Medication Template

Medication Complications: These are side effects or adverse events that result from taking prescription or over-the-counter medications.

Contraindications & Precautions: These are situations or conditions in which a medication should be used with caution because it may be harmful to the patient

Possible Interactions: with foods or other medications, etc.

Medication Administration: How should this medication be administered (with food/empty stomach, which route, etc.)?

STUDENT NAME __________________________________________________________________________________________________________

MEDICATION NAME CATEGORY CLASS _________________________________________________________________________________________________________

Therapeutic Use: Intended effect of the medication.

Expected Pharmacological Action: How a medication exerts its effect on the body.

PURPOSE OF MEDICATION: (Please see these definitions under content with this template.)

Interventions: Actions that promote, maintain or restore a patient’s health.

Patient Education: Refers to what does the patient need to know when taking this medication.

To fill templates out you should be completing 20 templates – one for each medication. Remember that you need to handwrite these and use the template that is provided. In bold are the classes – in lowercase are the medication names to complete each template for.

Cephalosporins

Cephalexin

Penicillin

amoxicillin

Carbapenems

imipenem

Monobactams

aztreonam

Sulfonamides

trimethoprim-sulfamethoxazole

Fluroquinolones

Levofloxacin

Macrolides

erythromycin

azithromycin

Aminoglycosides

gentamicin

Tetracyclines

Tetracycline

Antivirals: Antiherpes

acyclovir

Antifungals

fluconazole

amphotericin

Antimalarial

chloroquine

Antiprotozoals

metronidazole

Anthelmintics

mebendazole

Antituberculars

isoniazid

Antibacterial: Glycosides

vancomycin

HIV entry and Fusion Inhibitors

Maraviroc

Monoclonal Antibodies

Trastuzumab

OPTIONAL – THESE ARE VERY COMMONLY USED

antimicrobial

Rifampin

antibiotic

Nitrofurantoin

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