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MED-PASS:  The Fine Art of Document Design

Medication Side Effects and Adverse Effects - 100/pack


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Price: $42.50
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Updated to reflect the latest medication classes and side effects.

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Co-Developed with American Society of Consultant Pharmacists




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Co-developed by the American Society of Consultant Pharmacists and MED-PASS.

This form provides an extensive, alphabetical list of medication classes and examples of generic medications for each class that are commonly used by geriatric residents in the community, assisted living and the long-term care setting.

Numerous examples of generic medications are listed for 123 classes of medications along with their associated potential side effects/adverse effects.

By simply circling the medication classes on the form that correspond to a resident‘s medication regimen, LTC facilities can use this form to help comply with federal guidelines (F272) requiring listing of potential medication adverse effects in a resident‘s clinical record.

  • Coded to identify individual medications and medication classes on the ISMP (Institute for Safe Medication Practices) List of High-Alert Medications.
  • Utilizes Tall Man lettering to help prevent medication errors.
  • Reformatted into a convenient booklet style form.
  • 5 hole punched side and top to fit in standard facility charts and binders.
Size 11 x 8-5/8
Unit Package of 100
Number of Pages 8
Other Info Handwritten
Published Revised April 2016
Hole Punch 5 holes left, 5 holes top

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