Need-to-Know Pharmacology: 26 Medications and Their Variants

Vocabulary practice flashcards covering prototype medications, naming clues, mechanism of action, major complications, pre-administration nursing assessments, and critical client teaching.

Omeprazole

A prototype proton pump inhibitor (PPI) with the suffix "-prazole" that shuts down the stomach's acid pump by blocking the $H^+/K^+$ pump; indicated for ulcers and GERD, with long-term risks of C. diff, pneumonia, bone fractures, low $Mg$, and low $B12$.

Pantoprazole (Protonix)

A proton pump inhibitor available in PO and IV formulations; commonly administered intravenously in hospital settings for active GI bleeding, NPO clients, and stress-ulcer prophylaxis.

Famotidine (Pepcid)

An H2 receptor blocker with the suffix "-tidine"; acts as a weaker, faster acid reducer that can be taken at bedtime or before meals, and requires a decreased dose in kidney disease.

Ondansetron

A prototype 5-HT3 receptor antagonist antiemetic with the suffix "-setron" that blocks the serotonin vomit signal from the gut and brain; major risks include QT prolongation, serotonin syndrome, headache, and constipation.

Metoclopramide (Reglan)

A dopamine antagonist and prokinetic antiemetic that speeds gastric emptying; carries a critical risk of extrapyramidal symptoms (EPS) and tardive dyskinesia.

Promethazine

A phenothiazine antiemetic that is highly sedating; IV administration can cause severe tissue necrosis and injury, making deep IM injection the preferred parenteral route.

Docusate Sodium

A surfactant stool softener that acts like soap to let water penetrate stool and prevent straining (avoiding the Valsalva maneuver); typically produces bowel movements within $1\text{--}3\text{ days}$.

Polyethylene Glycol 3350

An osmotic laxative that acts as a water magnet in the colon to soften stool and promote defecation; standard dosing is $17\text{ g}$ in $4\text{--}8\text{ oz}$ of liquid daily, limited to $\le 7\text{ days}$ for OTC use to avoid dehydration and electrolyte imbalances.

Lactulose

An osmotic laxative also indicated for hepatic encephalopathy to decrease systemic ammonia levels, titrated to achieve a therapeutic target of $2\text{--}3$ soft stools per day.

Loperamide

A gut-only opioid antidiarrheal that binds mu-opioid receptors in the intestines to slow peristalsis; contraindicated in bloody stool, high fever, or C. diff due to the danger of inducing toxic megacolon.

Ferrous Sulfate

An oral iron supplement that increases hemoglobin and oxygen delivery; common side effects include constipation, GI upset, and harmless black stools, with a high danger of fatal overdose in children.

Iron Dextran (INFeD)

An IV and IM iron formulation that carries an FDA black box warning for fatal anaphylaxis; requires a test dose prior to full administration and IM injection using the Z-track technique.

Cyanocobalamin

Vitamin B12 necessary for RBC DNA synthesis and neuronal myelin production; patients with pernicious anemia lack intrinsic factor and require lifelong parenteral injections.

Folic Acid

Vitamin B9 used to treat megaloblastic anemia and prevent neural tube defects ($400\text{ mcg/day}$ recommended before and during pregnancy); can dangerously mask underlying vitamin B12 deficiency by correcting anemia while neurologic injury progresses.

Leucovorin (folinic acid)

An active form of folate administered as a rescue agent after high-dose methotrexate chemotherapy by bypassing the blocked folate metabolic pathway.

Potassium Chloride (KCl)

An electrolyte replacement for maintaining serum potassium ($3.5\text{--}5.0\text{ mEq/L}$); must NEVER be administered via IV push, requires a documented urine output of $\ge 30\text{ mL/hr}$ before IV infusion, and peripheral IV rates are typically capped at $\le 10\text{ mEq/hr}$.

Magnesium Sulfate IV

A high-alert IV electrolyte and anticonvulsant indicated for pre-eclampsia/eclampsia, torsades de pointes, and severe hypomagnesemia; monitored via deep tendon reflexes (DTRs), respiratory rate ($\ge 12$), and urine output, with calcium gluconate kept at bedside as an antidote.

Calcium Carbonate (Tums, Os-Cal)

An oral calcium supplement and antacid containing $40\%$ elemental calcium; depends on gastric acid for dissolution and absorption and must therefore be taken with food.

