Common NCLEX Medications: A Comprehensive Guide

in the United States. As part of the exam, nurses must demonstrate not only their clinical knowledge but also their ability to safely and effectively administer medications to patients. Understanding common medications, their uses, side effects, and nursing implications is key to passing the NCLEX. In this article, we will explore a selection of medications that frequently appear on the NCLEX and offer an overview of their important aspects.

1. Analgesics: Pain Relievers

a. Morphine

Morphine is a potent opioid analgesic used for the relief of moderate to severe pain. It works by binding to opioid receptors in the brain and spinal cord, altering pain perception and emotional response to pain.

• Nursing Implications:
  • Monitor for signs of respiratory depression, which can be life-threatening.
  • Assess pain levels and administer as needed, ensuring to evaluate the effectiveness of the medication.
  • Morphine can cause constipation, so encourage fluids, fiber, and possibly a stool softener.
• Common Side Effects:
  • Drowsiness, nausea, vomiting, constipation, and potential for dependence and addiction.

b. Acetaminophen (Tylenol)

Acetaminophen is a non-opioid analgesic that is commonly used for mild to moderate pain relief and fever reduction. It is often the first-line treatment for conditions such as headaches, osteoarthritis, and muscle aches.

• Nursing Implications:
  • Do not exceed the recommended dosage due to the risk of liver toxicity.
  • Monitor liver function in patients with pre-existing liver disease.
• Common Side Effects:
  • Generally well-tolerated, but excessive use can lead to liver damage.

2. Antibiotics: Infection Treatment

a. Amoxicillin

Amoxicillin is a broad-spectrum penicillin antibiotic used to treat various bacterial infections, including respiratory, urinary tract, and skin infections.

• Nursing Implications:
  • Assess for any allergic reactions, especially a history of penicillin allergy.
  • Encourage patients to complete the full course of therapy to prevent antibiotic resistance.
  • Monitor for signs of superinfection, such as diarrhea or yeast infections.
• Common Side Effects:
  • Nausea, diarrhea, rash, and allergic reactions.

b. Vancomycin

Vancomycin is an antibiotic that is used to treat serious infections caused by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA).

• Nursing Implications:
  • Monitor serum levels to avoid toxicity, especially in patients with kidney impairment.
  • Watch for red man syndrome, a reaction characterized by flushing and hypotension when the drug is infused too rapidly.
• Common Side Effects:
  • Nephrotoxicity, ototoxicity, and thrombophlebitis at the injection site.

3. Anticoagulants: Blood Thinners

a. Heparin

Heparin is an injectable anticoagulant that works by inhibiting thrombin and other clotting factors to prevent and treat deep vein thrombosis (DVT), pulmonary embolism, and other clotting disorders.

• Nursing Implications:
  • Monitor activated partial thromboplastin time (aPTT) to assess for therapeutic anticoagulation.
  • Be aware of signs of bleeding and implement bleeding precautions as necessary.
  • Ensure that the heparin dose is adjusted based on lab results.
• Common Side Effects:
  • Bleeding, heparin-induced thrombocytopenia (HIT), and osteoporosis with long-term use.

b. Warfarin

Warfarin is an oral anticoagulant used for long-term anticoagulation in conditions such as atrial fibrillation and mechanical heart valves.

• Nursing Implications:
  • Monitor International Normalized Ratio (INR) to adjust the warfarin dose.
  • Advise patients on consistent dietary vitamin K intake to prevent fluctuations in anticoagulation levels.
  • Teach patients to avoid activities that may increase the risk of bleeding.
• Common Side Effects:
  • Bleeding, bruising, and interactions with many other medications and foods.

4. Antihypertensives: Blood Pressure Medications

a. Lisinopril

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that is commonly prescribed for hypertension and heart failure. It works by blocking the enzyme that converts angiotensin I to angiotensin II, thereby lowering blood pressure and reducing the workload on the heart.

