Medication Research Form

Medication Order(written the way the MD ordered it)

generic name (lower case)

Dose (mg, mcg,

Route(po, sl, PR, TD, IM,

Frequency(daily, BID tid, qid, at hs, ac,

gm, units, etc.)

subcut., IV,

q2h,4,6, PRN (for what?)

lorsatan

Brand name: (One only) cozaar

Classification:

Maximum Safe Dose in 24 hours:

Antihypertensive

Indication(s): (Uses) hypertension

Common Side Effects (CSE): (only common as indicated in your pocket drug guide)
Dizziness , headache, sinusitis

Life Threatening Side Effects: (LTSE ) (as indicated in your pocket drug guide)
(If none write NONE DO NOT LEAVE Blank)
None

Drug Drug InteractionsDDI(List all that apply, or may apply) (If none Write NONE DO NOT LEAVE Blank)

Phenobarbital decreases serum levels.

Food Drug InteractionsFDI(List all that apply, or may apply) (If none Write NONE DO NOT LEAVE Blank)

None
Nursing Implications (individualized to your client) To include Assessment/Labs to monitor/client/family education
Monitor BP prior to schedule dose

Do not use potassium supplements or salt substitutes with consulting physician.

MEDICATION: (GENERIC NAME) ________losatan________________________

RNSG 1362 Medication Research Form supplement to Form B_sp2013_williams