How Mnemonics Can Help Students Ace the PCOA

JULY 11, 2018
If after 3 years of pharmacy school, just before the Pharmacy Curriculum Outcomes Assessment (PCOA), someone asked a student to write down all he or she remembered, it might be a disappointing list.

But mnemonics can help students easily recall information for the PCOA and later for the North American Pharmacist Licensure Examination (NAPLEX).

Although professors will say that acing the tests is not about memorization, those who have trouble remembering what they learned will not score well. Why does this matter? Some pharmacy schools that identify a student as a poor performer on the PCOA exam will place him or her under probation. Students may need to wait a year to repeat. With an average of just 48 seconds a question (180 minutes for 225 questions) a student must know the answers almost immediately.

As a pharmacology professor, when I see students many years down the road, they tell me they remember my stories and my mnemonics. Taking that information and putting it in book form, I created an interprofessional audiobook with 134 mnemonics encapsulating more than 450 drugs. It is called Memorizing Pharmacology Mnemonics: Pharmacy Flashcards and Fill-Ins for the Future Nurse, Doctor, Physician Assistant, and Pharmacist. Instead of reading it myself, I had Mike Lenz, a pharmacist from the Albany College of Pharmacy who is also a professional voice actor read it to make it more engaging. Although professors do a great job helping students understand the P1 through P3 material, it is critical to remember it for a few more years as well. Let’s see how these mnemonics work in a YouTube video that I will also describe.  

When trying to memorize antacids, for example, students may make 4 notecards for aluminum hydroxide, calcium carbonate, magnesium hydroxide, and sodium bicarbonate. Maybe they will note chelation and hypophosphatemia on the back. But when exam time comes, they hope they remember everything. To help them do this, I created a step-by-step story held by a single mnemonic ACIDIC MEALS. With a single notecard, they learn 4 medications and 4 adverse effects/interactions. These are:

A, aluminum hydroxide (Amphojel)
C, calcium carbonate (Tums)
D, decreased phosphate
I, ions and chelation
C, constipation
My students learned that aluminum hydroxide and calcium carbonate have similar adverse effects to chelation, constipation, and hypophosphatemia. Their proximity in this mnemonic half keeps them in mind spatially. It is the same idea as driving somewhere without having an address or walking to class without a room number. 
M, magnesium hydroxide (Milk of Magnesia)
L, laxative effect
S, sodium bicarbonate (in Alka-Seltzer)
Using the same principle, we add 2 more antacids: magnesium hydroxide and sodium bicarbonate. Because magnesium hydroxide is closer to laxative effect, spatially we understand that constipation goes with aluminum hydroxide and calcium carbonate and the laxative effect goes with magnesium hydroxide.
This video helps students memorize the 4 H2 blockers and their adverse effects with the mnemonic CALIFORNIA H2.  
The favorite pair of mnemonics from early reviews include the SSRI mnemonic 77. UPS AFFECT
P, paroxetine
S, sertraline
F, fluvoxamine
F, fluoxetine
E, escitalopram
C, citalopram
T, titrate to avoid agitation and anxiety adverse effect
Its partner is mnemonic 78. SSRIS HARM, outlining common adverse effects and serotonin syndrome symptoms.
S, sexual dysfunction
S, S-isomer
R, restlessness
I, insomnia
S, serotonin Syndrome
H, high temperature, hyperthermia
A, autonomic instability
R, rigidity
M, myoclonus
Even students who did not take the PCAT to get into pharmacy school will find that schools have made standardized exams a requirement to progress to P4 year. Mnemonics can help make sure students are ready.

Tony Guerra, PharmD
Tony Guerra, PharmD
Tony Guerra, PharmD, is chair, instructor, and pre-pharmacy advisor at Des Moines Area Community College's Pharmacy Technician program and Pharmacy Podcast Network Co-Host. He's Tony_PharmD on Twitter and TonyPharmD on YouTube providing Top 200 drugs and pronunciation help to over 4,500 followers with over 1 million views. His two audiobooks Memorizing Pharmacology: A Relaxed Approach and How to Pronounce Drug Names: A Visual Approach to Preventing Medication Errors are Amazon bestsellers. He graduated from Iowa State University with a BA in English and the University of Maryland with his PharmD.