• Nursing Implications:
  • Monitor blood pressure regularly, especially after the first dose, as ACE inhibitors can cause a sudden drop in blood pressure.
  • Assess for signs of hyperkalemia, such as muscle weakness or palpitations.
  • Advise the patient to avoid salt substitutes containing potassium.
• Common Side Effects:
  • Cough, dizziness, elevated potassium levels, and angioedema.

b. Amlodipine

Amlodipine is a calcium channel blocker that relaxes blood vessels, improving blood flow and reducing blood pressure. It is frequently prescribed for hypertension and angina.

• Nursing Implications:
  • Monitor blood pressure and heart rate regularly.
  • Educate the patient to avoid grapefruit juice, which can increase the drug’s effects.
  • Watch for signs of peripheral edema (swelling of the lower extremities).
• Common Side Effects:
  • Edema, headache, dizziness, and flushing.

5. Diuretics: Fluid Management

a. Furosemide (Lasix)

Furosemide is a loop diuretic used to treat conditions like heart failure, renal disease, and hypertension. It works by inhibiting sodium and chloride reabsorption in the kidneys, promoting fluid excretion.

• Nursing Implications:
  • Monitor electrolytes, especially potassium, as furosemide can lead to hypokalemia.
  • Assess for dehydration and hypotension, particularly with rapid administration.
  • Encourage the patient to take the medication in the morning to prevent nocturia.
• Common Side Effects:
  • Hypokalemia, dehydration, dizziness, and hypotension.

b. Hydrochlorothiazide

Hydrochlorothiazide is a thiazide diuretic used to treat hypertension and edema. It works by inhibiting sodium and chloride reabsorption in the kidneys, although it is less potent than loop diuretics like furosemide.

• Nursing Implications:
  • Monitor for electrolyte imbalances, particularly hypokalemia and hyponatremia.
  • Encourage potassium-rich foods or potassium supplements as needed.
  • Ensure the patient is hydrated to prevent dehydration.
• Common Side Effects:
  • Hypokalemia, dizziness, and increased urination.

6. Antidiabetic Medications: Diabetes Management

a. Insulin

Insulin is a hormone that regulates blood glucose levels. It is essential for people with type 1 diabetes and may be prescribed to those with type 2 diabetes who are unable to control blood sugar through oral medications.

• Nursing Implications:
  • Educate patients on how to administer insulin, including timing and proper technique.
  • Monitor blood glucose levels closely, especially during dose adjustments.
  • Be aware of signs of hypoglycemia (shaking, sweating, confusion), and know how to treat it.
• Common Side Effects:
  • Hypoglycemia, weight gain, and injection site reactions.

b. Metformin

Metformin is an oral medication commonly prescribed for type 2 diabetes. It works by improving insulin sensitivity and reducing hepatic glucose production.

• Nursing Implications:
  • Monitor blood glucose levels regularly and assess renal function before starting metformin.
  • Educate the patient to take metformin with meals to minimize gastrointestinal side effects.
  • Metformin should be withheld before and after contrast imaging studies due to the risk of lactic acidosis.
• Common Side Effects:
  • Nausea, vomiting, diarrhea, and lactic acidosis (rare but serious).

7. Antidepressants: Mood Stabilization

a. Sertraline (Zoloft)

Sertraline is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety disorders, and obsessive-compulsive disorder (OCD).

• Nursing Implications:
  • Monitor for signs of serotonin syndrome, which may present as confusion, agitation, fever, and muscle rigidity.
  • Instruct patients to report any thoughts of self-harm or suicide.
  • Gradually taper the dose when discontinuing to avoid withdrawal symptoms.
• Common Side Effects:
  • Nausea, insomnia, sexual dysfunction, and weight changes.

b. Amitriptyline

Amitriptyline is a tricyclic antidepressant (TCA) used to treat depression, chronic pain, and insomnia.

• Nursing Implications:
  • Monitor for anticholinergic side effects, such as dry mouth, constipation, and blurred vision.
  • Be aware of potential cardiac side effects, such as tachycardia or arrhythmias.
  • Educate the patient to avoid alcohol, which can increase sedative effects.
• Common Side Effects:
  • Dry mouth, drowsiness, constipation, and blurred vision.