NCLEX Pharmacology - Top 100 Drugs
Master the most frequently tested medications on the NCLEX-RN and NCLEX-PN with this essential pharmacology flashcard deck. Each card covers a drug's generic name, drug class, primary use, key nursing considerations, and critical side effects to monitor. Knowing these drugs cold is one of the most important steps in passing the NCLEX on your first attempt. This deck covers antibiotics, anticoagulants, cardiac medications, diuretics, pain medications, psychiatric drugs, diabetes medications, respiratory drugs, and more — all organized by drug class for efficient studying. Based on the NCSBN NCLEX-RN test plan and standard nursing pharmacology references.
All Cards in This Deck
Question
Metformin — Drug class, use, and key nursing consideration?
Answer
Class: Biguanide (antidiabetic). Use: Type 2 diabetes. Key consideration: Hold before contrast dye procedures (risk of lactic acidosis). Monitor renal function. Do NOT give if eGFR < 30.
Question
Insulin (Regular) — Onset, peak, and duration?
Answer
Onset: 30–60 min. Peak: 2–4 hours. Duration: 5–8 hours. Given 30 min before meals. Only insulin that can be given IV.
Question
Insulin (NPH) — Onset, peak, duration, and nursing alert?
Answer
Onset: 1–2 hrs. Peak: 4–12 hrs. Duration: 18–24 hrs. Cloudy appearance — roll, do NOT shake. Monitor for hypoglycemia at peak.
Question
Warfarin (Coumadin) — Drug class and key nursing considerations?
Answer
Class: Anticoagulant (Vitamin K antagonist). Monitor PT/INR (therapeutic INR: 2–3). Antidote: Vitamin K. Avoid foods high in Vitamin K (leafy greens). Many drug interactions.
Question
Heparin — Drug class, monitoring test, and antidote?
Answer
Class: Anticoagulant. Monitor aPTT (therapeutic: 60–100 seconds). Antidote: Protamine sulfate. Given IV or subcutaneous — NEVER intramuscular.
Question
Enoxaparin (Lovenox) — Drug class and key difference from heparin?
Answer
Class: Low Molecular Weight Heparin (LMWH). Does NOT require aPTT monitoring. Given subcutaneously. Antidote: Protamine sulfate (partial reversal).
Question
Aspirin — Drug class, uses, and overdose sign?
Answer
Class: NSAID / antiplatelet. Uses: Pain, fever, anti-inflammatory, MI prevention. Overdose sign: Tinnitus (ringing in ears). Do not give to children (Reye's syndrome risk).
Question
Digoxin (Lanoxin) — Drug class, use, and toxicity signs?
Answer
Class: Cardiac glycoside. Use: Heart failure, atrial fibrillation. Toxicity signs: Bradycardia, nausea/vomiting, visual disturbances (yellow-green halos). Therapeutic level: 0.5–2 ng/mL.
Question
Furosemide (Lasix) — Drug class, use, and key electrolyte concern?
Answer
Class: Loop diuretic. Use: Edema, heart failure, hypertension. Causes hypokalemia (low potassium) — monitor K+ levels and encourage foods high in potassium.
Question
Spironolactone (Aldactone) — Drug class and key difference from furosemide?
Answer
Class: Potassium-sparing diuretic. Use: Heart failure, hypertension, edema. Causes hyperkalemia (high potassium) — avoid potassium supplements and salt substitutes.
Question
Lisinopril — Drug class, use, and key side effects?
Answer
Class: ACE inhibitor. Use: Hypertension, heart failure, diabetic nephropathy. Side effects: Persistent dry cough, hyperkalemia, angioedema (stop immediately if swelling occurs).
Question
Losartan (Cozaar) — Drug class and advantage over ACE inhibitors?
Answer
Class: Angiotensin II Receptor Blocker (ARB). Use: Hypertension. Advantage: Does NOT cause dry cough like ACE inhibitors. Still monitor for hyperkalemia and angioedema.
Question
Metoprolol (Lopressor) — Drug class, use, and key nursing consideration?
Answer
Class: Beta-1 selective blocker. Use: Hypertension, angina, heart failure. Check apical pulse before giving — hold if < 60 bpm. Never stop abruptly (rebound tachycardia).
Question
Atenolol (Tenormin) — Drug class and use?
Answer
Class: Beta-1 selective blocker. Use: Hypertension, angina. Monitor heart rate and blood pressure. Hold if HR < 60. Do not stop abruptly.
Question
Amlodipine (Norvasc) — Drug class, use, and side effects?
Answer
Class: Calcium channel blocker (dihydropyridine). Use: Hypertension, angina. Side effects: Peripheral edema (ankle swelling), headache, flushing.
Question
Nitroglycerin — Drug class, use, and administration rules?
Answer
Class: Nitrate/vasodilator. Use: Angina, acute MI. Sublingual: up to 3 doses 5 min apart — call 911 if no relief after 1st dose. Store in dark glass bottle. Causes hypotension.
Question
Amiodarone (Cordarone) — Drug class, use, and serious side effects?
Answer
Class: Antiarrhythmic (Class III). Use: Ventricular arrhythmias, atrial fibrillation. Side effects: Pulmonary toxicity, thyroid dysfunction, corneal deposits, photosensitivity.
Question
Atropine — Drug class, use, and nursing consideration?
Answer
Class: Anticholinergic. Use: Bradycardia, organophosphate poisoning. Increases heart rate. Side effects: Dry mouth, urinary retention, constipation, blurred vision (SLUDGE reversal).
Question
Morphine — Drug class, use, and antidote?
Answer
Class: Opioid analgesic. Use: Severe pain, pulmonary edema, MI pain. Monitor respiratory rate — hold if RR < 12. Antidote: Naloxone (Narcan).
