NCLEX Medications

Anticholinergics

• Block the neurotransmitter acetylcholine.

• Used to treat various conditions.

• Side Effects: blurred vision, urinary retention, dry mouth, constipation, sedation

• Examples: antihistamines, tricyclic antidepressants, oxybutynin, tolterodine, solifenacin,dicyclomine, atropine, scopolamine, benztropine.

Proton Pump Inhibitors (PPI)

• Reduce stomach acid production.

• Examples: pantopraZOLE, lansopraZOLE, omepraZOLE, esomepraZOLE.

• Long-term use may reduce calcium absorption and promote osteoporosis.

• Take 30 minutes before meals.

Metoclopramide (Reglan)

• Increases GI motility and promotes stomach emptying.

• Used for delayed gastric emptying, GERD, and as an antiemetic.

• Side effects: sedation, restlessness, headache, dry mouth, constipation, diarrhea.

• Report dangerous side effects like EPS symptoms (movement dysfunction)

Antacids

• Neutralize stomach acid

• example: Sucralfate (carafate)

• Administer before meals with water, at least 2 hours apart from other meds

Fiber

• Used to relieve constipation

• Ex: psyllium, bran

Antidiarrheals

• Ex: loperamide (Imodium)

• Do not use for more than 2 days or with fever. Monitor Fluid and electrolyte levels

Tuberculosis

• Hepatotoxic except for Ethambutol

• Rifampin causes red/orange body fluids, wear glasses, and use non-hormonal birth control

• Isoniazid can cause peripheral neuropathy; take vitamin B6

• Ethambutol and Pyrazinamide treat active TB; monitor for optic neuritis

Antiemetic

• Ex: Ondansetron (Zofran)

• Monitor QT porlongation

Antiviral

• Used to treat herpes..

• Examples: acyclovir, famciclovir, valacyclovir.

Antipsychotics

• Typical/1st generation: haloperidol, fluphenazine.

  • Neuro symptoms, EPS

• Atypical/2nd generation: clozapine, risperidone, olanzapine.

  • Metabolic symptoms

• Clozapine can cause agranulocytosis. Monitor WBC and ANC, report fever or flu-like symptoms.

• Ziprasidone- QT prolongation

Antidepressants

• Monitor for worsening depression, behavior changes, and suicidal thoughts.

• MAOIs: avoid tyramine-rich foods and allow a 2-week washout period before other antidepressants to avoid hypertensive crisis

• TCA: Amitriptyline can cause cardiac toxicity.

• SSRI: take 1-4 weeks to see full effects, watch for serotonin syndrome. Can see increased affect with St John Wort. Side effect: sexual dysfunction

Stimulants

•  Used for ADHD.

• Examples: methylphenidate, dextroamphetamine

• Side effects: insomnia, decreased appetite, weight loss, headache, irritability, restlessness, tachycardia.

• Monitor growth and development.

Desmopressin

• Used for bedwetting and DI.

• Monitor for water intoxication/hyponatremia.

Lithium

• Used for bipolar disorder.

• Common side effects: dry mouth, constipation.

• Monitor sodium levels and kidney function.

• Therapeutic level: 0.6-1.2; risk factors for toxicity: DDDD (dehydration, diet low in sodium , decrease renal function, drug to drug interactions

• Toxicity symptoms: GI, neuro, seizures, encephalopathy.

Anticonvulsant

• Discontinue before ECT.

• May cause CNS depression, suicidal ideation, and SJS.

• Examples: carbamazepine, phenytoin, gabapentin, valproic acid, levetiracetam.

Antitussive

• Used to suppress cough.

• Examples: dextromethorphan

Expectorants and Mucolytics

•  Thins mucus in airways.

• Examples: guaifenesin, acetylcysteine.

Asthma Medications

• Bronchodilators for acute exacerbations.

• Monitor for side effects, rinse mouth after corticosteroid inhalers.

• Theophylline requires monitoring for toxicity.

Bisphosphonates

• Prevent loss of bone density.

• Take in the morning on an empty stomach, with water, and remain upright for 30 minutes.

• Take calcium and vitamin D for strong bones.

Alpha Adrenergic Blockers

•  Used to treat BPH.

• Side effects: orthostatic hypotension, syncope, ejaculatory dysfunction.

• Prazosin, Terzosin

Antifungals

• Used to treat fungal infections.

• Examples: fluconazole, nystatin, terbinafine.

Antibiotics

• Used to treat bacterial infections.

• Can negatively affect gut health.

• Frequent liquid stool may indicate C. difficile infection.

• Avoid alcohol

• Prophylactic antibiotics for dental procedures in certain cardiac patients.

Macrolides (Antibiotics)

• Includes Azithromycin, Erythromycin, Clarithromycin.

• Can cause prolonged QT interval and hepatotoxicity

Aminoglycosides (Antibiotics)

•  Monitor peak and trough levels.

• Serious adverse reactions include ototoxicity and nephrotoxicity.

