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