San Sebastian College Recoletos de Cavite

NURSING DEPARTMENT

DRUG STUDY

Name of Patient: Age: Sex:

Home Address: Diagnosis:
Chief Complaint: Attending Physician:

Name of Drug Classification /Action Indication Contraindication Side Effects Nursing Responsibilities

Generic name:

Brand Name:

Dose:

Frequency:
Drug Class:
Route
Action:
Form:

Color:

Reference:

Revised 2023