Pharmacology – Nurse Arcade

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Start here

How to use the class tables

Representative ADN-level medications; not a formulary or prescribing guide.

1 – Class

Learn the shared mechanism and predictable class effects before memorizing individual names.

2 – Indication

Connect every medication to why this patient is receiving it and the outcome you expect.

3 – Safety

Check allergies, baseline assessment, labs, route and form, interactions, organ function, and ordered parameters.

4 – Reassess

Evaluate therapeutic response and adverse effects at the medication-appropriate time.

5 – Teach

Explain purpose, schedule, administration, common effects, red flags, and when to seek help.

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Drug class review

Medication foundations

Rights, reconciliation, kinetics, safety

Medication administration begins with indication, allergies and reactions, current medications and substances, route and form, renal and hepatic function, baseline assessment, and a plan to evaluate effect.

Medication foundations medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Seven rights	Every medication administration	Preventable harm when any right is wrong	Interruptions, look-alike names, duplicate products	Stop and clarify every mismatch or incomplete order
Medication reconciliation	Transitions and every encounter	Omission, duplication, interaction, withdrawal	Prescription, OTC, alcohol, nicotine, supplements, food	Compare the best possible list with current orders
ADME and half-life	Predict onset, duration, accumulation, clearance	Toxicity with impaired kidney or liver function	Inducers, inhibitors, and competing clearance	Verify organ function, age, weight, route, timing, and levels
High-alert safeguards	Insulin, anticoagulants, opioids, electrolytes, chemotherapy, sedation	Severe harm from small errors	Multiple high-risk drugs compound harm	Use required independent checks and smart-pump libraries

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Drug class review

Analgesics and anti-inflammatory drugs

Pain, fever, inflammation

Nonopioids reduce pain and fever; NSAIDs also reduce inflammation but can injure the GI tract and kidneys. Opioids can depress respiration.

Analgesics and anti-inflammatory drugs medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Acetaminophen	Pain, fever	Nausea; hepatotoxicity in overdose	Alcohol; duplicate combination products	Verify total daily dose and liver risk
Ibuprofen, naproxen, ketorolac	Pain, inflammation	GI bleeding, renal injury, fluid retention	Anticoagulants, steroids, ACEI or ARB plus diuretics	Verify bleeding, renal, ulcer, and volume risk
Aspirin	Pain, fever; antiplatelet therapy	GI bleeding, tinnitus, bronchospasm	Anticoagulants, NSAIDs, alcohol	Verify indication and bleeding risk
Morphine, hydromorphone, oxycodone, fentanyl	Moderate to severe pain	Sedation, constipation, hypotension, respiratory depression	Alcohol, benzodiazepines, other sedatives	Hold or escalate unsafe sedation or respirations per order and policy
Naloxone	Opioid reversal	Acute withdrawal; recurrent sedation	Opioid duration may exceed naloxone	Reassess breathing and repeat per protocol

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Drug class review

Antibiotics

Bacterial infections

Antibiotics target bacterial structures or processes. Obtain cultures when ordered, assess allergy history carefully, give on schedule, and monitor clinical response and organ function.

Antibiotics medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Penicillin, amoxicillin, piperacillin-tazobactam	Streptococcal, respiratory, skin, broad inpatient infections	Rash, diarrhea, anaphylaxis	Methotrexate; warfarin effects may change	Hold and escalate suspected anaphylaxis or severe rash
Cephalexin, ceftriaxone, cefepime	Skin, urinary, respiratory, serious gram-negative infections	GI effects, allergy, C. difficile, neurotoxicity risk	Warfarin; product-specific compatibility	Verify allergy and renal dosing
Azithromycin	Respiratory and STI infections	GI upset, QT prolongation	Other QT-prolonging drugs	Verify QT and electrolyte risk
Doxycycline	Tick-borne, acne, atypical infections	Photosensitivity, esophagitis	Antacids and iron reduce absorption	Separate interacting products; check pregnancy and age considerations
Vancomycin	Serious gram-positive and MRSA infections	Infusion reaction, nephrotoxicity, ototoxicity	Other nephrotoxins	Verify AUC or level plan and renal function
Gentamicin, tobramycin	Serious gram-negative infections	Nephrotoxicity, ototoxicity	Loop diuretics and other nephrotoxins	Verify levels and renal function
Ciprofloxacin, levofloxacin	Selected urinary and respiratory infections	Tendon injury, neuropathy, CNS effects, QT change	Cations, steroids, QT drugs	Report tendon or neurologic symptoms
Metronidazole	Anaerobic and protozoal infections	GI upset, metallic taste, neuropathy	Alcohol, warfarin	Avoid alcohol; monitor interaction

