CEBU INSTITUTE OF TECHNOLOGY

UNIVERSITY

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

DRUG STUDY

Name of Student: ______________________________________ Level _________ Section _________ Rating: _________________

Supervising Clinical Instructor: ______________________________________ Name of Hospital: ________________________________
Area of Assignment: _____________________________________ Inclusive Dates of RLE: ____________________________________

Name of Drug Classification Mechanism of Indications and Side Effects Nursing Responsibilities
Action Contraindications (Before, During and After Responsibilities)

Generic Name:

Trade/Brand Name:

Contents:

Patient’s Dose:

Minimum Dose:

Maximum Dose

Reference Reference Reference Reference Reference Reference

Scoring System (20 points per drug)
Name of Drug – 2 points
Classification – 1 point
MOA – 3 points
Indications and Contraindications – 2 points
Side Effects – 2 point
Nursing Responsibilities – 9 points
References – 1 point