Antidote questions are free points if you’ve drilled the pairs. Here are the ones that show up most, grouped so they’re easier to remember.
The big four
- Opioids (morphine, fentanyl, hydromorphone) → naloxone (Narcan). Watch for the opioid to outlast the naloxone. They can get sleepy again.
- Benzodiazepines (lorazepam, midazolam) → flumazenil. Use with caution in long-term benzo users because of seizure risk.
- Heparin → protamine sulfate.
- Warfarin → vitamin K (plus prothrombin complex concentrate or plasma for serious bleeding).
Free for nursing students: my Suffix Decoder, 34 drug endings and their families on one printable page. Get the free Suffix Decoder →
The next tier
- Acetaminophen overdose → acetylcysteine (Mucomyst / Acetadote). Smells like rotten eggs, so offer it over ice or in juice if given by mouth.
- Digoxin toxicity → digoxin immune fab (DigiFab).
- Magnesium sulfate toxicity → calcium gluconate. Classic in OB: lost reflexes, slow breathing.
- Insulin / hypoglycemia → glucose or glucagon.
- Dabigatran → idarucizumab (Praxbind).
- Apixaban, rivaroxaban → andexanet alfa.
The ones that show up once and stump everyone
- Iron → deferoxamine.
- Methotrexate → leucovorin.
- Anticholinergics → physostigmine.
- Organophosphates (pesticides) → atropine and pralidoxime.
How to drill these
Make it a matching game, both directions. Drug to antidote, then antidote to drug. Then add the “why”: what you’d see in the patient that makes you reach for it. That last part is what the NCLEX is really testing.
The full chart, ready to print: my Drug Class Cheat Sheets include an antidote and reversal agent chart, therapeutic drug levels, high-alert meds, and 30 drug classes on one page each. See them on Etsy →
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Study aid only. Always follow your program, your facility’s policies, and a current drug reference.
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