate ic class: Time:  Skin and skin synthesis confusion, the response is
Potassiu Aminopenicil - Q12 structure during dizziness, not as expected.
m lins-beta- inter infections replicatio insomnia,  Give in oral
lactamase val  UTI caused by n. headache, preparations
Brand inhibitions - Q8 susceptible Cluvalanic seizures. only; amoxicillin
name: inter strains of acid is not affected by
Augmen val gram-positive increases GI: nausea, food.
tin Route: and gram- amoxicilli vomiting,  Continue therapy
Oral negative n’s diarrhea, for at least 2 days
Suspension organisms effectiven indigestion, after signs of
ess by gastritis, infection have
inactivatin stomatitis, disappeared;
g beta- glossitis, continuation for
lactamase black hairy 10 full days is
s, which tongue, recommended.
destroy enterocoliti  Use
amoxicilli s, corticosteroids,
n. pseudome antihistamines
mbranous for skin reactions.
colitis,
mucocutan Patient Teaching
eous,  Tell patient to
candidiasis, take entire
abnormal quantity of drug
pain exactly as
prescribed, even
GU: after feeling
Vaginal better.
candidiasis,  This antibiotic is
vaginitis specific for this
problem and
Hematolog should not be
ic: used to self-treat
anemia, other infections.
thrombocy  Instruct patient
topenic to take drug with
purpura, food to prevent
eosinophili GI upset. Advise
a, patient taking the
leukopenia, oral suspension
agranulocy to keep drug
tosis refrigerated, to
Other: shake it well
Hypersensi before taking it,
tivity and to discard
reactions, remaining drug
anaphylaxi after 10 days.
s, pruritus,  Tell patient to
rash, report all adverse
urticarial, reactions and to
angioedem call prescriber if a
a, rash occurs
overgrowt because rash may
h of non- indicate an
susceptible allergic reaction.
organisms,
serum
sickness
like
reaction