Cephalosporin (Antibiotics)

•  Includes Ceftriaxone (Rocephin) and Cephazolin.

• Cross sensitivity to penicillin

Quinolone (Antibiotics)

•  Includes Ciprofloxacin, Levofloxacin, Moxifloxacin.

• Risk of tendinitis and tendon rupture-black box warning.

Tetracycline (Antibiotics)

• Includes Doxycycline, Tetracycline, Minocycline.

• Take on an empty stomach with a full glass of water.

• Avoid antacids, dairy, or iron supplements.

• Side effects include photosensitivity and decreased oral contraceptive effectiveness.

Penicillin (Antibiotics)

• Includes Amoxicillin and Ampicillin.

Smoking Cessation Drugs

• Nicotine replacement therapy.

• Varenicline (Chantix), Bupropion (Wellbutrin, Zyban).

Alcohol Cessation Drug

•  Disulfiram (Antabuse) causes unpleasant reactions when alcohol is consumed.

•  Avoid hidden sources of alcohol.

•  Wear a bracelet to alert others.

Magnesium Sulfate

•  Used for seizures, preeclampsia, hypomagnesemia, torsades de pointes.

• Monitor for toxicity symptoms.

Blood Pressure Medication

• Calcium Channel Blockers (CCB): Nifedipine, Amlodipine, etc.

• ACE Inhibitors: Lisinopril, Captopril, Enalapril.- watch for hyperkalemia and

  angioedema

•  Beta Blockers (BB): Metoprolol, Atenolol, Carvedilol, Propranolol.

• A2RB: Angiotensin 2 receptor blocker: Losartan, Valsartan

Muscle Relaxants

• Baclofen, Cyclobenzaprine, Succinylcholine, Carisoprodol, Methocarbamol.

Diabetic Medications

• Metformin as 1st line for type 2 diabetes.

• Thiazolidinediones, Sulfonylureas, Glucagon, Insulin, Glucagon-like peptide-1 receptor

  agonists.

Antithyroid Medications

•  Propylthiouracil, Methimazole for hyperthyroidism.

• radioactive iodine for thyroid storm.

• Levothyroxine for hypothyroidism.

Anti-Anxiety Medications

• Benzodiazepines (Alprazolam, Lorazepam), sedatives.

Opiods (pain relievers)

• Various opioids with different effects.

• Watch for respiratory depression.

•  Naloxone for opioid overdose.

NSAIDs

• Commonly used for pain, inflammation, and fever.

• Can cause GI issues and bleeding.

Neuropathic Pain relievers

• Pregabalin anad Gabapentin

Corticosteroids

• Hydrocortisone, Dexamethasone, Prednisone, Methylprednisolone, etc.

• Suppress inflammation, immune system, and increases blood sugar

• Need for gradual discontinuation.

• Side effects include Cushing's syndrome and increased risk of infection.

Antineoplastic/Anticancer drugs

• Various drugs used in cancer treatment.

• Monitor WBC levels and follow-up closely.

Diuretics

• Loop, Potassium-Sparing, Thiazide, Osmotic diuretics.

• Monitor electrolytes and kidney function.

• Hypokalemia risk with most diuretics.

H1 Receptor Blockers (antihistamines)

• Inhibit the effects of histamine and used as antihistamines.

• Examples: Fexofenadine, cetirizine, levocetirizine, loratadine, diphenhydramine,

  promethazine.

• Used for allergic reactions to reduce the inflammatory response.

Anesthetics

• Used for anesthesia and sedation.

• Epidural anesthesia contraindicated in uncontrolled hypertension, coagulopathies, and

  epidural site infection.

Tocolytics

• Used to suppress premature labor.

• Examples: Terbutaline, magnesium sulfate, indomethacin, nifedipine.

• Prolong pregnancy by 2-7 days to allow lung maturation with steroids.

Uterotonic Drugs

• Given to increase labor contractions.

• Examples: Oxytocin, carboprost, misoprostol, methylergonovine.

• Used for inducing labor or controlling postpartum bleeding.

Phosphodiestease Inhibitors (PDE5 Inhibitors)

• Promote vasodilation and relax smooth muscles.

•  Examples: Tadalafil, sildenafil, vardenafil (used for erectile dysfunction).

• Side effects include hypotension and potential for prolonged erection.

Anticoagulants

• Used to prevent blood clots.

• Examples: Warfarin, heparin, dabigatran, rivaroxaban, apixaban.

• Monitor clotting times (PT, PTT, INR) for dosage adjustments.

• Bleeding precautions, watch for signs of bleeding, and avoid herbs and NSAIDs

Thrombolytics

• Used to treat active blood clots.

• Examples: Alteplase, tenecteplase, reteplase.

• Contraindicated in active bleeding, recent trauma, or hemorrhagic conditions.

Statins

• Used to lower cholesterol levels.

• Example: Rosuvastatin (Crestor).

• Monitor for muscle-related side effects and liver function.