Top 20 Drugs UK Nurses Administer (BNF Quick Reference)

A reference of 20 drugs that appear most commonly in UK nursing practice. Each entry has the key nursing considerations.

This is a summary, not a clinical reference. Always check the BNF, the prescription, and your trust’s local guidance for the specific patient in front of you. Doses and contraindications change; patient context matters.

1. Paracetamol

• Class: analgesic, antipyretic.
• Routes: oral, IV, rectal.
• Standard adult dose: 500 mg-1 g.
• Maximum: 4 g in 24 hours for adults (less for lower-weight, hepatic impairment, malnutrition).
• Nursing watch: hepatotoxicity in overdose; watch for over-the-counter combinations containing paracetamol.

2. Ibuprofen

• Class: NSAID.
• Routes: oral, occasionally IV.
• Standard dose: 200-400 mg three to four times daily.
• Cautions: GI bleeding risk, renal impairment, asthma exacerbation in some.
• Avoid: pregnancy (especially third trimester), known peptic ulcer, severe heart failure.

3. Codeine

• Class: weak opioid analgesic.
• Routes: oral.
• Standard dose: 30-60 mg up to four times daily.
• Nursing watch: constipation, sedation; CYP2D6 metaboliser variation means some patients get little effect and some get strong effect.
• Avoid: under 12 years old; breastfeeding.

4. Morphine

• Class: strong opioid.
• Routes: oral (immediate or modified release), IV, SC.
• Doses: highly variable by indication and patient.
• Nursing watch: respiratory rate, sedation level, constipation, addiction concerns.
• Reversal: naloxone for significant respiratory depression.

5. Amoxicillin

• Class: penicillin antibiotic.
• Routes: oral, IV.
• Common dose: 500 mg three times daily orally.
• Allergy: penicillin allergy is common; check before administering.
• Cautions: glandular fever (causes rash), renal impairment dose adjustment.

6. Co-amoxiclav

• Class: penicillin + beta-lactamase inhibitor.
• Routes: oral, IV.
• Common dose: 625 mg three times daily orally; 1.2 g IV.
• Allergy: penicillin allergy contraindication.
• Cautions: cholestatic jaundice risk in some patients.

7. Omeprazole / lansoprazole

• Class: proton pump inhibitor.
• Routes: oral, IV.
• Common dose: 20-40 mg daily.
• Cautions: long-term use linked to bone fracture risk, B12 deficiency, C. difficile risk.
• Watch: drug interactions (clopidogrel particularly).

8. Salbutamol

• Class: short-acting beta-2 agonist.
• Routes: inhaled, nebulised, IV (rare).
• Common dose: 100-200 mcg inhaled; 2.5-5 mg nebulised.
• Cautions: tachycardia, tremor; cardiac concerns at high doses.
• Education: inhaler technique is critical to effect.

9. Beclometasone / budesonide / fluticasone

• Class: inhaled corticosteroid.
• Routes: inhaled.
• Long-term controller for asthma/COPD.
• Education: regular use, mouth rinsing to prevent oral candidiasis.
• Watch: growth in children on high doses.

10. Insulin (various)

• Routes: SC primarily; IV in DKA and hyperglycaemic emergencies.
• Critical safety issues: dose precision, hypoglycaemia risk, brand and type confusion (rapid, short, intermediate, long-acting).
• Education: blood glucose monitoring, hypo recognition.
• Common error: confusing units with mL.

11. Warfarin

• Class: anticoagulant.
• Routes: oral.
• Dose: variable, INR-titrated.
• Watch: bleeding risk; INR monitoring; drug and food interactions extensive.
• Education: yellow book; consistent vitamin K intake; avoiding NSAIDs.

12. Enoxaparin (low-molecular-weight heparin)

• Class: anticoagulant.
• Routes: SC.
• Dosing: weight-based; prophylactic and treatment doses differ.
• Watch: bleeding risk; heparin-induced thrombocytopenia.
• Renal dose adjustment.

13. Amlodipine / lisinopril / ramipril

• Class: antihypertensives.
• Routes: oral.
• Standard chronic medications.
• Watch: postural hypotension, renal function with ACE inhibitors, ankle oedema with amlodipine.
• ACEi cough is common reason for discontinuation.

14. Atorvastatin / simvastatin

• Class: statins.
• Routes: oral.
• Long-term medication for cardiovascular risk reduction.
• Watch: muscle pain, liver function changes, drug interactions.

15. Furosemide

• Class: loop diuretic.
• Routes: oral, IV.
• Common dose: 20-80 mg orally; IV doses variable.
• Watch: electrolyte disturbance (potassium, sodium), dehydration, ototoxicity at high IV doses.
• Education: timing to avoid nocturia; food and fluid effects.

16. Metformin

• Class: oral diabetes drug.
• Routes: oral.
• Standard dose: 500 mg-1 g twice daily.
• Cautions: renal impairment; lactic acidosis risk (rare).
• Watch: GI side effects; pause before contrast studies in some protocols.

17. Levothyroxine

• Class: thyroid hormone replacement.
• Routes: oral.
• Standard chronic medication.
• Watch: dose adjustment in pregnancy, drug interactions (calcium, iron reduce absorption).
• Education: morning dose on empty stomach.

18. Sertraline / citalopram

• Class: SSRI antidepressants.
• Routes: oral.
• Common doses: 50-200 mg sertraline; 10-40 mg citalopram.
• Watch: serotonin syndrome interactions; initial agitation; suicidal ideation in early weeks.
• Citalopram: QT prolongation concern at higher doses.

19. Tramadol

• Class: opioid analgesic.
• Routes: oral, IV.
• Common dose: 50-100 mg up to four times daily.
• Watch: respiratory depression, serotonin syndrome interactions (especially with SSRIs).
• Cautions: lower seizure threshold.

20. Aspirin (low-dose)

• Class: antiplatelet.
• Routes: oral.
• Common dose: 75 mg daily for cardiovascular protection.
• Watch: bleeding risk, GI ulceration.
• Avoid in children under 16 (Reye syndrome risk).

How to use this reference

This list is reference, not exhaustive. For each drug:

• Read the prescription carefully: confirm dose, route, frequency.
• Check the BNF for any specific concerns at the patient’s age, weight, renal function.
• Check for allergies before administering.
• Apply the Five Rights.
• Document accurately.

For drugs not on this list, the same principles apply with the BNF as the reference.

This is the end of Part 7. The final part (chapters 95-100) covers the practical revalidation playbook: finding a confirmer, the NMC Online submission, the timeline, the annual fee, return to practice, and the final checklist.