NCLEX Pharm Cheat Sheet | Cheat Sheet Pharmacology

NCLEX Quick Sheet – Hematology & Blood Disorder

Pharmacology

•Heparin (UFH) – Binds antithrombin III → inactivates IIa & Xa. Monitor aPTT (1.5–2.5× normal). Antidote:

Protamine sulfate. Watch for HIT: ↓ platelets >50%, new thrombosis.

•Low-Molecular-Weight Heparin (enoxaparin) – Inhibits Xa > IIa. Predictable dosing, no aPTT monitoring.

Adjust dose for renal impairment. Partial protamine reversal.

•Warfarin – Inhibits vitamin K-dependent factors II, VII, IX, X. Monitor INR (2–3 typical; 2.5–3.5 mechanical

valves). Antidote: Vitamin K or PCC. Bridge with heparin when starting.

•DOACs – Dabigatran (IIa inhibitor), Apixaban/Rivaroxaban/Edoxaban (Xa inhibitors). No routine labs.

Antidotes: Idarucizumab (dabigatran), Andexanet alfa (Xa inhibitors). Hold before surgery based on renal

function.

•Aspirin – Irreversible COX-1 inhibition → ↓ TXA2 → ↓ platelet aggregation. Stop 7 days pre-op. NCLEX:

Watch for GI bleeding, tinnitus, avoid with viral illness (Reye’s).

•Clopidogrel – Irreversible P2Y12 blockade → ↓ platelet aggregation. Used for stents/ACS. Avoid with PPIs

(omeprazole). Monitor for bleeding, TTP.

•Glycoprotein IIb/IIIa Inhibitors (abciximab, eptifibatide, tirofiban) – Prevent final common platelet aggregation

step. IV use in PCI/ACS. Monitor platelets; risk of bleeding/thrombocytopenia.

•Thrombolytics (tPA/alteplase) – Convert plasminogen → plasmin to dissolve clots. Use for stroke, MI, PE.

Contraindicated if recent surgery, trauma, hemorrhage. NCLEX: Get CT before stroke tPA; monitor for ICH.

•Oral Iron (ferrous sulfate) – Take with vitamin C; avoid antacids/dairy/tea. SE: constipation, dark stools.

NCLEX: Use straw for liquid; keep from children (toxic).

•IV Iron (iron sucrose, ferric carboxymaltose) – Used if oral not tolerated. Monitor for anaphylaxis,

hypotension. NCLEX: Emergency kit ready during infusion.

•Vitamin B12 (cyanocobalamin) – IM for pernicious anemia or post-gastrectomy. NCLEX: Treat B12 deficiency

before folate to avoid worsening neuro symptoms.

•Folic Acid – Prevents neural tube defects, treats megaloblastic anemia. Check B12 first. Interacts with

methotrexate and phenytoin.

•Erythropoiesis-Stimulating Agents (epoetin alfa, darbepoetin) – Stimulate RBC production in CKD/chemo.

NCLEX: Target Hgb 10–11 g/dL; hold if >11; monitor BP; need adequate iron.

•Granulocyte Colony-Stimulating Factor (filgrastim, pegfilgrastim) – ↑ neutrophils after chemo. SE: bone pain,

splenomegaly. NCLEX: Give ≥24h after chemo; monitor CBC.

•Romiplostim – TPO receptor agonist for ITP. SE: HA, thrombosis if platelets too high. NCLEX: Weekly

platelet monitoring; avoid abrupt stop (rebound thrombocytopenia).

•NCLEX Hematology Tip – Always monitor CBC, aPTT/INR when indicated, avoid IM injections in

anticoagulated patients, and assess for bleeding/bruising with all antithrombotics.

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NCLEX Quick Sheet – Hematology & Blood Disorder

Pharmacology

Heparin (UFH) – Binds antithrombin III^ →^ inactivates IIa & Xa. Monitor aPTT (1.5–2.5× normal). Antidote: Protamine sulfate. Watch for HIT: ↓ platelets >50%, new thrombosis.
Low-Molecular-Weight Heparin (enoxaparin) – Inhibits Xa > IIa. Predictable dosing, no aPTT monitoring. Adjust dose for renal impairment. Partial protamine reversal.
Warfarin – Inhibits vitamin K-dependent factors II, VII, IX, X. Monitor INR (2–3 typical; 2.5–3.5 mechanical valves). Antidote: Vitamin K or PCC. Bridge with heparin when starting.
DOACs – Dabigatran (IIa inhibitor), Apixaban/Rivaroxaban/Edoxaban (Xa inhibitors). No routine labs. Antidotes: Idarucizumab (dabigatran), Andexanet alfa (Xa inhibitors). Hold before surgery based on renal function.
Aspirin – Irreversible COX-1 inhibition^ →^ ↓^ TXA2^ →^ ↓^ platelet aggregation. Stop 7 days pre-op. NCLEX: Watch for GI bleeding, tinnitus, avoid with viral illness (Reye’s).
Clopidogrel – Irreversible P2Y12 blockade^ →^ ↓^ platelet aggregation. Used for stents/ACS. Avoid with PPIs (omeprazole). Monitor for bleeding, TTP.
Glycoprotein IIb/IIIa Inhibitors (abciximab, eptifibatide, tirofiban) – Prevent final common platelet aggregation step. IV use in PCI/ACS. Monitor platelets; risk of bleeding/thrombocytopenia.
Thrombolytics (tPA/alteplase) – Convert plasminogen^ →^ plasmin to dissolve clots. Use for stroke, MI, PE. Contraindicated if recent surgery, trauma, hemorrhage. NCLEX: Get CT before stroke tPA; monitor for ICH.
Oral Iron (ferrous sulfate) – Take with vitamin C; avoid antacids/dairy/tea. SE: constipation, dark stools. NCLEX: Use straw for liquid; keep from children (toxic).
IV Iron (iron sucrose, ferric carboxymaltose) – Used if oral not tolerated. Monitor for anaphylaxis, hypotension. NCLEX: Emergency kit ready during infusion.
Vitamin B12 (cyanocobalamin) – IM for pernicious anemia or post-gastrectomy. NCLEX: Treat B12 deficiency before folate to avoid worsening neuro symptoms.
Folic Acid – Prevents neural tube defects, treats megaloblastic anemia. Check B12 first. Interacts with methotrexate and phenytoin.
Erythropoiesis-Stimulating Agents (epoetin alfa, darbepoetin) – Stimulate RBC production in CKD/chemo. NCLEX: Target Hgb 10–11 g/dL; hold if >11; monitor BP; need adequate iron.
Granulocyte Colony-Stimulating Factor (filgrastim, pegfilgrastim) –^ ↑^ neutrophils after chemo. SE: bone pain, splenomegaly. NCLEX: Give ≥24h after chemo; monitor CBC.
Romiplostim – TPO receptor agonist for ITP. SE: HA, thrombosis if platelets too high. NCLEX: Weekly platelet monitoring; avoid abrupt stop (rebound thrombocytopenia).
NCLEX Hematology Tip – Always monitor CBC, aPTT/INR when indicated, avoid IM injections in anticoagulated patients, and assess for bleeding/bruising with all antithrombotics.

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NCLEX Quick Sheet – Hematology & Blood Disorder

Pharmacology