Pharmacology
Core concepts
Know drug classifications and their prototypes: analgesics (opioid vs. non-opioid), antibiotics, antihypertensives (ACE inhibitors, beta blockers, diuretics), anticoagulants, antidiabetics (insulin types by onset/peak/duration), bronchodilators, corticosteroids, and vaccines. Understand the six rights of medication administration - right patient, drug, dose, route, time, and documentation. Know common routes (oral, sublingual, IM, subcutaneous, IV, topical, inhalation), absorption differences, and first-pass metabolism. Learn the key adverse effects and antidotes that appear on exams: naloxone for opioids, protamine sulfate for heparin, vitamin K for warfarin, and epinephrine for anaphylaxis.
Traps in questions
- Sound-alike names: distractors swap similar drug names or classes; read the generic name carefully.
- Timing of insulin: rapid-acting (lispro) peaks quickly; long-acting (glargine) has no pronounced peak - do not assign a peak to it.
- Route logic: sublingual avoids first-pass metabolism; IM absorbs faster than subcutaneous in most cases.
- Antidote pairing: match the antidote to the specific drug, not the drug class generally.
- 'Hold and report' parameters: know that certain vitals (e.g., low heart rate before a beta blocker, low potassium before digoxin) require holding the dose and notifying the provider.
Rule of thumb
Before administering any drug, verify the six rights and check the parameters that would make the dose unsafe. If a stem gives a vital sign outside the safe range, the correct answer usually involves holding the medication and reporting.
Worked example
Stem: 'A patient on warfarin has an elevated INR and bleeding gums. What is the antidote?' Warfarin antagonizes vitamin K-dependent clotting factors, so the antidote is vitamin K (phytonadione), not protamine sulfate (heparin antidote).