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Drug class review

Anticoagulants, antiplatelets and thrombolytics

Prevent or treat thrombosis

These drugs reduce clot formation or platelet aggregation. Balance thrombosis prevention with bleeding risk and use the correct monitoring and reversal pathway.

Anticoagulants, antiplatelets and thrombolytics medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Heparin	VTE and ACS treatment or prevention	Bleeding, HIT	Antiplatelets, NSAIDs	Verify aPTT or anti-Xa protocol and platelets; stop and escalate suspected HIT
Enoxaparin	VTE and ACS	Bleeding, thrombocytopenia	NSAIDs, antiplatelets	Verify renal function, weight, platelets, and neuraxial timing
Warfarin	AF, VTE, selected valves	Bleeding, skin necrosis, fetal harm	Many drugs; vitamin K intake changes	Verify INR and indication; hold only per order or protocol
Apixaban, rivaroxaban, dabigatran	AF and VTE	Bleeding	Strong CYP or P-gp modifiers; NSAIDs	Verify renal and hepatic function and last dose
Aspirin, clopidogrel	ACS, stroke, stent prevention	Bleeding, bruising	NSAIDs, anticoagulants	Verify bleeding and procedure plan
Alteplase, tenecteplase	Selected ischemic stroke, MI, or PE	Major or intracranial bleeding	Anticoagulants and antiplatelets	Use strict checklist, timing, BP, labs, and contraindications

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Drug class review

Antihypertensives

Hypertension, heart failure, rate control

These classes lower blood pressure through RAAS blockade, vascular effects, reduced sympathetic tone, or slower heart rate. Trend BP, renal function, potassium, and symptoms.

Antihypertensives medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Lisinopril, enalapril	HTN, HF, renal protection	Cough, hyperkalemia, hypotension, angioedema, renal change	Potassium, NSAIDs, lithium	Escalate angioedema; verify BP, potassium, creatinine, pregnancy
Losartan, valsartan	HTN, HF, renal protection	Hyperkalemia, hypotension, renal change	Potassium, NSAIDs, lithium	Verify BP, potassium, renal function, pregnancy
Amlodipine, nifedipine	HTN, angina	Edema, flushing, headache, hypotension	CYP3A4 modifiers	Verify BP and symptomatic hypotension
Diltiazem, verapamil	Rate control, angina, HTN	Bradycardia, heart block, hypotension, constipation	Beta blockers, digoxin	Verify HR, BP, rhythm, and HF status
Metoprolol, carvedilol, propranolol	HTN, angina, rate control, HF, migraine	Bradycardia, hypotension, fatigue, bronchospasm; masks hypoglycemia	Other rate-slowing drugs	Use ordered HR and BP parameters; assess wheeze and perfusion
Clonidine	HTN	Sedation, dry mouth, bradycardia; rebound HTN	CNS depressants	Do not stop abruptly; verify BP and HR
Prazosin, tamsulosin	HTN; BPH symptoms	Orthostatic hypotension, dizziness	PDE-5 inhibitors, other BP drugs	Fall precautions; verify BP and symptoms

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Drug class review

Diuretics

Edema, heart failure, hypertension

Diuretics change sodium and water handling. Monitor weight and volume trends, BP, electrolytes, kidney function, and hearing with high-dose loop therapy.

