Autonomic & Respiratory Pharmacology
Atropine is a muscarinic antagonist that increases heart rate and reduces secretions; it is used for symptomatic bradycardia.
Atropine is also used as an antidote for organophosphate poisoning, usually alongside an oxime such as pralidoxime.
Organophosphates inhibit acetylcholinesterase, producing excessive cholinergic activity such as salivation, lacrimation, bronchospasm, and bradycardia.
Salbutamol (albuterol) is a short-acting β₂ agonist used for rapid relief of bronchospasm and may cause tremor and tachycardia.
Salmeterol and formoterol are long-acting β₂ agonists used for maintenance therapy and are not intended to replace a rapid-relief bronchodilator during acute attacks.
Inhaled corticosteroids are the main anti-inflammatory controller therapy for persistent asthma.
Montelukast blocks leukotriene receptors and can be useful in asthma, particularly when allergic rhinitis is also present.
Theophylline has a narrow therapeutic index, and toxicity can cause nausea, tremor, tachycardia, and serious arrhythmias or seizures.
Ipratropium is a short-acting muscarinic antagonist commonly used as a bronchodilator in COPD.
Tiotropium is a long-acting muscarinic antagonist used primarily for maintenance treatment of COPD.
GI Pharmacology
Proton-pump inhibitors (PPIs) such as omeprazole suppress gastric acid secretion by irreversibly inhibiting the H⁺/K⁺-ATPase proton pump.
H₂-receptor antagonists such as famotidine reduce gastric acid secretion by blocking histamine H₂ receptors.
Antacids neutralize gastric acid directly and can interfere with the absorption of several orally administered drugs.
Metoclopramide is a dopamine D₂ antagonist that promotes gastric emptying and can cause extrapyramidal adverse effects.
Ondansetron is a 5-HT₃ receptor antagonist commonly used to prevent chemotherapy-induced and postoperative nausea and vomiting.
Loperamide reduces intestinal motility and is used for symptomatic treatment of uncomplicated diarrhea.
Lactulose is an osmotic laxative that is also used to reduce ammonia absorption in hepatic encephalopathy.
Misoprostol, a prostaglandin E₁ analogue, protects the gastric mucosa but can cause diarrhea and uterine contractions.
Sucralfate forms a protective barrier over ulcerated mucosa and requires separation from some other medications because it can reduce their absorption.
Bismuth compounds have gastroprotective and antimicrobial effects and may cause temporary darkening of the tongue and stool.
Pain & Anti-inflammatory Drugs
Paracetamol (acetaminophen) is an analgesic and antipyretic with minimal anti-inflammatory activity at usual doses.
N-acetylcysteine is the antidote for potentially toxic paracetamol overdose because it replenishes glutathione.
NSAIDs inhibit cyclooxygenase enzymes, reducing prostaglandin synthesis and producing analgesic, antipyretic, and anti-inflammatory effects.
NSAIDs can cause gastrointestinal ulceration, renal impairment, fluid retention, and increased cardiovascular risk.
Ketorolac is a potent NSAID intended for short-term use because prolonged therapy increases the risk of serious adverse effects.
Celecoxib selectively inhibits COX-2 and generally causes less gastrointestinal irritation than non-selective NSAIDs but may increase cardiovascular risk.
Opioids activate opioid receptors, particularly μ receptors, producing analgesia but potentially causing respiratory depression, constipation, and sedation.
Naloxone is an opioid receptor antagonist used to rapidly reverse opioid-induced respiratory depression.
Tramadol has both opioid activity and monoaminergic effects, so it can contribute to seizures and serotonin syndrome.
Morphine can cause respiratory depression, constipation, nausea, and hypotension, with active metabolites accumulating in significant renal impairment.
Antimicrobial Pharmacology
Penicillin allergy can range from mild rash to life-threatening anaphylaxis, so the nature of the previous reaction is clinically important.
Vancomycin infusion too rapidly can cause “red man syndrome,” characterized by flushing and hypotension; slowing the infusion helps prevent it.
Aminoglycosides exhibit concentration-dependent bacterial killing and have a significant risk of nephrotoxicity and ototoxicity.
Linezolid inhibits bacterial protein synthesis at the 50S ribosomal subunit and can cause thrombocytopenia with prolonged use.
Linezolid is also a reversible MAO inhibitor, so interactions with serotonergic drugs can contribute to serotonin syndrome.
Clindamycin inhibits the 50S ribosomal subunit and is strongly associated with C. difficile-associated diarrhea.
Doxycycline is a tetracycline that commonly causes photosensitivity and gastrointestinal irritation.
Fluoroquinolones should be separated from aluminum-, magnesium-, calcium-, and iron-containing products because chelation reduces their absorption.
Rifampin can turn urine, sweat, tears, and other body fluids an orange-red color.
Isoniazid can cause peripheral neuropathy and hepatotoxicity; pyridoxine supplementation helps prevent neuropathy in at-risk patients.
Renal, Electrolytes & Other Important Drugs
Acetazolamide inhibits carbonic anhydrase and increases urinary bicarbonate excretion, making it useful in conditions such as altitude sickness and certain forms of glaucoma.
Mannitol is an osmotic diuretic that can reduce intracranial pressure but should be used cautiously in patients with significant heart or renal failure.
Potassium-sparing diuretics can cause hyperkalemia, particularly when combined with ACE inhibitors, ARBs, or other potassium-raising drugs.
Allopurinol inhibits xanthine oxidase and reduces uric acid production, making it useful for long-term gout management.
Colchicine inhibits microtubule polymerization and is used for acute gout attacks and gout prophylaxis; gastrointestinal toxicity is common.
Alteplase is a thrombolytic that converts plasminogen to plasmin and can cause serious bleeding.
Nitroglycerin releases nitric oxide, causing predominantly venodilation and reducing cardiac preload.
Nitrates should not be combined with PDE-5 inhibitors such as sildenafil because severe hypotension can occur.
Amiodarone is a potent antiarrhythmic with a very long half-life and can cause pulmonary, thyroid, hepatic, ocular, and cardiac toxicity.
Adenosine has an extremely short half-life and can terminate certain supraventricular tachycardias by transiently slowing AV-node conduction.
🔑 Ultra-fast revision trick
For these 100 one-liners, focus on remembering the “drug → one defining fact” association:
- Warfarin → INR
- Heparin → aPTT
- Protamine → heparin antidote
- Vitamin K → warfarin reversal
- Naloxone → opioids
- Flumazenil → benzodiazepines
- N-acetylcysteine → paracetamol
- Atropine → organophosphates/bradycardia
- Digoxin → arrhythmias + visual symptoms
- Amiodarone → thyroid/lung toxicity
- Vancomycin → Gram-positive infections
- Aminoglycosides → kidney + ear toxicity
- Rifampin → CYP induction
- Isoniazid → neuropathy/hepatotoxicity
- Metformin → B12/lactic acidosis
- Spironolactone → hyperkalemia + gynecomastia
- Nitrates + sildenafil → severe hypotension
Pharmacy Exam Mock Test - Test#1
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