Patient’s Name:_________________________ Health Agency:___________________________Room/Bed

No.:___________
Age:___________Gender:_________________ Attending Physician:________________________
Civil Status:____________________ Medical Diagnosis:_________________________________

Drug Classification Indication Route Mode of Action Side Effects Adverse Effects Nursing
Intervention

Brand Oral iron Iron PO for Iron combines Constipation, diar Gastrointestinal Assessment
Name: bivalent deficiency Adults, with porphyrin rhea, stomach cra disorders: Gastroi and
Ironorm preparations anemia, and IM and globin mps, or upset ntestinal monitoring: All
Drops. blood loss for an chains to form stomach may irritation, iron
related to infant. hemoglobin, occur. These nausea, preparations
pregnancy which is critical effects are usually vomiting, Assess
or GI for oxygen temporary and epigastric pain,
bleeding delivery from may disappear as diarrhea,
(NSAIDs), the lungs to your body adjusts constipation,  Signs and
Generic hookworm other tissues. to this medication. blackening of symptoms
Name: infestation, Iron deficiency If any of these stool, tooth of iron
Ferrous or excess causes microcyti effects last or get discoloration, deficiency
Sulfate, coffee. c anemia due to worse, contact abdominal anemia; e.g.,
Iron, the formation of your doctor discomfort. pallor,
Iron small or pharmacist pro Immune system tachycardia,
(Ferrous erythrocytes mptly. disorders: Hypers dyspnea,
Sulfate) with insufficient ensitivity. and fatigue
hemoglobin.  Laboratory
test results:
CBC,
hemoglobin,
hematocrit,
iron level,
ferritin, total
iron-binding
 capacity

Reference: Ferrous Sulfate. 2019, December,17. MIMS. https://www.mims.com/philippines/drug/info/ferrous%20sulfate?

mtype=generic

Ferrous Sulfate Tablet, Delayed Release (Enteric Coated) - Uses, Side Effects, and More. 2005-2013. WebMD LLC.
https://www.webmd.com/drugs/2/drug-4127/ferrous-sulfate-oral/details
 Drug Classificat Indication Route Mode of Side Effects Adverse Nursing
ion Action Effects Intervention

Brand Vitamins, Folic acid, USP Folic acid, Folic acid, redness, skin Allergic Assessment of
Name: Water- is effective in vitamin B9 is whether given rash, itching, sensitization, pregnant
Folic Soluble. the treatment administered by mouth or feeling unwell, flushing, Mother;
Acid of in parenterally, st and difficulty irritability,
megaloblastic subcutaneous, imulates the breathing difficulty Except during
anemias due to intravenous, or production of sleeping, and pregnancy and
a deficiency of by deep red blood cells, malaise may lactation, folic
folic acid, USP intramuscular white blood occur. acid should not
(as may be injection. cells, and be given in
Generic seen in tropical platelets in therapeutic
Name: or nontropical persons doses greater
Folic sprue) and in suffering from than 0.4 mg
Acid anemias of certain daily until
nutritional megaloblastic pernicious
origin, anemias. anemia has been
pregnancy, ruled out.
infancy, or
childhood.

Reference: Folic Acid. 2020, November 11. RxList Inc. https://www.rxlist.com/slideshow_faint_fainting_reasons/article.htm

Drug Index. 2001-2023. Pediatric Oncall. https://www.pediatriconcall.com/drugs/folic-acid/596#:~:text=An

%20exogenous%20source%20of%20folate,suffering%20from%20certain%20megaloblastic%20anemias.
Patient’s Name:_________________________ Health Agency:___________________________Room/Bed
No.:___________
Age:___________Gender:_________________ Attending Physician:________________________
Civil Status:____________________ Medical Diagnosis:_________________________________

Drug Classificatio Indication Route Mode of Action Side Effects Adverse Effects Nursing
n Intervention

Brand Autonomic Terbutaline Terbutali Terbutaline is a For Mother: Irregular Assessment and
Name: Nervous is used to ne can be bronchodilator, a racing, heartbeats, monitoring of
Brethine, System prevent and given a medication heartbeat, extra fluid in Pregnant Mother
Bricanyl, Agent; Beta- treat subcutan that dilates skin flushing, the lungs and Neonate:
Brethaire Adrenergic wheezing, eously, (expands) air tremors, (which is called
Agonist; shortness of which passages in the restlessness, pulmonary  Assess vital
Bronchodilat breath, and means lungs. It dizziness, edema), and signs: Baseline
or chest injected attaches to beta drowsiness or chest pain. pulse and BP
tightness into the adrenergic headache The more and before each
Generic caused by skin, or receptors on serious side dose.
Name: asthma, intraven muscles For baby: effects tend to  Monitor for
Terbutali chronic ously surrounding the Terbutaline occur when symptoms of
ne bronchitis, (IV), air passages, can cause a women are hypoglycemia in
and which causing the temporary taking high neonates born of
emphysema. means muscles to relax increase in the doses, but the a mother who
It works by given and dilate the baby’s heart effects can also used terbutaline
relaxing and through air passages. rate and blood occur with during
opening the a vein. Wider air sugar levels. standard doses. pregnancy.
airways, passages allow Terbutaline  Monitor patient
making it more air to flow may also being treated for
easier to in and out of the increase risk of premature labor
breathe. lungs. Increased diabetes. for CV S&S for
airflow reduces 12 h after drug
shortness of is discontinued.
breath,  Keep
 wheezing, and appointments
cough. with physician
for evaluation of
continued drug
effectiveness
and clinical
condition.

References:

PharmD, O. O. (2019b, August 1). Terbutaline (Brethine) Uses, Side Effects & Dosage. MedicineNet.
https://www.medicinenet.com/terbutaline/article.htm

The Healthline Editorial Team. (2017, September 21). Terbutaline and Its Use in Preterm Labor. Healthline.
https://www.healthline.com/health/pregnancy/preterm-labor-terbutaline#administration

TERBUTALINE SULFATE. (n.d.). http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/T016.html