Drug Name: ___________________(generic name) _________________(trade name)

Classification:

Prototype:  Yes  No If no, prototype is: _________________

Selected Indications:

Preferred Route:

Dosage Range:

Pharmacotherapeutics Pharmacokinetics Pharmacodynamics

(Desired Benefit) (Body  Drug) (Drug  Body)
DRUG KNOWLEDGE

Contraindications/Precautions Adverse Effects Drug Interactions

Health Status Life Span/Gender

PATIENT VARIABLES

Lifestyle, Diet, and Habits Environment

NURSING DIAGNOSIS

INTERVENTIONS
Maximize therapeutics Minimize adverse Patient/Family Education