NCLEX Quick Sheet โ Cardiopharmacology & Cardiac
Emergencies
โขAntihypertensives โ Monitor BP before giving. Teach to rise slowly. Avoid abrupt withdrawal (rebound HTN).
โขACE Inhibitors (e.g., lisinopril) โ โ afterload, โ Kโ . SE: cough, angioedema, hyperkalemia. NCLEX: hold if
Kโ >5.0 or BP <100 systolic.
โขARBs (e.g., losartan) โ Use if ACEI not tolerated; less cough, same risk of hyperkalemia.
โขBeta Blockers (e.g., metoprolol, carvedilol) โ โ HR/BP/Oโ demand. Hold if HR <50 or SBP <90. NCLEX:
avoid abrupt stop (rebound tachycardia). Contraindicated in asthma (nonselective).
โขCalcium Channel Blockers (e.g., diltiazem, amlodipine) โ โ contractility, HR, and BP. SE: bradycardia,
edema, constipation. NCLEX: avoid grapefruit juice.
โขNitrates (e.g., nitroglycerin) โ Vasodilation โ โ preload/afterload. SE: headache, hypotension, flushing.
NCLEX: check BP before giving, keep in dark container, 3 doses 5 min apart max.
โขHydralazine โ Arterial vasodilator used in HF and HTN. SE: lupus-like syndrome. Monitor BP and renal
function.
โขLoop Diuretics (e.g., furosemide) โ โ preload via diuresis. SE: hypokalemia, ototoxicity. NCLEX: monitor Kโ ,
daily weights, give in AM.
โขThiazide Diuretics โ Mild diuresis. SE: hypokalemia, hyperglycemia, โ uric acid. NCLEX: monitor electrolytes
and gout risk.
โขPotassium-Sparing Diuretics (e.g., spironolactone) โ Kโ retention. SE: hyperkalemia, gynecomastia. Avoid
Kโ supplements.
โขAntiplatelets (e.g., aspirin, clopidogrel) โ Prevent arterial thrombosis. NCLEX: monitor for bleeding; hold 5โ7
days before surgery.
โขAnticoagulants โ Heparin (aPTT 60โ80 sec, antidote = protamine). Warfarin (INR 2โ3, antidote = vitamin K).
NOACs (apixaban, dabigatran): no routine monitoring. NCLEX: monitor bleeding, consistent diet (vit K).
โขDigoxin โ โ contractility, โ HR. Toxicity: vision halos, N/V, bradycardia. Hold if HR <60, monitor Kโ and dig
level (0.5โ2.0).
โขStatins โ โ LDL. SE: myopathy, โ LFTs. NCLEX: take at night, report muscle pain, avoid grapefruit juice.
โขVasopressors (e.g., norepinephrine, dopamine, phenylephrine) โ โ BP/CO. NCLEX: use central line, titrate
carefully, monitor for extravasation (treat with phentolamine).
โขEpinephrine โ Used for cardiac arrest/anaphylaxis. 1 mg IV q3โ5 min in ACLS; causes โ HR/BP. NCLEX:
ensure CPR quality before drug admin.
โขAtropine โ Anticholinergic for bradycardia (<40 bpm). Dose: 0.5 mg IV q3โ5 min (max 3 mg). NCLEX: monitor
HR, dry mouth, urinary retention.
โขAmiodarone โ For ventricular arrhythmias and AFib. SE: pulmonary fibrosis, thyroid dysfunction, QT
prolongation. NCLEX: monitor ECG, LFTs, lungs, eyes.
โขAdenosine โ SVT termination. Rapid IV push followed by flush; transient asystole expected. NCLEX: patient
warning, continuous ECG monitoring.
โขMagnesium Sulfate โ Used for torsades de pointes. Monitor Mg levels and reflexes; keep calcium gluconate
on standby.
โขLidocaine โ Antiarrhythmic for ventricular ectopy. Toxicity: neuro (seizures, confusion). Monitor level (1.5โ5).
โขNitroprusside โ Rapid BP control in crisis. Protect from light; risk of cyanide toxicity with prolonged use.
โขMilrinone โ Inotrope for acute HF. Monitor BP and renal function. NCLEX: continuous ECG and IV pump
required.
โขDopamine Dose-Dependent Effects โ Low dose = renal vasodilation; moderate = inotrope; high =
vasoconstriction.
โขHeart Failure Drug Therapy โ Core: ACEI/ARB/ARNI + Beta-blocker + Loop diuretic ยฑ Aldosterone antagonist
ยฑ SGLT2 inhibitor.
โขPost-MI Medications โ Dual antiplatelet therapy (aspirin + P2Y12), beta-blocker, ACEI/ARB, statin, stool
softener, nitro PRN.
โขChest Pain Protocol (MONA) โ Morphine, Oxygen, Nitrates, Aspirin (order of administration depends on
symptoms). NCLEX: give Oโ if SpOโ <90%.
โขCardiac Arrest Drugs (ACLS) โ Epinephrine 1 mg q3โ5 min for asystole/PEA. Amiodarone 300 mg IV for
VF/pulseless VT. Defibrillate if shockable rhythm.