Diuretics medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Furosemide, bumetanide	Edema, HF, pulmonary congestion	Hypokalemia, dehydration, hypotension, renal change, ototoxicity	Digoxin, lithium, NSAIDs	Verify BP, potassium, magnesium, renal function, volume status
Hydrochlorothiazide, chlorthalidone	HTN, mild edema	Hyponatremia, hypokalemia, hyperuricemia, glucose change	Lithium, NSAIDs	Verify electrolytes, renal function, BP
Spironolactone, eplerenone	HF, aldosteronism, ascites	Hyperkalemia, renal change; gynecomastia with spironolactone	ACEI, ARB, potassium	Verify potassium and renal function
Mannitol	Raised ICP or IOP; selected renal uses	Fluid shifts, pulmonary edema, electrolyte change	Other nephrotoxic or volume-altering drugs	Verify osmolality, renal and cardiac status, and filter

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Drug class review

Cardiac and emergency drugs

Angina, dysrhythmia, heart failure, arrest

These agents can rapidly change rate, rhythm, contractility, vascular tone, or perfusion. Continuous assessment and indication-specific protocols matter.

Cardiac and emergency drugs medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Nitroglycerin	Angina, ACS, pulmonary edema	Headache, hypotension, reflex tachycardia	PDE-5 inhibitors, other BP drugs	Verify BP and recent PDE-5 use
Digoxin	HF symptom support, AF rate control	Bradycardia, dysrhythmia, GI or visual changes	Amiodarone, verapamil; low potassium increases toxicity	Verify apical rate, potassium, renal function, and level when ordered
Amiodarone	Atrial and ventricular dysrhythmias	Bradycardia, QT change, lung, liver, thyroid toxicity	Warfarin, digoxin, QT drugs	Verify rhythm, QT, BP, and organ monitoring
Adenosine	Selected regular narrow-complex SVT	Flushing, chest pressure, transient asystole, bronchospasm	Caffeine and theophylline; dipyridamole	Continuous ECG; rapid push per protocol; resuscitation readiness
Atropine	Symptomatic bradycardia; secretions	Tachycardia, dry mouth, urinary retention	Other anticholinergics	Verify rhythm and indication
Epinephrine, norepinephrine, dopamine, dobutamine	Arrest, shock, anaphylaxis, low output – agent specific	Dysrhythmia, ischemia, hypertension, extravasation	MAOI and other sympathomimetics	Continuous hemodynamic monitoring; verify concentration and line

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Drug class review

Respiratory drugs

Asthma, COPD, allergy, airway edema

Bronchodilators open airways; inhaled steroids control inflammation but do not rescue acute bronchospasm. Technique and device teaching are essential.

Respiratory drugs medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Albuterol	Acute bronchospasm	Tremor, tachycardia, hypokalemia	Other stimulants; nonselective beta blockers	Reassess breath sounds, HR, and work of breathing
Ipratropium, tiotropium	COPD and asthma adjunct	Dry mouth, urinary retention, glaucoma concern	Other anticholinergics	Avoid eye exposure; verify urinary and glaucoma risk
Fluticasone, budesonide	Asthma and COPD control	Thrush, dysphonia; systemic effects at high dose	Strong CYP3A4 inhibitors	Not rescue; rinse mouth
Montelukast	Asthma and allergic-rhinitis control	Neuropsychiatric effects	Review the complete profile	Report behavior or mood changes
Theophylline	Selected asthma or COPD	Nausea, tremor, seizures, dysrhythmia	Many CYP drugs; caffeine; smoking changes levels	Verify level, interactions, HR
Acetylcysteine	Mucolytic; acetaminophen antidote	Bronchospasm, nausea, anaphylactoid reaction IV	Activated-charcoal timing	Verify indication, protocol, and airway response

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Drug class review

Diabetes drugs

Diabetes and hyperglycemia

Match drug action to meals, renal function, illness, and glucose trend. Hypoglycemia is the immediate safety priority; insulin is high-alert.

