100+ Pharmacology Mnemonics for the NCLEX-RN

How to use this list

Pharmacology on the NCLEX is pattern recognition. Most questions don't ask you to recall a single drug; they ask whether you'd hold the drug, what side effect to watch for, or what teaching to give. If you know the class pattern, you'll get most of those right without ever memorizing the specific drug.

Use the structure: (1) recognize the suffix, (2) recall the action, (3) recall the side-effect mnemonic, (4) recall the lab/vital monitor. That's the four-step muscle memory that makes pharm questions fast.

Drug class endings — the big 25

Ending	Class	Action / use	Watch for
-pril	ACE inhibitor	HTN, HF	Cough, hyperK, angioedema
-sartan	ARB	HTN, HF	HyperK; no cough vs ACEI
-olol	Beta blocker	HTN, MI, arrhythmia	Bradycardia, mask hypoglycemia
-pine (-dipine)	CCB (DHP)	HTN	Peripheral edema, flushing
-statin	HMG-CoA inhibitor	Hyperlipidemia	Myopathy, ↑LFT
-prazole	PPI	GERD, ulcer	Long-term: ↓Mg, ↓B12, fracture
-tidine	H2 blocker	GERD	Confusion in elderly (cimetidine)
-floxacin	Fluoroquinolone	Broad-spectrum abx	Tendon rupture, QT prolongation
-cycline	Tetracycline	Acne, atypicals	Photosensitivity, teeth staining (peds)
-mycin / -micin	Aminoglycoside (gent/tobra)	Gram-neg sepsis	Nephro/ototox, peak/trough
-cillin	Penicillin	Strep, syphilis	Allergy cross-react with cephalosporins
-cef-/-ceph-	Cephalosporin	Broad abx	Penicillin allergy cross-react ~10%
-azole	Antifungal (PO)	Candida, dermatophytes	↑LFT, drug interactions (CYP)
-vir	Antiviral	HSV, HIV, HCV	Renal dosing
-pam / -lam	Benzodiazepine	Anxiety, seizure	Respiratory depression; reverse w/ flumazenil
-phylline	Methylxanthine	Asthma/COPD	Narrow therapeutic; tachycardia, seizure
-terol	β2 agonist	Asthma rescue/maintenance	Tachycardia, tremor
-asone / -solone	Glucocorticoid	Inflammation	HyperGlu, ↑BP, infection risk, taper
-iptin (-gliptin)	DPP-4 inhibitor	T2DM	Pancreatitis
-glitazone	TZD	T2DM	Fluid retention, ↑MI risk
-flozin	SGLT2 inhibitor	T2DM, HF	UTI/yeast, euglycemic DKA
-tide / -nide	GLP-1 agonist	T2DM, weight	Pancreatitis, GI; thyroid C-cell tumor BBW
-parin	Heparin / LMWH	Anticoagulant	HIT, bleeding; antidote: protamine
-xaban	Factor Xa inhibitor	Anticoagulant	Bleeding; reversal: andexanet alfa
-triptan	5-HT agonist	Migraine abortive	Coronary vasospasm — avoid in CAD

High-yield side-effect mnemonics

ACE inhibitor cough — "ACE the cough": ACE inhibitors cause a dry cough via bradykinin accumulation. Switch to an ARB if intolerable.

Beta blocker — "ABCD": Asthma worsening, Bradycardia, Cardiac depression, Decompensated HF (in initial use).

Lithium toxicity — "LITH": Lethargy, Increased reflexes/tremor, Tinnitus, HyperGI (N/V/D). Therapeutic 0.6–1.2; toxic ≥1.5.

Digoxin toxicity — "DIG": Disturbed vision (yellow halos), Irregular pulse, GI (anorexia, N/V). Therapeutic 0.5–2; hold if HR <60. Antidote: digoxin immune fab.

Heparin — "HHH": Hemorrhage, HIT, Hyperkalemia. Monitor aPTT (1.5–2× normal) and platelets. Antidote: protamine.

Warfarin — "WARP": Watch INR (2–3 routine, 2.5–3.5 valves), Avoid green leafy excess, Risk bleeding, antidote Phytonadione (vitamin K).

Morphine — "POP": Pinpoint pupils, hypOtension, suppressed breathing. Antidote: naloxone.

NSAIDs — "BUGS": Bleeding (GI), Ulcers, Glomerular (renal) injury, Sodium/fluid retention.

Steroids long-term — "CUSHINGOID": Cataracts, Ulcers, Striae/Skin thinning, HTN, Hirsutism, Infection, Necrosis (avascular), Glucose ↑, Osteoporosis, Immunosuppression, Depression.

Lithium and ACE/thiazide caution — "LAST": Lithium + ACEI/Thiazide = Sudden Toxicity. Both raise lithium levels.

