DRUG STUDY

Name of Patient: _________________________________ Patient’s Health Profile: ________________________________________________________________

Age: _______ Sex: _________ ____________________________________________________________________________________
Occupation: _____________________________________ Initial Complaint:______________________________________________________________________
Date of Admission: ________________________________ Diagnosis: ___________________________________________________________________________
Status: _____________ Religion: _____________________

Name of Drug:
Route and
Generic name Classification Mechanism of Action Contraindication Side effects Nursing Responsibilities
Dosage
Brand name