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Pharmacology Spotters
1. Identification

2. Class

3. MOA

4. Specific Indication

5. ADRs

6. Contradictions

󾠯 Paper 2
󾠰 Paper 3
󾠱 Paper 4
🔢 Miscellaneous

Pharmacology Spotters 1
 󾠯
Paper 2

ANS

Antimicrobials

Paper 2 1
 ANS

1. Pilocarpine (eye drop, topical)

2. Direct-acting cholinomimetic (alkaloid)

3. Acts mainly on M3 receptors and stimulate it (cause contraction of circular

muscles of iris and ciliary muscle)

4. Open-angle glaucoma

5. eye irritation, blurred vision,

6. Bronchial asthma, acute iritis

ANS 1
 1. Neostigmine (injection - iv, im , sc )

2. Indirectly acting parasympathomimetic (reversible)

3. Binds to esteratic site of Ach esterase and inhibit it by carbamylation →

decrease break down of Ach → increase amount of Ach

4. Myasthenia gravis, post-operative urinary retention

5. salivation, bradycardia, bronchospasm

6. bronchial asthma, mechanical ileus

ANS 2
 1. Physostigmine (iv, im)

2. Indirectly acting parasympathomimetic (reversible)

3. Binds to esteratic site of Ach esterase and inhibit it by carbamylation →

decrease break down of Ach → increase amount of Ach

4. Atropine poisoning, glaucoma, terminating effect of tubacurarine

5. sweating, salivation, bradycardia

6. bronchial asthma, peptic ulcer

ANS 3
 1. Atropine (Injection /IV,IM,SC)

2. Anti - cholinergic (anti-muscarinic) drug

3. Block both central and peripheral muscarinic receptors blocking the binding of
acetylcholine

4. Organophosphate poisoning, as a mydriatic agent

5. tachycardia, dryness of mouth, urinary retention

6. Cardiac failure, narrow-angle glaucoma, enlarged prostate

ANS 4
 1. Hyoscine (scopolamine)

2. semisynthetic Anticholinergic (antimuscarinic) drug

3. Block muscarinic receptors preventing the binding of Ach

4. Motion sickness, lie detector, abdominal cramps

5. constipation, sedation, dizzyness

6. pyloric obstruction, prostate hypotrophy

ANS 5
 1. Biperiden (tablets)

2. Synthetic anticholinergic (antimuscarinic) drug

3. block cholinergic (muscarinic) receptors

4. Parkinson

5. Drowsiness, dry mouth

6. Narrow-angle glaucoma

ANS 6
 1. Adrenaline/epinephrine (IM, SC, IV - after dilution)

2. Sympathomimetic drug

3. Stimulation of all the adrenergic receptors (a1 a2 b1 b2)

4. Anaphylactic shock, Bronchial asthma, cardiac arrest

5. Tachycardia, tremors, Hypertension, cerebral hemorrhage

6. Hypertension, hemorrhagic shock, arrhythmia, coronary artery disease

ANS 7
 1. Atenolol, metoprolol (tablets)

2. selective B1 blockers

3. Blocking B1 receptors in the heart and prevent adrenergic action

4. Hypertension, Angina, CHF, acute MI, ventricular tachycardia

5. Dry mouth, dizziness, depression, stomach pain

ANS 8
 6. 2nd & 3rd degree heart block, severe sinus bradycardia, COPD, asthma

ANS 9
 1. Terazosin, Prazosin (tablets)

2. Alpha 1 selective adrenergic receptor blockers

3. Block alpha 1 adrenergic receptors preventing the action of

adrenaline/noradrenaline

4. Hypertension, benign hypertrophy of prostate

5. Postural hypotension, reflex tachycardia, sedation, dizziness and syncope

6. heart failure

1. Propranolol, Timolol

2. Non selective beta-blockers without intrinsic sympathomimetic activity

3. Block beta-blockers non selectively and prevent the binding of adrenaline and
noradrenaline reducing the sympathetic activity

4. Propranolol - Hypertension, Angina, Migraine prophylaxis, Thyrotoxicosis,

Pheochromocytoma along with alpha-blocker

Timolol - Open-angle glaucoma

ANS 10
 5. Bradycardia, Hypotension, Bronchospasm

6. Bronchial asthma, diabetes mellitus, heart block

1. Oxymetazoline

2. sympathomimetic - non selective alpha adrenergic agonists

3. stimulate alpha adrenergic receptors nonselectively

4. Nasal decongestant, facial erythema, rhinitis

5. dizziness, nervousness, restlessness, hypertension

6. Hypertension

ANS 11
 Antimicrobials

1. Ceftriaxone injection (iv,im)

2. Ceftriaxone - 3rd generation cephalosporin

Tazobactam - beta lactamases inhibitor

1. inhibition of bacterial cell wall peptidoglycan synthesis by inhibition of penicillin-

sensitive enzymes (transpeptidases, carboxypeptidases) ; inhibit
transpeptidation

