Pharmacology · 6 min read · April 8, 2026
Pharmacology is the #1 reason FNP students fail their boards. Not because the drugs are impossible to learn — but because most students try to memorize them in isolation, without a framework. These mnemonics are designed to anchor the highest-yield concepts so they stick under pressure.
"Don't memorize drugs. Memorize classes. The individual drugs will follow."
1. "Betas Block Beats" — Beta Blockers Beta blockers slow the heart rate and reduce cardiac output. Think: Betas Block Beats. Key drugs: metoprolol, carvedilol, atenolol. Board pearl: hold if HR < 60 or SBP < 90.
2. "ACE the Cough" — ACE Inhibitors ACE inhibitors cause a dry, persistent cough due to bradykinin accumulation. If your patient can't tolerate the cough → switch to an ARB (same mechanism, no cough). Board pearl: contraindicated in pregnancy (Category D).
3. "Statins STOP Cholesterol" — HMG-CoA Reductase Inhibitors Statins inhibit HMG-CoA reductase, the rate-limiting step in cholesterol synthesis. Monitor LFTs and watch for myopathy. Board pearl: grapefruit juice inhibits CYP3A4 → increases statin levels → increases myopathy risk.
4. "THIAZIDES Throw out Potassium" — Thiazide Diuretics Thiazides cause hypokalemia. Monitor K+ levels. Board pearl: first-line for hypertension in uncomplicated patients per JNC guidelines.
5. "Metformin Moves Glucose In" — Biguanides Metformin decreases hepatic glucose production and increases peripheral insulin sensitivity. Board pearl: hold before contrast dye (risk of lactic acidosis), contraindicated in eGFR < 30.
6. "SSRIs Start Slow" — Antidepressants SSRIs take 4–6 weeks for full therapeutic effect. Board pearl: increased suicide risk in the first 1–2 weeks of therapy — especially in patients under 25. Counsel patients on this at every initiation visit.
7. "Levothyroxine is Lonely — Take it Alone" Levothyroxine must be taken on an empty stomach, 30–60 minutes before food, and separated from calcium, iron, and antacids by at least 4 hours. Board pearl: TSH is the monitoring lab, not T4.
8. "Warfarin Watches Everything" Warfarin has dozens of drug and food interactions. Key: Vitamin K-rich foods (leafy greens) decrease INR. Monitor INR regularly. Board pearl: therapeutic INR for A-fib = 2.0–3.0.
9. "Fluoroquinolones Fry Tendons" Fluoroquinolones carry a black box warning for tendon rupture, especially the Achilles tendon. Risk increases with concurrent steroid use. Board pearl: avoid in patients under 18.
10. "Opioids Obstruct Everything" Opioids cause constipation, respiratory depression, urinary retention, and miosis. Board pearl: naloxone reverses opioid toxicity. Respiratory rate < 12 is your trigger.
Mnemonics are a starting point — not an endpoint. Once you have the hook, go deeper: understand the mechanism, know the contraindications, and practice applying them in board-style questions. That's how they become truly ...