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171 Med Sheet Fall 21 REVISED 11-21

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Suffix/prefix
Pharmacologic class
Therapeutic class
generic name
Brand(s)
MOA
Indication(s)
Pre-administration assessment(s)
Evaluation(s) (include timing)
Nursing Considerations
Side Effects (common and life threatening)
Other (ex, labs, drug or food interactions, contraindications, antidote,
with or without food), timing, route(s)
Patient/family Education (layman’s terms) including when to call the provider
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