Chart — Pharmacology
Drug Classes Quick Reference Chart
A concise overview of the drug classes most frequently tested on NCLEX and encountered in clinical practice. For each class: mechanism, primary indications, representative drugs, and critical nursing considerations.
Educational use only. This chart is for nursing education and clinical practice. Individual drug dosing, contraindications, and interactions are not exhaustively listed. Always verify with current pharmacology references, provider orders, and institutional protocols. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Cardiovascular
ACE Inhibitors
Suffix: -prilExamples: Lisinopril, enalapril, captopril, ramipril
Mechanism: Inhibit angiotensin-converting enzyme → reduce angiotensin II → vasodilation + reduced aldosterone
Indications: Hypertension, heart failure (HFrEF), diabetic nephropathy, post-MI
Key nursing considerations:
- Monitor for persistent dry cough (most common reason for discontinuation)
- Hold for angioedema — life-threatening emergency
- Monitor renal function and potassium — risk of hyperkalemia
- Avoid in pregnancy (teratogenic — Category D)
Beta-Blockers
Suffix: -ololExamples: Metoprolol, carvedilol, atenolol, propranolol, labetalol
Mechanism: Block beta-adrenergic receptors → decreased HR, contractility, and BP
Indications: Hypertension, angina, heart failure, dysrhythmias, post-MI, anxiety (propranolol)
Key nursing considerations:
- Do not abruptly discontinue — risk of rebound hypertension and angina
- Hold for HR < 60 or per facility parameter
- Mask signs of hypoglycemia in diabetic patients — monitor carefully
- Cardioselective (metoprolol, atenolol) vs. non-selective (propranolol) — important in asthma/COPD
Calcium Channel Blockers
Suffix: -dipine (dihydropyridines) / verapamil, diltiazemExamples: Amlodipine, nifedipine (vasc.); verapamil, diltiazem (cardiac)
Mechanism: Block calcium channels → vasodilation (dihydropyridines) or decreased HR/conduction (non-dihydropyridines)
Indications: Hypertension, angina, dysrhythmias (verapamil/diltiazem), Raynaud's
Key nursing considerations:
- Monitor HR and BP — bradycardia risk with verapamil/diltiazem
- Peripheral edema (common with amlodipine)
- Grapefruit juice inhibits CYP3A4 — increases drug levels
- Constipation common with verapamil
Diuretics (Thiazide)
Suffix: -thiazideExamples: Hydrochlorothiazide (HCTZ), chlorthalidone, metolazone
Mechanism: Inhibit NaCl reabsorption in distal convoluted tubule → increased urine output
Indications: Hypertension (first-line), edema, heart failure
Key nursing considerations:
- Monitor electrolytes — hypokalemia, hyponatremia risk
- Monitor for hyperglycemia, hyperuricemia (gout risk)
- Teach patient: take in morning to avoid nocturia
Loop Diuretics
Suffix: -mideExamples: Furosemide (Lasix), bumetanide, torsemide
Mechanism: Inhibit Na-K-2Cl cotransporter in loop of Henle → potent diuresis
Indications: Heart failure (acute and chronic), edema, pulmonary edema, hypertension, hypercalcemia
Key nursing considerations:
- Monitor electrolytes — hypokalemia is the most important concern
- Monitor renal function, BUN/creatinine
- Ototoxicity risk with high doses or rapid IV administration
- Weigh patient daily — 1 kg ≈ 1 L fluid
Pain & Analgesics
Opioid Analgesics
Examples: Morphine, oxycodone, hydromorphone, fentanyl, codeine, tramadol
Mechanism: Bind mu, kappa, delta opioid receptors → CNS-mediated analgesia
Indications: Moderate to severe acute and chronic pain, dyspnea (morphine), cancer pain
Key nursing considerations:
- Monitor respiratory rate and sedation level before each dose
- Have naloxone (Narcan) immediately available for IV opioids
- Anticipate constipation — initiate bowel regimen prophylactically
- High-alert medication: independent double check for infusions/PCA
NSAIDs
Examples: Ibuprofen, naproxen, ketorolac, indomethacin, celecoxib (COX-2)
Mechanism: Inhibit COX-1 and/or COX-2 enzymes → reduce prostaglandin synthesis
Indications: Mild-moderate pain, fever, inflammation, dysmenorrhea
Key nursing considerations:
- Take with food — GI irritation and ulcer risk
- Monitor renal function — can cause AKI, especially in elderly/dehydrated
- Avoid in patients with GI ulcer history, renal impairment, or heart failure
- Cardiovascular risk with long-term use
Mental Health
SSRIs
Examples: Fluoxetine, sertraline, escitalopram, paroxetine, citalopram
Mechanism: Block serotonin reuptake transporters → increased synaptic serotonin
Indications: Depression, anxiety disorders, OCD, PTSD, panic disorder
Key nursing considerations:
- May worsen depression or suicidality initially — monitor closely, especially in first weeks and in patients < 25
- Therapeutic effect takes 2–4 weeks — set realistic expectations
- Serotonin syndrome risk when combined with other serotonergic agents (tramadol, triptans, MAOIs)
- Taper slowly to avoid discontinuation syndrome
Benzodiazepines
Suffix: -am / -pamExamples: Lorazepam, diazepam, midazolam, alprazolam, clonazepam
Mechanism: Enhance GABA activity → CNS depression
Indications: Anxiety, seizure disorders, alcohol withdrawal, procedural sedation, insomnia (short-term)
Key nursing considerations:
- Fall risk — especially in elderly (Beers Criteria)
- Respiratory depression risk, especially with opioids or alcohol
- Dependence and withdrawal risk with prolonged use
- Reversal: flumazenil (short-acting — resedation possible)
Antibiotics
Penicillins
Suffix: -cillinExamples: Amoxicillin, ampicillin, piperacillin-tazobactam (Pip-Tazo), oxacillin
Mechanism: Inhibit bacterial cell wall synthesis by binding penicillin-binding proteins
Indications: Gram-positive infections, dental prophylaxis, respiratory/urinary infections
Key nursing considerations:
- Screen for penicillin allergy — cross-reactivity with cephalosporins (~1–2%)
- Anaphylaxis risk — keep epinephrine available for first IV dose in allergy-risk patients
- Probenecid can increase penicillin levels
Fluoroquinolones
Suffix: -floxacinExamples: Ciprofloxacin, levofloxacin, moxifloxacin
Mechanism: Inhibit bacterial DNA gyrase and topoisomerase IV → disrupts DNA replication
Indications: UTIs, respiratory infections, GI infections (including anthrax), skin infections
Key nursing considerations:
- Black box warning: tendinopathy and tendon rupture risk (especially Achilles)
- QT prolongation / torsades risk (Warnings & Precautions, not boxed) — check QTc before use
- Avoid in children and pregnancy (cartilage effects)
- Antacids/dairy reduce absorption — space by 2 hours
Endocrine
Corticosteroids
Suffix: -sone / -oloneExamples: Prednisone, methylprednisolone, dexamethasone, hydrocortisone
Mechanism: Bind glucocorticoid receptors → anti-inflammatory, immunosuppressive effects
Indications: Autoimmune disorders, asthma, COPD exacerbations, septic shock (selected), organ transplant
Key nursing considerations:
- Long-term use causes adrenal suppression — taper; never abruptly stop
- Monitor blood glucose — cause hyperglycemia
- Monitor for infection — immunosuppressive; may mask fever
- Osteoporosis, weight gain, mood changes, gastric ulcer risk with long-term use
Related Guides
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with NCLEX-RN Test Plan / Pharmacology Standards. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →