Metformin — Drug class, use, and key nursing consideration? — 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.

Insulin (Regular) — Onset, peak, and duration? — Onset: 30–60 min. Peak: 2–4 hours. Duration: 5–8 hours. Given 30 min before meals. Only insulin that can be given IV.

Insulin (NPH) — Onset, peak, duration, and nursing alert? — Onset: 1–2 hrs. Peak: 4–12 hrs. Duration: 18–24 hrs. Cloudy appearance — roll, do NOT shake. Monitor for hypoglycemia at peak.

Warfarin (Coumadin) — Drug class and key nursing considerations? — 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.

Heparin — Drug class, monitoring test, and antidote? — Class: Anticoagulant. Monitor aPTT (therapeutic: 60–100 seconds). Antidote: Protamine sulfate. Given IV or subcutaneous — NEVER intramuscular.

Enoxaparin (Lovenox) — Drug class and key difference from heparin? — Class: Low Molecular Weight Heparin (LMWH). Does NOT require aPTT monitoring. Given subcutaneously. Antidote: Protamine sulfate (partial reversal).

Aspirin — Drug class, uses, and overdose sign? — 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).

Digoxin (Lanoxin) — Drug class, use, and toxicity signs? — 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.

Furosemide (Lasix) — Drug class, use, and key electrolyte concern? — Class: Loop diuretic. Use: Edema, heart failure, hypertension. Causes hypokalemia (low potassium) — monitor K+ levels and encourage foods high in potassium.

Spironolactone (Aldactone) — Drug class and key difference from furosemide? — Class: Potassium-sparing diuretic. Use: Heart failure, hypertension, edema. Causes hyperkalemia (high potassium) — avoid potassium supplements and salt substitutes.

Lisinopril — Drug class, use, and key side effects? — Class: ACE inhibitor. Use: Hypertension, heart failure, diabetic nephropathy. Side effects: Persistent dry cough, hyperkalemia, angioedema (stop immediately if swelling occurs).

Losartan (Cozaar) — Drug class and advantage over ACE inhibitors? — Class: Angiotensin II Receptor Blocker (ARB). Use: Hypertension. Advantage: Does NOT cause dry cough like ACE inhibitors. Still monitor for hyperkalemia and angioedema.

Metoprolol (Lopressor) — Drug class, use, and key nursing consideration? — Class: Beta-1 selective blocker. Use: Hypertension, angina, heart failure. Check apical pulse before giving — hold if < 60 bpm. Never stop abruptly (rebound tachycardia).

Atenolol (Tenormin) — Drug class and use? — Class: Beta-1 selective blocker. Use: Hypertension, angina. Monitor heart rate and blood pressure. Hold if HR < 60. Do not stop abruptly.

Amlodipine (Norvasc) — Drug class, use, and side effects? — Class: Calcium channel blocker (dihydropyridine). Use: Hypertension, angina. Side effects: Peripheral edema (ankle swelling), headache, flushing.

Nitroglycerin — Drug class, use, and administration rules? — 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.

Amiodarone (Cordarone) — Drug class, use, and serious side effects? — Class: Antiarrhythmic (Class III). Use: Ventricular arrhythmias, atrial fibrillation. Side effects: Pulmonary toxicity, thyroid dysfunction, corneal deposits, photosensitivity.

Atropine — Drug class, use, and nursing consideration? — Class: Anticholinergic. Use: Bradycardia, organophosphate poisoning. Increases heart rate. Side effects: Dry mouth, urinary retention, constipation, blurred vision (SLUDGE reversal).

Morphine — Drug class, use, and antidote? — Class: Opioid analgesic. Use: Severe pain, pulmonary edema, MI pain. Monitor respiratory rate — hold if RR < 12. Antidote: Naloxone (Narcan).

Naloxone (Narcan) — Drug class and use? — 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.

Acetaminophen (Tylenol) — Key concern and antidote? — Key concern: Hepatotoxicity (liver damage) in overdose. Max dose: 4g/day (2g/day in liver disease or alcohol users). Antidote: N-acetylcysteine (Mucomyst).

