Free NCLEX Pharmacology Cheat Sheet: 50 Must-Know Drugs (2026 Printable)

Pharmacology is the topic nursing students dread most. It is also the topic the NCLEX tests most heavily. Most pass-rate data shows that the difference between a first-try pass and a fail comes down to how confidently you can recognize drug classes, their mechanisms, and the critical nursing considerations under time pressure.

This cheat sheet is the distilled list of the 50 highest-yield drugs and drug classes you need to know cold for the 2026 NCLEX. Updated for the April 1, 2026 test plan.

How to use this cheat sheet

The NCLEX does not test you on drug names. It tests you on what the drug does, what could go wrong, and what you, as the nurse, need to watch for. Use this list to anchor every drug to a class, a side effect to watch, and a nursing intervention.

Cardiovascular drugs (high-yield)

Beta Blockers ("-olol")

Metoprolol, atenolol, propranolol. Use ABCD mnemonic for contraindications: Asthma, Bradycardia, CHF, Diabetes. Hold if HR less than 60 or SBP less than 100.

ACE Inhibitors ("-pril")

Lisinopril, enalapril, captopril. Top side effects: dry cough, hyperkalemia, angioedema. First-line for HTN with diabetes.

ARBs ("-sartan")

Losartan, valsartan. Used when ACE inhibitor causes the cough. Same K+ watch.

Calcium Channel Blockers

Dihydropyridines ("-dipine") for HTN. Non-DHP (verapamil, diltiazem) for rate control. Watch for constipation and bradycardia.

Diuretics

Loop (furosemide): wastes K+. Thiazide (HCTZ): wastes K+. K-sparing (spironolactone): retains K+. Always recheck K+.

Digoxin

Therapeutic range 0.5 to 2 ng/mL. Toxic level above 2. Antidote: digoxin immune fab (Digibind). Hold if HR less than 60.

Warfarin

INR target 2 to 3 (or 2.5 to 3.5 for mechanical valves). Antidote: vitamin K. Watch leafy greens.

Heparin

Monitor aPTT (1.5 to 2.5x normal). Antidote: protamine sulfate. Watch for HIT (heparin-induced thrombocytopenia).

Pain and inflammation

Opioids

Morphine, hydromorphone, fentanyl. Watch RR (hold if less than 12). Antidote: naloxone. Side effect to memorize: constipation.

NSAIDs

Ibuprofen, naproxen, ketorolac. GI bleed, kidney damage. No NSAIDs in 3rd trimester pregnancy.

Acetaminophen

Max 4 g/day adults. Hepatotoxic. Antidote: acetylcysteine.

Endocrine

Insulin

• Rapid (lispro, aspart): onset 15 min, peak 1 hour
• Short (regular): onset 30 min, peak 2 to 3 hours — only IV insulin
• Intermediate (NPH): peak 4 to 12 hours — cloudy
• Long (glargine, detemir): no peak — never mix

When mixing: clear before cloudy (regular before NPH).

Oral antidiabetics

Metformin: hold 48 hours before contrast. Sulfonylureas (glipizide, glyburide): hypoglycemia risk. SGLT2 inhibitors ("-flozin"): UTI risk.

Levothyroxine

Take on empty stomach, 30 to 60 min before food. Lifelong therapy. Monitor TSH.

Psych and neuro

SSRIs

Fluoxetine, sertraline, paroxetine. 4 to 6 weeks for full effect. Watch for serotonin syndrome.

Lithium

Therapeutic 0.6 to 1.2 mEq/L. Maintain sodium intake. Watch tremors, polyuria, GI upset.

Antipsychotics

Typical (haloperidol): EPS risk — give benztropine. Atypical (risperidone, olanzapine): metabolic side effects, weight gain.

Benzodiazepines

Diazepam, lorazepam. Antidote: flumazenil. Risk: respiratory depression.

GI and respiratory

PPIs ("-prazole")

Omeprazole, pantoprazole. Long-term: osteoporosis, B12 deficiency, C. diff.

Bronchodilators

SABA (albuterol): rescue inhaler. LABA (salmeterol): never alone in asthma. Tachycardia side effect.

Inhaled corticosteroids

Fluticasone, budesonide. Rinse mouth after (thrush risk). Maintenance, not rescue.

Anticoagulants and antiplatelets

DOACs

Apixaban, rivaroxaban, dabigatran. No INR monitoring. Antidotes: andexanet (Xa inhibitors), idarucizumab (dabigatran).

Aspirin

Antiplatelet at 81 mg. Watch for Reye syndrome in children with viral illness.

The 4 antidotes you must memorize

How to actually study this

1. Make flashcards by class, not by individual drug. Your brain will retrieve faster.
2. Drill the antidotes daily. They appear on every NCLEX.
3. Do 25 pharmacology Q-bank questions per night. Application beats recognition.
4. Pair this cheat sheet with the Crash Course Notes for the test-taking strategy layer.

Frequently Asked Questions

How many pharmacology questions are on the NCLEX?

Pharmacology and parenteral therapies make up roughly 12 to 18 percent of the NCLEX-RN, which usually means 15 to 25 questions in a full-length exam.

Do I need to memorize generic and brand names?

The NCLEX uses generic names. You do not need to memorize brand names, but recognizing both helps with clinicals.

What is the highest-yield drug class on the NCLEX?

Cardiovascular (especially beta blockers, ACE inhibitors, and diuretics) and insulin are the most heavily tested in 2026.

Is this cheat sheet enough to pass pharmacology on the NCLEX?

It will get you 60 to 70 percent of the way. For the full picture, use a dedicated pharmacology guide and complete at least 200 pharm Q-bank questions before exam day.