Question
Naloxone (Narcan) — Drug class and use?
Answer
Class: Opioid antagonist. Use: Reversal of opioid overdose. Acts rapidly (2–5 min). May need repeated doses. Monitor for return of pain and re-sedation.
Question
Acetaminophen (Tylenol) — Key concern and antidote?
Answer
Key concern: Hepatotoxicity (liver damage) in overdose. Max dose: 4g/day (2g/day in liver disease or alcohol users). Antidote: N-acetylcysteine (Mucomyst).
Question
Ibuprofen (Advil) — Drug class and key contraindications?
Answer
Class: NSAID. Use: Pain, fever, inflammation. Contraindications: Peptic ulcer disease, renal impairment, third trimester pregnancy, heart failure. Take with food.
Question
Prednisone — Drug class, use, and key side effects?
Answer
Class: Corticosteroid. Use: Inflammation, autoimmune conditions, allergic reactions. Side effects: Hyperglycemia, immunosuppression, Cushingoid features, osteoporosis. Never stop abruptly.
Question
Levothyroxine (Synthroid) — Drug class and administration rules?
Answer
Class: Thyroid hormone replacement. Use: Hypothyroidism. Take on empty stomach, 30–60 min before breakfast. Check TSH levels regularly. Many drug interactions.
Question
Omeprazole (Prilosec) — Drug class and use?
Answer
Class: Proton Pump Inhibitor (PPI). Use: GERD, peptic ulcers, H. pylori. Take 30 min before meals. Long-term use may reduce magnesium and B12 levels.
Question
Ranitidine / Famotidine — Drug class and use?
Answer
Class: H2 receptor antagonist. Use: GERD, peptic ulcers, heartburn. Less potent than PPIs. Famotidine (Pepcid) is the current standard (ranitidine was withdrawn).
Question
Ondansetron (Zofran) — Drug class, use, and concern?
Answer
Class: Antiemetic (5-HT3 antagonist). Use: Nausea and vomiting from chemotherapy, surgery, pregnancy. Monitor for QT prolongation.
Question
Metoclopramide (Reglan) — Drug class, use, and key side effect?
Answer
Class: Antiemetic / prokinetic. Use: Nausea, GERD, gastroparesis. Risk of tardive dyskinesia with long-term use (involuntary movements).
Question
Vancomycin — Drug class, use, and key monitoring?
Answer
Class: Glycopeptide antibiotic. Use: MRSA and other resistant gram-positive infections. Monitor: Trough levels, renal function. Side effect: "Red man syndrome" (slow infusion rate).
Question
Penicillin — Drug class and key nursing consideration?
Answer
Class: Beta-lactam antibiotic. Use: Strep, syphilis, pneumococcal infections. Always ask about penicillin allergy — anaphylaxis risk. Cross-reactivity with cephalosporins.
Question
Ciprofloxacin (Cipro) — Drug class and key considerations?
Answer
Class: Fluoroquinolone antibiotic. Use: UTIs, respiratory and GI infections. Avoid in children and pregnant women. May cause tendon rupture. Avoid dairy and antacids (reduce absorption).
Question
Metronidazole (Flagyl) — Drug class, use, and key warning?
Answer
Class: Antiprotozoal / antibiotic. Use: C. difficile, bacterial vaginosis, anaerobic infections. No alcohol during treatment and 48 hours after (severe nausea/vomiting — disulfiram-like reaction).
Question
Fluconazole (Diflucan) — Drug class and use?
Answer
Class: Antifungal (azole). Use: Candida infections (oral thrush, vaginal yeast infections, systemic candidiasis). Monitor liver function with prolonged use.
Question
Albuterol (ProAir, Ventolin) — Drug class, use, and key consideration?
Answer
Class: Short-acting beta-2 agonist (SABA) / bronchodilator. Use: Acute asthma/COPD attacks. Use BEFORE corticosteroid inhalers (opens airways first). Side effects: Tachycardia, tremor.
Question
Fluticasone (Flovent) — Drug class, use, and nursing instruction?
Answer
Class: Inhaled corticosteroid. Use: Asthma (maintenance, not rescue). Instruct patient to rinse mouth after use to prevent oral candidiasis (thrush).
Question
Lithium — Drug class, therapeutic level, and toxicity signs?
Answer
Class: Mood stabilizer. Use: Bipolar disorder. Therapeutic level: 0.6–1.2 mEq/L. Toxicity signs: Tremor, confusion, ataxia, polyuria. Monitor levels regularly. Maintain adequate fluid and sodium intake.
Question
Haloperidol (Haldol) — Drug class, use, and key side effect?
Answer
Class: Typical (first-generation) antipsychotic. Use: Schizophrenia, acute psychosis, severe agitation. Risk of extrapyramidal side effects (EPS) including tardive dyskinesia.
Question
Sertraline (Zoloft) — Drug class, use, and important warning?
Answer
Class: SSRI antidepressant. Use: Depression, anxiety, PTSD, OCD. Black box warning: Increased suicidal ideation in children and adolescents. Takes 4–6 weeks for full effect.
Question
Lorazepam (Ativan) — Drug class, use, and antidote?
Answer
Class: Benzodiazepine. Use: Anxiety, seizures, alcohol withdrawal, acute agitation. Antidote: Flumazenil. Risk of dependence. CNS depressant — monitor respiratory rate.
Question
Phenytoin (Dilantin) — Drug class, use, and key nursing considerations?
Answer
Class: Anticonvulsant (hydantoin). Use: Seizures. Therapeutic level: 10–20 mcg/mL. IV: Give slowly, use NS only (precipitates in dextrose). Side effects: Gingival hyperplasia, nystagmus, ataxia.