BROKENSHIRE COLLEGE

Madapo, Davao City

DRUG STUDY
Name of Client: _____________________________ Age: ___ Sex: ___ Date of Birth: _______ Marital Status: ___________ Religion: ____________
Chief Complaint/Reason for Admission: _______________________________________________________________________________________
Date and Time of Admission: _____________________________________Accompanied by/Informant: ___________________________________
Medical Diagnosis/Impression: ___________________________________ Operation Perform (if any): ____________________________________
GENERIC BRAND GENERAL MECHANISM ROUTE OF ADVERSE NURSING
INDICATIONS CONTRAINDICATIONS
NAME NAME CLASSIFICATION OF ACTION DOSAGE REACTIONS RESPONSIBILITY
Tramadol Dolcet Opioid Agonist Binds to mu-opioid Dose: 1 tab Moderate to Severe Patients who have previously Dizziness,  Check
Hydrochloride receptors and Frequency: q8 Pain demonstrated hypersensitivity to somnolence, medication
inhibits the reuptake PRN tramadol, paracetamol, and any nausea, ticket
of norepinephrine Duration: 3 days other component of Dolcet or constipation.  Check
and serotonin; opioids. It is also contraindicated medication
causes many effects in cases of acute intoxication Label
similar to the with alcohol, hypnotics,  Follow the
opioids. narcotics, centrally-acting, Three check;
analgesics, opioids or when it is
psychotropic drugs. withdrawn
from the
shelves,
before and
after the
medication
 Assess
hypersensitivi
ty and any
allergic
reactions
 Follow the
rights in
administering
drugs
 Document
pertinent data
and
effectivity.

Submitted by:_______________________________________________________________Clinical Instructor:______________________________

Year and Section:______________________________________________________________Date Submitted:______________________________