Antidotes — drug : reversal

• Acetaminophen → N-acetylcysteine
• Heparin → Protamine sulfate
• Warfarin → Vitamin K (phytonadione); FFP for emergency
• Direct factor Xa (apixaban, rivaroxaban) → Andexanet alfa
• Dabigatran → Idarucizumab
• Opioids → Naloxone (Narcan)
• Benzodiazepines → Flumazenil (rarely used; risk of seizure if chronic use)
• Beta blockers → Glucagon
• Calcium channel blockers → IV calcium
• Magnesium → IV calcium gluconate
• Digoxin → Digoxin immune fab
• Iron → Deferoxamine
• Lead → Succimer / EDTA / dimercaprol
• Methotrexate → Leucovorin
• Tylenol PM (anticholinergic) → Physostigmine
• Organophosphates → Atropine + pralidoxime
• Ethylene glycol / methanol → Fomepizole

Pregnancy & lactation — the can'ts

Memorize "ATCG" as drugs to avoid in pregnancy:

• Ace inhibitors / ARBs (renal anomalies)
• Tetracyclines (teeth/bones)
• Chemo / Coumadin (warfarin)
• Giving statins (lipid metabolism critical for fetal development)

Plus: isotretinoin (severe teratogen — iPLEDGE program), methotrexate, NSAIDs in 3rd trimester (premature ductus closure), lithium (Ebstein's anomaly).

Lab monitoring — what to check before / during / after

• Heparin → aPTT (1.5–2× normal), platelets (HIT screen)
• Warfarin → PT/INR (2–3 routine; 2.5–3.5 valves)
• Vancomycin → trough (10–20 mcg/mL; AUC for severe infections)
• Aminoglycosides → peak and trough; SCr
• Digoxin → level (0.5–2 ng/mL), K (low K = digtoxicity)
• Lithium → level (0.6–1.2), TSH, BUN/Cr
• Theophylline → level (10–20 mcg/mL)
• Methotrexate → CBC, LFTs, SCr; folic acid supplement
• Phenytoin → level (10–20 mcg/mL); free level if low albumin
• Statins → baseline LFTs, CK if myalgias

Insulin — onset / peak / duration

Insulin	Onset	Peak	Duration	NCLEX cue
Lispro / Aspart / Glulisine	~15 min	1 hr	3–5 hr	Give with meal
Regular (R)	30–60 min	2–4 hr	5–8 hr	Only insulin given IV
NPH (N)	1–2 hr	4–10 hr	10–18 hr	Cloudy; mix with R: clear-before-cloudy
Glargine / Detemir	~1 hr	No peak	~24 hr	Don't mix; once daily

Psych — quick patterns

• SSRI side effects: "SSRI" — Serotonin syndrome (with MAOI/triptan), Sexual dysfunction, Restlessness, Insomnia.
• MAOI dietary restriction: avoid tyramine — aged cheese, wine, smoked/cured meats, fava beans (hypertensive crisis).
• Lithium: levels q2–3 days when starting, then weekly until stable. Avoid dehydration and thiazides.
• Antipsychotic EPS: ADAPT — Akathisia (restless), Dystonia (acute), Akinesia (parkinsonism), Pseudoparkinsonism, Tardive dyskinesia (late, often permanent).
• Neuroleptic malignant syndrome (NMS): "FEVER" — Fever, Encephalopathy (altered MS), autonomic Vital instability, Elevated CK/enzymes, Rigidity. Stop drug, dantrolene, ICU.
• Serotonin syndrome: agitation, hyperreflexia, clonus, tremor — vs NMS which has rigidity. Stop drug, supportive care, sometimes cyproheptadine.

Cardiac — drug-specific NCLEX traps

• Hold beta blocker if HR < 60 or SBP < 100 (institutional thresholds vary; this is the typical NCLEX cue).
• Hold digoxin if HR < 60 in adults, < 70 child, < 90 infant.
• Nitroglycerin SL: 1 dose, wait 5 min, repeat up to 3 doses; call EMS if no relief after first dose.
• Adenosine: rapid IV push (1–2 sec) followed by 20-mL saline flush. Patient feels brief asystole — warn them.
• Amiodarone: "AMI" toxicity — Affects everything. Pulm fibrosis, hyper/hypothyroid (high iodine load), corneal microdeposits, hepatotoxicity. Long half-life (~60 days).

The 5 patterns that account for 80% of NCLEX pharm questions

1. Hold-the-drug: identify the vital/lab cutoff and decide.
2. Recognize toxicity: match the symptom set to the drug.
3. Patient teaching: identify the wrong statement (food, timing, lifestyle).
4. Antidote / reversal: match drug to antidote.
5. Drug interaction: recognize the dangerous pair (warfarin + NSAID, MAOI + SSRI, lithium + ACEI/thiazide).