ACE Inhibitors
Suffix: -prilExamples: lisinopril, enalapril, captopril
Mechanism: Block ACE → reduce afterload
🏥 Nursing Alert: Monitor K⁺ (hyperkalemia), dry cough, first-dose hypotension, contraindicated in pregnancy, hold if SBP <90
Cardiac Medications
ARBs
Suffix: -sartanExamples: losartan, valsartan
Mechanism: Block angiotensin II receptors
🏥 Nursing Alert: Similar to ACE but NO dry cough. Monitor K⁺, contraindicated in pregnancy
Beta-Blockers
Suffix: -ololExamples: metoprolol, atenolol, carvedilol, propranolol
Mechanism: Block beta receptors → reduce HR, BP
🏥 Nursing Alert: Hold if HR <60 or SBP <90. Do NOT stop abruptly. Mask hypoglycemia in diabetics
Calcium Channel Blockers
Suffix: -dipine / diltiazem, verapamilExamples: amlodipine, nifedipine, diltiazem
Mechanism: Block calcium channels → vasodilation
🏥 Nursing Alert: Monitor HR and BP. Avoid grapefruit. Constipation (verapamil). No crushing ER
Loop Diuretics
Suffix: -semideExamples: furosemide, bumetanide
Mechanism: Block Na-K-2Cl → massive diuresis
🏥 Nursing Alert: Monitor K⁺, Na⁺, Mg²⁺. Ototoxicity. Daily weights. Give AM dose
K-Sparing Diuretics
Suffix: —Examples: spironolactone, eplerenone
Mechanism: Block aldosterone → retain K⁺
🏥 Nursing Alert: Monitor K⁺ (hyperkalemia). Do NOT give with ACE/ARB carelessly. Gynecomastia
Anticoagulants Medications
Heparin (UFH)
Suffix: —Examples: heparin IV/SQ
Mechanism: Activates antithrombin III
🏥 Nursing Alert: Monitor aPTT (1.5–2.5× control). Antidote: protamine. HIT monitoring
LMWH
Suffix: -parinExamples: enoxaparin (Lovenox)
Mechanism: Inhibits factor Xa
🏥 Nursing Alert: SQ abdomen. Do NOT rub. No routine aPTT. Antidote: protamine (partial)
Warfarin
Suffix: —Examples: Coumadin
Mechanism: Blocks vitamin K factors (II, VII, IX, X)
🏥 Nursing Alert: Monitor INR (2.0–3.0). Antidote: vitamin K. Consistent diet. Teratogenic
DOACs
Suffix: -xaban / -gatranExamples: rivaroxaban, apixaban, dabigatran
Mechanism: Direct Xa or thrombin inhibitors
🏥 Nursing Alert: No routine monitoring. Renal function important. Antidotes exist
Diabetes Medications
Rapid-Acting Insulin
Suffix: —Examples: lispro (Humalog), aspart (NovoLog)
Mechanism: Onset 15 min, peak 1–2 hr
🏥 Nursing Alert: Give before meals. CLEAR. Hypoglycemia at peak. Draw clear first when mixing
Long-Acting Insulin
Suffix: —Examples: glargine (Lantus), detemir
Mechanism: Onset 1–2 hr, no peak, 24 hr
🏥 Nursing Alert: Same time daily. CLEAR. Do NOT mix. Lower hypo risk (no peak)
NPH Insulin
Suffix: —Examples: Humulin N
Mechanism: Onset 1–2 hr, peak 4–12 hr
🏥 Nursing Alert: CLOUDY — roll gently. Peak = hypo risk window. Can mix with rapid
Metformin
Suffix: —Examples: Glucophage
Mechanism: Decreases hepatic glucose
🏥 Nursing Alert: Hold before contrast dye. GI side effects. No hypo as monotherapy
Frequently Asked Questions
What is the suffix for ACE inhibitors?
ACE inhibitors end in -pril (lisinopril, enalapril, captopril). Monitor K⁺, watch for dry cough, first-dose hypotension, avoid in pregnancy.
What is the difference between ACE inhibitors and ARBs?
-pril (ACE) can cause dry cough from bradykinin. -sartan (ARB) blocks angiotensin II receptors directly — no dry cough. Both monitor K⁺, both contraindicated in pregnancy.
When should beta-blockers be held?
Hold if HR <60 or SBP <90. Do NOT stop abruptly (rebound tachycardia, HTN, MI). Mask hypoglycemia in diabetics.
What is the antidote for heparin and for warfarin?
Heparin → protamine sulfate. Warfarin → vitamin K (phytonadione). Monitor aPTT for heparin, INR for warfarin.