Ibuprofen (Advil) — Drug class and key contraindications? — Class: NSAID. Use: Pain, fever, inflammation. Contraindications: Peptic ulcer disease, renal impairment, third trimester pregnancy, heart failure. Take with food.

Prednisone — Drug class, use, and key side effects? — Class: Corticosteroid. Use: Inflammation, autoimmune conditions, allergic reactions. Side effects: Hyperglycemia, immunosuppression, Cushingoid features, osteoporosis. Never stop abruptly.

Levothyroxine (Synthroid) — Drug class and administration rules? — Class: Thyroid hormone replacement. Use: Hypothyroidism. Take on empty stomach, 30–60 min before breakfast. Check TSH levels regularly. Many drug interactions.

Omeprazole (Prilosec) — Drug class and use? — 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.

Ranitidine / Famotidine — Drug class and use? — Class: H2 receptor antagonist. Use: GERD, peptic ulcers, heartburn. Less potent than PPIs. Famotidine (Pepcid) is the current standard (ranitidine was withdrawn).

Ondansetron (Zofran) — Drug class, use, and concern? — Class: Antiemetic (5-HT3 antagonist). Use: Nausea and vomiting from chemotherapy, surgery, pregnancy. Monitor for QT prolongation.

Metoclopramide (Reglan) — Drug class, use, and key side effect? — Class: Antiemetic / prokinetic. Use: Nausea, GERD, gastroparesis. Risk of tardive dyskinesia with long-term use (involuntary movements).

Vancomycin — Drug class, use, and key monitoring? — Class: Glycopeptide antibiotic. Use: MRSA and other resistant gram-positive infections. Monitor: Trough levels, renal function. Side effect: "Red man syndrome" (slow infusion rate).

Penicillin — Drug class and key nursing consideration? — Class: Beta-lactam antibiotic. Use: Strep, syphilis, pneumococcal infections. Always ask about penicillin allergy — anaphylaxis risk. Cross-reactivity with cephalosporins.

Ciprofloxacin (Cipro) — Drug class and key considerations? — 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).

Metronidazole (Flagyl) — Drug class, use, and key warning? — Class: Antiprotozoal / antibiotic. Use: C. difficile, bacterial vaginosis, anaerobic infections. No alcohol during treatment and 48 hours after (severe nausea/vomiting — disulfiram-like reaction).

Fluconazole (Diflucan) — Drug class and use? — Class: Antifungal (azole). Use: Candida infections (oral thrush, vaginal yeast infections, systemic candidiasis). Monitor liver function with prolonged use.

Albuterol (ProAir, Ventolin) — Drug class, use, and key consideration? — Class: Short-acting beta-2 agonist (SABA) / bronchodilator. Use: Acute asthma/COPD attacks. Use BEFORE corticosteroid inhalers (opens airways first). Side effects: Tachycardia, tremor.

Fluticasone (Flovent) — Drug class, use, and nursing instruction? — Class: Inhaled corticosteroid. Use: Asthma (maintenance, not rescue). Instruct patient to rinse mouth after use to prevent oral candidiasis (thrush).

Lithium — Drug class, therapeutic level, and toxicity signs? — 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.

Haloperidol (Haldol) — Drug class, use, and key side effect? — Class: Typical (first-generation) antipsychotic. Use: Schizophrenia, acute psychosis, severe agitation. Risk of extrapyramidal side effects (EPS) including tardive dyskinesia.

Sertraline (Zoloft) — Drug class, use, and important warning? — 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.

Lorazepam (Ativan) — Drug class, use, and antidote? — Class: Benzodiazepine. Use: Anxiety, seizures, alcohol withdrawal, acute agitation. Antidote: Flumazenil. Risk of dependence. CNS depressant — monitor respiratory rate.

Phenytoin (Dilantin) — Drug class, use, and key nursing considerations? — 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.