POLYTECHNIC COLLEGE OF DAVAO DEL SUR, INC.

MacArthur Highway, Brgy. Kiagot, Digos City, Davao del Sur, Philippines 8002

DRUG STUDY
Name of Patient: Patient X Attending Physician:
__________________________________
Age: Sex: Civil Status: Diagnosis:
__________________________________________
Occupation: Religion: Chief Complaint:
_____________________________________
Address: Date of Admission: _________________
 DATE/ BRAND ROUTE/ DRUG ADVERSE NURSING
TIME NAME ACTION INDICATIO DOSAGE/ INTERACTION EFFECT PRECAUTION/ RESPONSIBILITIES
CONTRAINDICATION
ORDERE N TIME S
D INTERVAL
BCG vaccine Active Abacavir The Significant: Risk Precautionary Use:
TICE® is an attenuated immunization Intradermal / therapeutic efficacy of of bladder
strain of for prevention 0.05mL for BCG vaccine can be contracture
bacillus of Children less decreased when used in (intravesical),
Calmette- Tuberculosis than 1 year old combination with malaise, fever and
Guérin and newborn Abacavir. chills, flu-like
Mycobacteriu Abatacept The risk symptoms.
m bovis used or severity of infection Blood and
as biologic can be increased when lymphatic system
response BCG vaccine is combined disorders: Contraindicated:
modifier. It is with Abatacept. Anaemia. Hypersensitivity.
GENERIC also used as an HALF-LIFE Acetic acid The Gastrointestinal Impaired immune
NAME active therapeutic efficacy of disorders: response, congenital
immunotherap BCG vaccine can be Abdominal pain, or acquired immune
Bacillus y for the decreased when used in nausea, diarrhoea. deficiencies (e.g.
Calmette – treatment of combination with Acetic General disorders HIV-infection,
Guerin (BCG) bladder acid. and leukaemia,
carcinoma in Acetyl sulfisoxazole administration lymphoma, cancer
situ by causing The therapeutic site conditions: therapy, Hodgkin’s
a local, chronic efficacy of BCG vaccine Rigors. disease), active
inflammatory can be decreased when Musculoskeletal tuberculosis, acute
response used in combination with and connective severe febrile illness,
involving Acetyl sulfisoxazole. tissue disorders: generalised infected
macrophage Acyclovir The Arthralgia, arthritis, skin conditions,
and leukocyte therapeutic efficacy of myalgia. current or previous
infiltration of BCG vaccine can be Renal and urinary evidence of BCG
the bladder, decreased when used in disorders: Cystitis, infection, urinary tract
resulting in the combination with dysuria, pollakuria, infection, gross
destruction of Acyclovir. haematuria, UTI, haematuria, <14 days
superficial Adalimumab The risk urinary of biopsy, TUR, or
tumour cells of or severity of adverse incontinence. traumatic
the urothelium. effects can be increased Respiratory, catheterization.
when Adalimumab is thoracic and Concomitant therapy
combined with BCG mediastinal with
vaccine. disorders: immunosuppressive
Adefovir dipivoxil Pneumonitis. agents, bone marrow
The therapeutic Potentially Fatal: depressants,
efficacy of BCG vaccine Rarely, systemic antibiotics, radiation
can be decreased when granulomatous therapy.
used in combination with illness.
Adefovir dipivoxil.
Aldesleukin The risk
or severity of infection
can be increased when
Ward: Room No: Bed No: ________
Student Name: Year & Sec.: Group No.: Rating:__________________
References_______________________________________________________________________ Criteria: Promptness (15%), Format/Neatness (15%), Assessment (15%),
Nursing Diagnosis (15%), Objectives (15%), Objectives of Care (10%), Nursing Action (30%), Evaluation (10%)
Clinical Instructor:____________________________________