Top 10 Medications You’ll Be Expected to Know Cold on the NP Boards
Real Talk from a Certified Nurse Practitioner
By Wes Clayton, MSN, FNP-BC
Founder of Next-NP: The Affordable, All-in-One NP Board Review
Let’s be real—pharmacology is one of the most heavily tested, highest-stress topics on the NP boards. Whether you're taking the AANP or ANCC, you’re guaranteed to get hit with questions that test your knowledge of drug classes, interactions, side effects, and contraindications.
The truth is, you don’t need to know every drug out there. But there are some medications that come up again and again—not just on exams, but in everyday primary care practice.
These 10 medications are board favorites and form the foundation of clinical decision-making in family and adult-gero primary care. If you memorize anything, make it this list.
💊 1. Lisinopril (ACE Inhibitor)
Used for: Hypertension, heart failure, post-MI care
Watch for: Dry cough, hyperkalemia, angioedema
Avoid in: Pregnancy, bilateral renal artery stenosis
✅ Board Pearl: Know the ACE cough and how it differs from ARBs.
💊 2. Metformin (Biguanide)
Used for: Type 2 diabetes
Watch for: GI upset, lactic acidosis risk, B12 deficiency
Hold if: Undergoing contrast studies or if eGFR < 30
✅ Board Pearl: Always assess renal function before initiating or continuing metformin.
💊 3. Levothyroxine (Thyroid Hormone Replacement)
Used for: Hypothyroidism
Important: Take on an empty stomach, same time daily
Watch for: Signs of over-replacement—tachycardia, anxiety, insomnia
✅ Board Pearl: Adjust dose based on TSH trends, not symptoms alone.
💊 4. Amoxicillin-Clavulanate (Beta-Lactam Antibiotic)
Used for: Sinusitis, otitis media, skin infections
Watch for: Allergic reactions, GI upset, C. diff
Pearl: First-line for many uncomplicated bacterial infections
✅ Board Pearl: Know the difference between beta-lactams and macrolides for respiratory bugs.
💊 5. Hydrochlorothiazide (Thiazide Diuretic)
Used for: Hypertension, mild fluid retention
Watch for: Hypokalemia, hyponatremia, increased uric acid
Monitor: Periodic BMP for electrolytes
✅ Board Pearl: Thiazides can exacerbate gout and worsen glucose control.
💊 6. Albuterol (SABA – Short-Acting Beta Agonist)
Used for: Asthma and COPD rescue treatment
Watch for: Tachycardia, tremors, restlessness
Teaching: Always carry a rescue inhaler
✅ Board Pearl: If using rescue inhaler >2x/week, it's time to reassess controller therapy.
💊 7. Statins (e.g., Atorvastatin)
Used for: Hyperlipidemia, CV risk reduction
Watch for: Myalgias, elevated LFTs
Avoid: Grapefruit juice due to CYP450 interaction
✅ Board Pearl: Know the ASCVD risk calculator and statin intensity guidelines.
💊 8. Omeprazole (Proton Pump Inhibitor)
Used for: GERD, PUD, H. pylori regimens
Watch for: B12 deficiency, hypomagnesemia, bone loss
Caution: Reevaluate long-term use regularly
✅ Board Pearl: PPIs are often overprescribed—be ready to deprescribe.
💊 9. Prednisone (Systemic Corticosteroid)
Used for: Inflammatory conditions, asthma/COPD flares
Watch for: Hyperglycemia, mood changes, bone loss
Tapering: Needed if used >2–3 weeks
✅ Board Pearl: Know steroid side effects cold—they’re almost guaranteed to show up.
💊 10. Warfarin (Vitamin K Antagonist)
Used for: Atrial fibrillation, DVT/PE prevention
Monitor: INR regularly (goal usually 2–3)
Watch for: Numerous drug and food interactions
✅ Board Pearl: Know what increases/decreases INR—especially antibiotics and leafy greens.
📚 Quick Tips to Master Pharmacology
✅ Focus on drug classes, not just individual meds
✅ Know black box warnings and common side effects
✅ Use spaced repetition tools like Anki or Quizlet
✅ Don’t skip pharmacology—it’s one of the highest-yield exam sections
Final Thoughts
Pharmacology doesn’t have to feel like a beast. With the right focus and resources, you can master the medications that matter most—for both the boards and the real world. Start with these 10, and you’ll already be way ahead of the game.
Want a smarter, more focused way to prep for boards? Check out Next-NP—your affordable, all-in-one NP review that cuts through the fluff and gives you exactly what you need to pass.
Written by Wes Clayton, MSN, FNP-BC
Certified Family Nurse Practitioner | Founder of Next-NP