Master pharmacology for the NCLEX with confidence! This comprehensive guide covers the most commonly tested drug classes, critical nursing actions, and proven strategies to tackle pharmacology questions successfully.

What You'll Learn

 Essential drug classes and their nursing considerations  High-risk medications requiring special attention

 Memory tricks and mnemonics for drug identification  Practice questions in NCLEX format

  Critical safety protocols every nurse must know

???? Core Drug Classes & Nursing Actions

Cardiovascular Medications

ACE Inhibitors (lisinopril, enalapril, captopril) Key Nursing Actions:

  ✅ Monitor blood pressure before and after administration

  ✅ Assess for dry, persistent cough (common side effect)

 ✅ Watch for hyperkalemia - avoid salt substitutes

  ⚠ CRITICAL: Assess for angioedema (face, lips, tongue swelling) - EMERGENCY

Patient Education:

 Take on empty stomach for best absorption  Change positions slowly to prevent dizziness

  Report persistent cough to healthcare provider

Beta Blockers (metoprolol, propranolol, atenolol) Key Nursing Actions:

 ✅ ALWAYS check apical pulse for 1 full minute

  ✅ Hold medication if HR < 60 bpm (or per facility protocol)

  ✅ Monitor blood pressure

  ✅ Assess for signs of heart failure

Patient Education:

 Never stop suddenly - must taper gradually

 May mask signs of hypoglycemia in diabetics

  Report dizziness, fatigue, or shortness of breath

Calcium Channel Blockers (amlodipine, diltiazem, nifedipine) Key Nursing Actions:

 ✅ Monitor blood pressure and heart rate

 ✅ Assess lower extremities for edema

  ✅ Check for constipation (especially with verapamil)

Patient Education:

 Avoid grapefruit juice - increases drug levels  Rise slowly from sitting/lying position

 Report swelling in feet or ankles

Fluid & Electrolyte Management Loop Diuretics (furosemide, bumetanide) Key Nursing Actions:

  ✅ Monitor daily weights (same time, same scale, same clothes)

 ✅ Check electrolytes, especially potassium and sodium  ✅ Assess for dehydration and orthostatic hypotension  ✅ Monitor kidney function (BUN, creatinine)

Patient Education:

 Take in morning to avoid nighttime urination  Eat potassium-rich foods (bananas, oranges)

  Report muscle cramps, weakness, or irregular heartbeat

Thiazide Diuretics (HCTZ, chlorthalidone) Key Nursing Actions:

  ✅ Monitor for hypokalemia, hyponatremia, hyperuricemia

 ✅ Check blood glucose (can increase levels)

  ✅ Assess for photosensitivity

Anti-Infective Medications Antibiotics - General Principles Key Nursing Actions:

  ✅ ALWAYS verify allergies before administration

  ✅ Obtain cultures before first dose when possible

  ✅ Monitor for signs of superinfection (C. diff, thrush)

 ✅ Assess for adverse reactions

Patient Education:

 Complete entire prescribed course

 Take with food if GI upset occurs (unless contraindicated)  Report signs of allergic reaction immediately

Specific Antibiotic Classes:

  Penicillins (-cillin): Watch for allergic reactions, take on empty stomach

  Macrolides (-mycin): Monitor liver function, drug interactions

  Fluoroquinolones (-floxacin): Risk of tendon rupture, avoid dairy

  Aminoglycosides: Monitor kidney function and hearing

⚠ High-Risk Medications (High-Alert Drugs)

Insulin

Critical Safety Measures:

 ✅ Double-check dose with another nurse

 ✅ Use insulin syringes only

 ✅ Monitor blood glucose before and after

  ✅ Have glucagon available

  ⚠ Never mix insulin types unless specifically ordered

Signs of Hypoglycemia: Shakiness, sweating, confusion, rapid pulse

Anticoagulants

Heparin

Key Monitoring:

  ✅ Check aPTT (goal: 1.5-2.5 times normal)

  ✅ Monitor platelet count (HIT risk)

 ✅ Assess for bleeding signs

  ✅ Have protamine sulfate available (antidote)

Warfarin (Coumadin) Key Monitoring:

  ✅ Check INR regularly (goal: 2-3 for most conditions)

  ✅ Monitor for bleeding

  ✅ Assess drug and food interactions

Patient Education:

 Maintain consistent vitamin K intake  Report unusual bleeding or bruising  Carry medical alert identification

Opioid Pain Medications

Critical Assessments:

 ✅ Check respiratory rate, depth, and quality

  ✅ Hold if RR < 12/min (or per facility protocol)

 ✅ Monitor sedation level

  ✅ Have naloxone (Narcan) available

Digoxin

Key Nursing Actions:

 ✅ Check apical pulse for 1 full minute

 ✅ Hold if HR < 60 bpm in adults, < 90-110 in children  ✅ Monitor digoxin levels (therapeutic: 0.8-2.0 ng/mL)  ✅ Watch for toxicity signs

Digoxin Toxicity Signs:

 Visual: Yellow-green halos, blurred vision  GI: Nausea, vomiting, diarrhea

 Cardiac: Bradycardia, arrhythmias

???? Memory Aids & Drug Suffixes

Essential Drug Endings

Mnemonics for Common Side Effects

ACE Inhibitors - "ACE the HACK":

 Angioedema  Cough

 Elevated potassium

 Hypotension

 Acute kidney injury

 Contraindicated in pregnancy

 Kidney function monitoring

Digoxin Toxicity - "VAIN":

 Visual changes

 Arrhythmias

 Intestinal upset

 Neurological symptoms

???? NCLEX-Style Practice Questions