Diabetes drugs medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Insulin lispro or aspart	Meal and correction glucose control	Hypoglycemia, hypokalemia	Other glucose drugs; beta blockers mask symptoms	Verify glucose, meal availability, dose, and independent check
Regular insulin	Meal or correction; IV DKA and hyperkalemia protocols	Hypoglycemia, hypokalemia	Other glucose-lowering drugs	Verify route and concentration; IV only by protocol
NPH insulin	Intermediate basal coverage	Hypoglycemia	Other glucose drugs	Verify timing, appearance, and mixing rules
Glargine, detemir, degludec	Basal coverage	Hypoglycemia	Other glucose drugs	Do not mix glargine; verify dose and trend
Metformin	Type 2 diabetes	GI effects, B12 reduction; rare lactic acidosis	Contrast and renal impairment increase risk	Verify eGFR and contrast or sick-day policy
Glipizide, glyburide	Type 2 diabetes	Hypoglycemia, weight gain	Alcohol, other glucose drugs	Verify glucose and meal; consider renal and older-adult risk
Semaglutide, liraglutide	Type 2 diabetes, weight and cardiovascular benefit	GI effects, gallbladder and pancreatitis concerns	Slows gastric emptying	Verify escalation and severe abdominal symptoms
Empagliflozin, dapagliflozin	Type 2 diabetes, HF and renal benefit	Genital infection, volume loss, euglycemic DKA	Diuretics	Verify renal function, hydration, and perioperative sick-day plan

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Drug class review

Thyroid and corticosteroids

Thyroid disorders, inflammation, adrenal replacement

Thyroid replacement requires consistent administration. Systemic corticosteroids alter immunity, glucose, mood, bone, fluid, and adrenal function.

Thyroid and corticosteroids medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Levothyroxine	Hypothyroidism	Overreplacement: tachycardia, tremor, insomnia	Iron, calcium, antacids; warfarin	Give consistently; verify TSH plan and cardiac symptoms
Methimazole, propylthiouracil	Hyperthyroidism	Agranulocytosis, hepatotoxicity	Warfarin and digoxin needs may change	Urgently report fever or sore throat; monitor liver cues
Prednisone, methylprednisolone, dexamethasone	Inflammation, immune disease, cerebral or airway edema	Hyperglycemia, infection, mood, GI, bone, adrenal effects	NSAIDs, vaccines, glucose drugs	Verify infection and glucose; do not abruptly stop long therapy
Hydrocortisone	Adrenal replacement, shock adjunct	Systemic corticosteroid effects	Same class interactions	Stress dosing and taper per plan

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Drug class review

GI drugs

Acid disease, nausea, bowel disorders

GI drugs alter acid, motility, secretion, or emesis pathways. Identify obstruction, bleeding, severe abdominal pain, and electrolyte loss before treating symptoms.

GI drugs medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Omeprazole, pantoprazole	GERD, ulcer, GI bleed protocols	Headache; long-term low magnesium or B12, fractures, infection	Clopidogrel interaction strongest with omeprazole	Verify indication and duration
Famotidine	GERD and ulcer	Headache, confusion in older or renal patients	May alter absorption of pH-dependent drugs	Verify renal dosing
Ondansetron	Nausea and vomiting	Headache, constipation, QT prolongation	Other QT and serotonergic drugs	Verify QT and electrolytes when at risk
Metoclopramide	Gastroparesis, nausea	EPS, tardive dyskinesia, sedation	Antipsychotics, serotonergic drugs	Hold and escalate abnormal movements
Loperamide	Diarrhea	Constipation, ileus; cardiac toxicity in overdose	QT drugs in misuse	Avoid with suspected invasive infection or ileus per plan
Lactulose	Constipation, hepatic encephalopathy	Diarrhea, electrolyte loss	Other laxatives	Titrate to ordered endpoint; verify hydration
Polyethylene glycol, senna, bisacodyl	Constipation	Cramping, diarrhea, electrolyte change	Other laxatives	Verify obstruction and bowel pattern

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Drug class review

Neurologic drugs

Seizures, neuropathic pain, Parkinson disease

Antiseizure therapy requires adherence and drug-specific monitoring. Many agents cause CNS depression and have major pregnancy or interaction considerations.