Calcium Gluconate IV

An IV calcium replacement that is gentler on peripheral veins; used for acute hypocalcemia, cardioprotection against dysrhythmias in severe hyperkalemia, and as the antidote for magnesium toxicity.

Calcium Chloride IV

A concentrated IV calcium formulation delivering $3\times$ more elemental calcium than calcium gluconate; preferred for cardiac arrest and ideally infused through a central line to prevent severe tissue necrosis from extravasation.

Calcitriol (Rocaltrol)

The active form of vitamin D indicated for chronic kidney disease (CKD) and hypoparathyroidism because impaired kidneys cannot activate precursor vitamin D; carries a heightened risk of hypercalcemia.

Levothyroxine

A synthetic thyroid hormone (T4) replacement taken lifelong for hypothyroidism; must be administered on an empty stomach $30\text{--}60\text{ min}$ before breakfast and separated by at least $4\text{ hr}$ from calcium and iron.

Methimazole

An oral thioamide antithyroid drug that inhibits thyroid hormone synthesis; requires immediate patient reporting of sore throat or fever due to the danger of agranulocytosis.

Propylthiouracil (PTU)

A thioamide antithyroid medication carrying an FDA black box warning for severe liver injury; clinically preferred over methimazole during the first trimester of pregnancy and in thyroid storm emergencies.

Prednisone

A synthetic glucocorticoid corticosteroid ending in "-sone" / "-olone" that suppresses inflammation and immunity; must be tapered gradually upon discontinuation to prevent life-threatening adrenal crisis.

Metformin

A biguanide oral antidiabetic drug that decreases liver glucose production and improves insulin sensitivity without causing hypoglycemia alone; carries a black box warning for lactic acidosis and must be temporarily withheld around iodinated contrast dye procedures.

Glyburide

A sulfonylurea antidiabetic agent (beginning with "gli-" / "gly-") that stimulates pancreatic beta cells to secrete insulin; carries a major risk of severe, prolonged hypoglycemia and weight gain.

Insulin Lispro

A rapid-acting mealtime insulin ("-log, -pid, -spart") with an onset of $15\text{ min}$, a peak of $\sim 1\text{ hr}$, and a duration of $3\text{--}5\text{ hr}$; clients must eat within $15\text{ min}$ of injection to avoid rapid hypoglycemia.

Regular Insulin

A short-acting human insulin with an onset of $30\text{--}60\text{ min}$, peak of $2\text{--}4\text{ hr}$, and duration of $5\text{--}8\text{ hr}$; the standard insulin used for IV infusions (DKA) and drawn up clear before cloudy when combined with NPH.

NPH Insulin

An intermediate-acting cloudy insulin with an onset of $1\text{--}2\text{ hr}$, peak of $4\text{--}12\text{ hr}$, and duration of $12\text{--}18\text{ hr}$; must be rolled gently rather than shaken, administered subQ only, and places clients at peak risk for afternoon or overnight hypoglycemia.

Insulin Glargine

A long-acting basal insulin analog ("-glar, -tem, -dec") with an onset of $1\text{--}2\text{ hr}$, no pronounced peak, and a duration of $\sim 24\text{ hr}$; must never be mixed in the same syringe with other insulins and never administered IV.

Conjugated Estrogens

Hormone replacement therapy for postmenopausal symptoms that increases the risks of endometrial cancer (if unopposed by progestin), deep vein thrombosis, pulmonary embolism, stroke, myocardial infarction, and dementia.

Medroxyprogesterone (Depo-Provera)

An injectable synthetic progestin contraceptive administered deep IM every $13\text{ weeks}$; carries a major danger of progressive bone mineral density loss and irregular bleeding.

Testosterone

A Schedule III androgen replacement for male hypogonadism; topical gel forms carry a black box warning for secondary transfer causing accidental virilization in children and female contacts.

Tamsulosin

A prostate-selective alpha-1 adrenergic antagonist (suffix "-osin") that relaxes smooth muscle in the prostate and bladder neck to improve urinary flow in BPH; causes orthostatic hypotension and intraoperative floppy iris syndrome during cataract surgery.

Sildenafil

A PDE-5 inhibitor (suffix "-afil") that increases cGMP to cause smooth muscle relaxation and vasodilation for erectile dysfunction or pulmonary arterial hypertension; absolutely contraindicated with nitrates due to severe, potentially fatal hypotension.