2025 NCLEX Pharmacology Cheat Sheet – What’s New and What Matters

I’ve coached thousands of nurses through boards and bedside alike, and year after year the NCLEX keeps pace with the biggest changes in practice. For 2025, three drug groups stand out: GLP-1 receptor agonists, SGLT-2 inhibitors, and updated advanced-cardiac-life-support (ACLS) medications. Master these now and half the pharmacology battle is already won.

Why these three?
• They’re headline makers in current journals and guideline updates.
• They fit perfectly into Next-Gen NCLEX case studies that test clinical judgment instead of rote recall.
• They’re drugs you will actually pass in real ICUs and med-surg units soon after licensure.

1. GLP-1 Receptor Agonists – Beyond Diabetes

Semaglutide, tirzepatide, liraglutide: once seen only as glucose-lowering agents, they’re now FDA-approved for weight management and have fresh cardiovascular indications. In 2024 the weight-loss formulation of semaglutide gained approval to cut major CV events in obese patients with heart disease. 

Key points to remember:

  • Mechanism: mimics endogenous GLP-1 → increases insulin, slows gastric emptying.

  • NCLEX alerts: watch for hypoglycemia when combined with sulfonylureas, monitor GI intolerance, contraindicated in medullary thyroid carcinoma history.

  • In NGN scenarios, expect them inside obesity or heart-failure case studies rather than plain diabetes vignettes.

2. SGLT-2 Inhibitors – Heart-Failure and Kidney Protection

Dapagliflozin, empagliflozin, and canagliflozin are no longer “just diabetes pills.” ESC and ADA guideline updates push them to the front line for heart-failure management and renal protection, even in non-diabetic patients. 

What to lock in:

  • Mechanism: blocks renal glucose reabsorption → osmotic diuresis, lowers preload and afterload.

  • NCLEX alerts: genital mycotic infections, volume depletion, euglycemic ketoacidosis warning signs.

  • Case-study twist: look for improved ejection fraction or falling BNP after initiation.

3. ACLS Drug Algorithm Tweaks

The 2023 AHA focused update confirmed epinephrine 1 mg IV/IO every 3-5 min as first-line in adult cardiac arrest, but renewed emphasis on early high-quality CPR and defibrillation means med questions are now tied to clinical-judgment decisions: “deliver shock first or drug first?” Amiodarone vs. lidocaine dosing tables are also fair game. 

Need-to-know doses:

  • Epinephrine: 1 mg IV/IO q 3–5 min.

  • Amiodarone: 300 mg bolus, then 150 mg.

  • Lidocaine alternative: 1–1.5 mg/kg, then 0.5–0.75 mg/kg.

How to Study These Efficiently

  1. Create a one-page chart: mechanism, indications, red-flag side effects, nursing priorities.

  2. Tie each drug to a memorable patient image—think “semaglutide: middle-aged patient celebrating smaller waistline and better ejection fraction.”

  3. Run timed mini-quizzes: five mixed questions, two minutes each, to mimic NGN pacing.

  4. Review ACLS drugs with rhythm strips; drugs never come alone on the exam.

Free Sample Notes

I’ve condensed the high-yield pharmacology facts into a two-page PDF—easy to tape above your desk or view on your phone. Download it from the Free Resources tab on Your Nursing Space. If it helps, the full Pharmacology Crash-Course (video + 120 practice questions) is ready whenever you are—no pressure, just there when you need deeper dives.

Final Takeaway

Focus on drug classes making headlines in real practice, and you’ll be ready for anything the 2025 NCLEX throws at you. These three groups cover endocrine, cardiovascular, renal, and emergency-care content in one sweep. Study smart now, and the exam becomes a confirmation of what you already know instead of a pop quiz on what you don’t.

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