Neurologic drugs medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Levetiracetam	Seizures	Somnolence, dizziness, mood or behavior change	CNS depressants	Verify renal dosing; report suicidal or behavior change
Phenytoin	Seizures	Nystagmus, ataxia, gingival growth, rash, dysrhythmia IV	Many CYP interactions; tube feeds	Verify level, albumin, IV rate and line, rash
Valproate	Seizures, bipolar disorder, migraine	Hepatotoxicity, pancreatitis, thrombocytopenia, fetal harm	Many CNS and antiseizure drugs	Verify liver, platelets, pregnancy risk, level
Carbamazepine	Focal seizures, trigeminal neuralgia	Hyponatremia, marrow suppression, serious rash	Strong CYP inducer; grapefruit	Verify CBC, sodium, and screening plan
Gabapentin, pregabalin	Neuropathic pain, seizures	Sedation, dizziness, edema, respiratory risk with opioids	Opioids and CNS depressants	Verify renal dosing and sedation
Carbidopa-levodopa	Parkinson symptoms	Nausea, orthostasis, dyskinesia, hallucinations	Protein and iron can affect absorption; antipsychotics oppose	Give on time; verify mobility and mental status

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Drug class review

Psychiatric drugs

Depression, anxiety, bipolar disorder, psychosis

Monitor suicidality, serotonin toxicity, mania, extrapyramidal symptoms, metabolic effects, and cardiac conduction.

Psychiatric drugs medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Sertraline, fluoxetine, escitalopram	Depression, anxiety	GI effects, sexual dysfunction, insomnia, hyponatremia, bleeding	MAOI, serotonergic drugs, NSAIDs	Monitor suicidality and serotonin syndrome; never combine with MAOI
Venlafaxine, duloxetine	Depression, anxiety; neuropathic pain	Nausea, BP increase, withdrawal	MAOI and serotonergic drugs	Verify BP and taper plan
Amitriptyline	Depression, neuropathic pain	Anticholinergic effects, orthostasis, overdose dysrhythmia	MAOI, QT and CNS depressants	Verify ECG or overdose risk and anticholinergic burden
Lorazepam, diazepam	Acute anxiety, seizures, withdrawal	Sedation, falls, respiratory depression, dependence	Opioids, alcohol, CNS depressants	Hold or escalate unsafe sedation or respiration; taper long use
Haloperidol	Psychosis, agitation	EPS, QT prolongation, NMS	QT drugs, CNS depressants	Monitor movement, temperature or rigidity, ECG risk
Quetiapine, risperidone, olanzapine	Psychosis, bipolar disorder	Sedation, orthostasis, metabolic effects, EPS	CNS depressants, BP drugs	Monitor weight, glucose, lipids, movement, BP
Lithium	Bipolar disorder	Tremor, GI effects, renal or thyroid injury, toxicity	NSAIDs, ACEI or ARB, thiazides, dehydration	Verify level, renal and thyroid status, sodium and fluid changes

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Drug class review

Sedation, anesthesia and paralysis

Procedures, ventilation, anesthesia

These drugs can abolish consciousness, breathing, airway reflexes, or movement. Paralysis does not provide sedation or analgesia.

