Suffix decoding — the whole class in one ending
You will meet drugs you've never seen on the exam. The ending tells you the class, the class tells you the assessment.
Memory trick
-olol = beta blocker (hold HR<60). -pril = ACE inhibitor (cough, angioedema, K⁺ up). -sartan = ARB (no cough). -dipine = CCB (edema, hypotension). -statin = cholesterol (LFTs, muscle pain). -azole = antifungal. -cillin = penicillin. -mycin = aminoglycoside (nephro + ototoxic). -prazole = PPI. -tidine = H2 blocker. -pam/-lam = benzo (flumazenil). -osin = alpha blocker (first-dose syncope).
You don't know 400 drugs. You know 20 endings and you're fabulous.
Antidotes you will absolutely be asked
Free points if memorized, guaranteed miss if not.
Memory trick
Heparin → protamine sulfate. Warfarin → vitamin K. Opioids → naloxone. Benzos → flumazenil. Acetaminophen → acetylcysteine. Magnesium → calcium gluconate. Digoxin → digoxin immune Fab. Iron → deferoxamine.
Pair them like couples. Heparin and protamine are a toxic situationship.
The hold parameters that keep you employed
'Which action does the nurse take before administering' is the most common pharm stem in existence.
Memory trick
Digoxin: apical pulse 1 full minute, hold if <60 (adult). Beta blocker: hold HR<60 or SBP<90. Metformin: hold 48h around IV contrast. Warfarin: INR goal 2–3, hold if higher. Heparin: aPTT 1.5–2.5× control. Insulin: check glucose. Vancomycin: trough before the dose, watch creatinine.
Therapeutic ranges worth memorizing
Narrow-window drugs are exam favorites because the margin for error is real.
Memory trick
Digoxin 0.5–2 ng/mL. Lithium 0.6–1.2 mEq/L. Phenytoin 10–20 mcg/mL. Theophylline 10–20 mcg/mL. Vancomycin trough 10–20 mcg/mL. Magnesium (OB) 4–7 mEq/L.
Lithium and dehydration are enemies. Steady salt, steady water, steady level.
Insulin timing — onset is the question
Peak time is when hypoglycemia happens, and that's what they ask.
Memory trick
Lispro/aspart: onset 15 min, peak ~1 h — food must be in front of them. Regular: 30 min / peak 2–4 h — the only IV insulin. NPH: onset 1–2 h / peak 4–12 h — cloudy. Glargine: no peak, never mix, once daily.
Clear before cloudy when mixing — RN before NPH. Air in cloudy first, though.
Toxicity signs that show up as 'the patient reports…'
The stem describes a symptom, you have to name the drug.
Memory trick
Ringing in the ears = aspirin (salicylism) or aminoglycoside. Yellow-green halos = digoxin. Fine tremor + polyuria = lithium. Gingival hyperplasia = phenytoin. Dry mouth, can't pee, can't see, can't spit = anticholinergics. Muscle pain + dark urine = statin rhabdo.
Halos aren't a religious experience. That's dig toxicity, call somebody.
Pregnancy and pediatric red flags
One-liner questions that everyone gets wrong once.
Memory trick
No ACE inhibitors, ARBs, warfarin, isotretinoin, or tetracyclines in pregnancy. No aspirin in kids with a viral illness (Reye's). No tetracyclines under age 8 (teeth).
Dosage calc without spiraling
You lose these points to arithmetic, not knowledge.
Memory trick
Desired / Have × Volume. For drips: (mL/hr) = (dose × weight × 60) / concentration. Always write the units in the equation and cancel them — if the units don't cancel, the answer is wrong before you ever divide.
Label your units. Unlabeled math is how patients get 10× doses.
