How to Study Pharmacology in Nursing School

Pharmacology has a reputation as the class that breaks nursing students. It's not that any single drug is hard. It's that there are hundreds of them, they all have side effects, interactions and nursing considerations, and the exams expect you to apply all of it to a patient scenario.

The students who get through it don't memorize more. They organize better. Here's a system that works.

This post is about how to study, not clinical guidance. Always follow your program's references, your instructors and current drug information when it comes to actual patient care.

Learn by class, not by drug

Trying to learn 300 drugs as 300 separate facts is what makes pharm feel impossible. Most of those drugs fall into a few dozen classes, and drugs in the same class share a mechanism, uses, major side effects and nursing considerations.

So learn the class first, through one prototype drug: the drug your textbook uses as the example. If you really know metoprolol, you already know most of what matters about atenolol and carvedilol. Then learn only what's different about the others.

A good order for each class:

1. What it does in one sentence (the mechanism, in plain words).
2. What it's used for.
3. The adverse effects that matter, especially the dangerous ones.
4. What you assess before giving it and when you'd hold it.
5. What you teach the patient.

Use suffixes to recognize the class

Generic drug names follow patterns. Learning the common suffixes means you can usually tell a drug's class the first time you see it on an exam.

Suffixes aren't perfect. Some classes don't have a clean pattern, and a few drugs break the rule, so treat this as a shortcut, not a guarantee. Make a flashcard for each suffix and quiz yourself both ways: suffix to class and class to suffix.

Focus on what nurses get tested on

Pharmacology for nurses isn't pharmacology for pharmacists. Your exams, and later the NCLEX, care most about safe administration. The NCLEX-RN test plan from the NCSBN includes pharmacological and parenteral therapies as a major content area, and the questions are almost always about a patient: what do you check, what do you report, what do you teach.

For every class, make sure you can answer:

• What do I assess before giving it? Blood pressure and heart rate before antihypertensives and beta blockers. Apical pulse for a full minute before digoxin. Potassium levels with loop diuretics and digoxin.
• When would I hold it and call the provider? For example, an apical pulse below 60 in an adult before digoxin, or a heart rate or blood pressure below the parameters for a beta blocker.
• What's the most dangerous adverse effect? Angioedema with ACE inhibitors, bleeding with anticoagulants, respiratory depression with opioids.
• What's the antidote, if there is one?
• What does the patient need to know? Rise slowly with antihypertensives, avoid grapefruit juice with certain drugs, don't stop beta blockers suddenly.

Antidotes worth knowing cold

Therapeutic levels you'll see on exams

Different textbooks give slightly different ranges, and some have changed over time (digoxin especially), so use the values your program teaches. A common set looks like this:

Make a drug card for every prototype

A drug card (or drug template) is one page or one note per prototype with the same headings every time: class, mechanism, uses, adverse effects, nursing assessments, hold parameters, patient teaching, antidote. Using the same layout every time trains you to think through the same questions on the exam.

Keep the cards short. If a drug card runs a full page of tiny text, you copied the drug guide. Pull out what's testable.

Turn the cards into flashcards

Drug cards are for understanding. Flashcards are for remembering. Break each card into small questions with one answer each:

• What class is lisinopril?
• What dangerous adverse effect should you watch for with ACE inhibitors?
• What do you assess before giving digoxin?
• What's the antidote for heparin?

Avoid cards like "Metoprolol: everything." You'll recognize the answer and think you know it. (More on this in how to make flashcards.)

Then review a little every day. Pharmacology is the perfect subject for spaced repetition: lots of separate facts you need for a full year, and later for the NCLEX. Spacing your review out beats cramming the same amount of time (Cepeda et al., 2006), and ten to twenty minutes a day keeps earlier units from fading while you learn new ones.

If writing cards for every lecture is eating your evenings, you can generate them. Upload your pharm slides to the Revizly flashcard maker and it writes question-and-answer cards from them, with spaced repetition built in. You can also start with our free pharmacology flashcards to see what good cards look like. Either way, check them against your course material, since your instructors' slides are what your exams are based on.

Do NCLEX-style questions every week

Knowing facts isn't enough. Pharm exams in nursing school ask you to apply them: a patient on a beta blocker has a heart rate of 52, what do you do first? The only way to get good at that is to practice that kind of question.

• Do 20 to 30 questions a week from your textbook's question bank or a review book.
• Read every rationale, including for questions you got right.
• Keep a list of mistakes and turn each one into a flashcard.

You can also make a practice test from your own lecture slides to check yourself on exactly what your instructor covered.

Don't forget dosage calculations

Med math is a separate skill from pharmacology, and many programs test it on its own, often with a high passing score. It doesn't get easier by reading. It gets easier by doing problems.

• Pick one method (dimensional analysis is the most common in nursing programs) and use it for every problem.
• Always write the units at every step. Most errors are unit errors.
• Do five to ten problems a few times a week, not fifty the night before.
• Check whether your answer makes sense: if you calculated 15 tablets for one dose, something went wrong.

A weekly routine that works

Common mistakes

• Memorizing drug by drug. Learn the class through the prototype.
• Skipping nursing considerations. They're most of the test.
• Cramming before exams. Pharm builds all year. What you cram in October you'll need again in March.
• Only reading. If you're not quizzing yourself, you're not studying pharm, you're looking at it.

Pharmacology is a lot of material, but it's organized material. Learn the classes, learn what nurses do with each one, and test yourself a little every day. By the end of the semester you'll be surprised how much of it you can reason out instead of just remembering.

Sources

Drug information in this post is for studying only; always use your program's references for clinical practice. The learning research cited above:

• Cepeda, N. J., Pashler, H., Vul, E., Wixted, J. T., and Rohrer, D. (2006). Distributed practice in verbal recall tasks: A review and quantitative synthesis. Psychological Bulletin, 132(3), 354 to 380. doi:10.1037/0033-2909.132.3.354