Sedation, anesthesia and paralysis medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Propofol	Procedural and ICU sedation	Apnea, hypotension, bradycardia, hypertriglyceridemia	Other CNS depressants	Continuous airway and hemodynamic monitoring
Dexmedetomidine	ICU and procedural sedation	Bradycardia, hypotension	Other rate-slowing drugs	Verify HR, BP, and sedation goal
Midazolam	Sedation, seizures	Respiratory depression, hypotension, paradoxical agitation	Opioids, CYP3A4 inhibitors	Continuous respiration and sedation monitoring
Ketamine	Anesthesia and analgesia	Emergence effects, hypertension, secretions	CNS depressants, sympathomimetics	Verify BP and airway readiness
Succinylcholine	Rapid paralysis	Hyperkalemia, malignant hyperthermia, bradycardia	Volatile anesthetics; risk conditions	No sedation or analgesia; verify contraindications and ventilation
Rocuronium, vecuronium	Paralysis	Prolonged weakness, anaphylaxis	Aminoglycosides and other blockers	Ensure sedation, analgesia, and mechanical ventilation

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Drug class review

Reproductive and obstetric drugs

Contraception, labor, hemorrhage, hypertensive emergencies

Pregnancy and lactation alter benefit and risk decisions. Verify gestational context, fetal assessment, contraindications, and unit protocols.

Reproductive and obstetric drugs medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Ethinyl estradiol combinations	Contraception, cycle control	VTE, hypertension, nausea	Enzyme inducers; smoking increases vascular risk	Verify pregnancy, VTE, migraine, and smoking risks
Oxytocin	Induction or augmentation; postpartum hemorrhage	Tachysystole, fetal compromise, water intoxication, hypotension	Other uterotonics	Continuous maternal, fetal, and contraction monitoring per protocol
Magnesium sulfate	Preeclampsia seizure prevention; fetal neuroprotection	Flushing, weakness, respiratory depression, loss of reflexes	CNS depressants, calcium-channel blockers	Verify reflexes, respirations, urine output, and level per protocol
Methylergonovine	Postpartum hemorrhage	Hypertension, vasospasm	Other vasoconstrictors	Avoid or hold with hypertension per protocol
Carboprost	Postpartum hemorrhage	Diarrhea, fever, bronchospasm	Other uterotonics	Avoid or verify with asthma
Misoprostol	Cervical ripening, uterine atony, ulcer prevention	Fever, diarrhea, uterine tachysystole	Other uterotonics	Use route- and dose-specific obstetric protocol
Terbutaline	Selected uterine tachysystole; bronchodilation	Tachycardia, tremor, hyperglycemia	Other sympathomimetics	Verify maternal HR and BP and fetal response

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Drug class review

Electrolytes, renal drugs and blood products

Electrolyte correction, anemia, renal disease, transfusion

Electrolytes are medications. Route, concentration, infusion rate, renal function, ECG findings, compatibility, and repeat labs determine safety.

Electrolytes, renal drugs and blood products medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Potassium chloride	Hypokalemia	Hyperkalemia, dysrhythmia, vein injury	ACEI, ARB, potassium-sparing diuretics	Never IV push; verify potassium, renal function, rate, concentration
Magnesium sulfate	Hypomagnesemia, torsades, obstetric uses	Hypotension, weakness, respiratory depression	CNS depressants	Verify magnesium, reflexes and respirations in high-dose use, renal function
Calcium gluconate	Symptomatic hypocalcemia; membrane stabilization	Bradycardia, extravasation	Digoxin; product-specific compatibility	Verify line, rhythm, and compatibility
Sodium bicarbonate	Selected acidosis, hyperkalemia, toxicology uses	Alkalosis, sodium and fluid load, low ionized calcium	Many IV incompatibilities	Use indication-specific protocol and ABG or chemistry
Epoetin alfa	CKD or chemotherapy anemia	Hypertension, thrombosis	Iron status affects response	Verify hemoglobin target, BP, iron
RBCs, platelets, plasma	Anemia, bleeding, coagulation indications	Hemolytic, allergic, febrile reactions, TACO, TRALI	Compatibility and product requirements	Stop transfusion and follow reaction protocol for suspected reaction

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Drug class review

Immunology, allergy and vaccines

Allergy, immune disease, prevention

Epinephrine is first-line for anaphylaxis. Immunosuppressants and biologics increase infection risk. Vaccines require product-specific schedules and screening.

Immunology, allergy and vaccines medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Diphenhydramine	Allergy, dystonia adjunct	Sedation, anticholinergic effects	Alcohol and CNS depressants	Fall and airway risk; not a substitute for epinephrine in anaphylaxis
Cetirizine, loratadine	Allergic rhinitis, urticaria	Drowsiness, dry mouth	CNS depressants	Verify renal or hepatic dosing when relevant
Epinephrine IM	Anaphylaxis	Tachycardia, tremor, hypertension	Beta blockers may blunt response	Do not delay in anaphylaxis; monitor and repeat per protocol
Tacrolimus, cyclosporine	Transplant and immune suppression	Nephrotoxicity, hypertension, infection, neurotoxicity	Many CYP3A4 drugs; grapefruit	Verify trough, renal function, BP, interactions
Methotrexate	Autoimmune disease; cancer	Marrow, liver, lung toxicity; fetal harm	TMP-SMX, NSAIDs, alcohol	Verify CBC, liver, renal, pregnancy; distinguish weekly from daily dosing
Common vaccines	Infection prevention	Local reaction, fever; rare anaphylaxis	Immunosuppression affects live vaccines	Screen contraindications, route, interval, and product

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Drug class review

Antineoplastic essentials

Cancer therapy

Cancer drugs are regimen-specific and hazardous. Verify diagnosis, protocol, cycle and day, body-size basis, labs, organ function, line, premedications, and independent checks.

Antineoplastic essentials medication reference table
Drugs	What they treat	Common + serious effects	Key interactions	Verify / hold / escalate
Cyclophosphamide	Hematologic and solid tumors	Myelosuppression, hemorrhagic cystitis, infertility	Other marrow suppressants	Verify CBC, hydration or mesna plan, urine
Doxorubicin	Hematologic and solid tumors	Cardiomyopathy, myelosuppression, vesicant injury	Other cardiotoxic drugs	Verify lifetime dose, cardiac function, blood return
Cisplatin	Solid tumors	Nephrotoxicity, ototoxicity, severe nausea, electrolyte loss	Other nephrotoxic or ototoxic drugs	Verify hydration, renal function, magnesium, potassium, hearing
Paclitaxel	Breast, ovarian, lung cancers	Neuropathy, myelosuppression, hypersensitivity	CYP modifiers	Premedicate per protocol; monitor infusion reaction
Methotrexate	Leukemia, lymphoma, solid tumors	Mucositis, marrow, liver, renal toxicity	NSAIDs, TMP-SMX, PPIs in high-dose context	Verify level, leucovorin, and hydration protocol
Checkpoint inhibitors	Multiple cancers	Immune-mediated organ inflammation	Immunosuppressive treatment affects response	Report new diarrhea, cough, rash, endocrine, or neurologic symptoms

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High-yield safety

Medication safety patterns worth memorizing

Class knowledge helps predict what to assess before and after administration.

Bleeding

Anticoagulants, antiplatelets, thrombolytics, NSAIDs, and chemotherapy.

Respiratory depression

Opioids, benzodiazepines, sedatives, anesthesia drugs, and high-risk combinations.

QT or dysrhythmia

Antiarrhythmics, some antibiotics, antipsychotics, antidepressants, and antiemetics; risk rises with low potassium or magnesium.

Renal injury

NSAIDs, aminoglycosides, vancomycin, and vulnerable ACEI or ARB plus diuretic combinations.

Serotonin toxicity

Multiple serotonergic drugs; watch agitation, clonus, hyperreflexia, and fever.

Hypoglycemia

Insulin and sulfonylureas; beta blockers can mask adrenergic warning signs.

Severe skin reaction

Mucosal lesions or systemic symptoms with a new rash are urgent.

Marrow suppression

Connect CBC trends to infection and bleeding risk.

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Reference notes

Sources + clinical boundaries

Drug labeling and standards change; verify current information before clinical use.