2. UTI, respiratory infections, typhoid

3. diarrhea, nausea, vomiting

4. penicillin allergy , breast feeding women

Antimicrobials 1
 1. Cefotaxime (IM,IV)

2. 3rd generation cephalosporin

3. cell wall inhibition by preventing transpeptiation

4. gonorrhea, meningitis, UTI

5. rash, itching, nausea, vomiting

6. hypersensitivity, porphyria

Antimicrobials 2
 1. Cefuroxime (injection) IM/IV

2. 3rd generation cephalosporin

3. cell wall inhibition by preventing transpeptiation

4. respiratory infections, UTIs, gonorrhea

5. nausea, vomiting, diarrhoea

6. hypersensitivity

1. cefpodoxime (tablets)

Antimicrobials 3
 2. 3rd generation cephalosporins

3. cell wall inhibition by preventing transpeptiation

4. respiratory infections, gonorrhea, UTIs

5. abdominal pain, nausea, vomiting, diarrhoea

6. hypersensitivity

1. Cephalexin (one of the most commonly used cephalosporins)

2. 1st generation cephalosporin

3. cell wall inhibition by preventing transpeptiation

4. UTI , RTI, streptococcus pharyngitis

5. Nausea, diarrhea, vomiting

6. chronic kidney disease, hypersensitivity

Antimicrobials 4
 1. Ciprofloxacin

2. 1sr generation flouroquinolone

3. inhibit DNA replication by interfering with DNA gyrase (in gram -ve bacteria)

inhibit topoisomerase IV (in gram +ve bacteria)

4. Typhoid, UTI, Gonorrhea, TB

5. Nausea, Vomiting, diarrhea (GI)

Headache, dizziness (CNS - due to GABA antagonism)

6. Contradicted in children below 12 yrs.

Antimicrobials 5
 1. Nalidixic acid

2. Quinolones

3. Inhibits DNA replication by inhibiting bacterial DNA gyrase

4. Diarrhea caused by E.coli, proteus, shigella. As urinary antiseptic

Antimicrobials 6
 5. GI upset, Rashes, neurotoxicity (headache, drowsiness)

6. porphyria, G6PD deficiency

1. Vancomycin (injection)

2. Glycopeptide antibiotics

3. Inhibits cell wall synthesis by binding to the D-Ala-D-Ala side chain preventing
transglycosylation

4. MRSA infections, bacterial meningitis, surgical prophylaxis

5. Red man syndrome, nephrotoxicity

6. Kidney disease

Antimicrobials 7
 1. Amoxicillin and potassium clavulanate

2. Extended-spectrum penicillins (semi synthetic)

3. MOA - cell wall inhibition by preventing transpeptidation by binding to PBPs.

Basis of combination - Amoxicillin has a small R group hence susceptible to

Beta-lactamases → Clavulanic acid inhibits beta-lactamases (class II -
IV)

4. RTI, Pharyngitis UTI, Soft tissue infections

5. diarrhea, Rash, Kounis syndrome

6. Hypersensitivity

Antimicrobials 8
 1. Azithromycin

2. Newer Macrolides

3. binds to 50s subunit of the bacterial ribosome → inhibits translocation step of

protein synthesis → Inhibits protein synthesis

4. Pharyngitis, tonsillitis, legionnaires' pneumonia, Chancroid

5. Nausea, vomiting, hepatotoxicity, abdominal pain

6. Hypersensitivity

Antimicrobials 9
 1. Doxycycline

2. Tetracyclines

3. binds reversibly to the bacterial 30s ribosomal subunit → block access of amino
acyl tRNA to mRNA ribosome complex at acceptor site → Protein synthesis
inhibition

4. Rocky Mountain spotted fever, Rickettsial infections, venereal diseases,

cholera, malaria

5. oesophagitis, diarrhea, nausea

6. Pregnancy, while taking OCPs

Antimicrobials 10
 1. Ampicillin + Cloxacillin (AMPILOX) (Inj. IM/IV)

2. Ampicillin → extended spectrum penicillins

Cloxacillin → Penicillinase resistant antibiotics

3. Cell wall inhibition by preventing transpeptidation after binding to PBPs.

(cloxacillin will be penicillinase-resistant due to presence of a large R group)

4. Post operative infections, skin & soft tissue infections, RTI, UTI

5. Upset stomach, nausea, vomiting, diarrhea

6.

Antimicrobials 11
 1. Fluconazole

2. Antifungal → Azoles → Triazoles

3. binds to fungal cytochrome P-450 → inhibits C-14 demethylase → interruption of

the conversion of lanosterol to ergosterol → disruption of fungal membranes
(fungistatic)

4. Candidiasis, Onychomycosis, Cryptococcal meningitis

5. Nausea, Diarrhea, Vomiting

6. Hypersensitivity, Pregnancy, SSRI drug users

Antimicrobials 12
 1. Itraconazole

2. Antifungal → Azoles → Triazoles

3. binds to fungal cytochrome P-450 → inhibits C-14 demethylase → interruption of

the conversion of lanosterol to ergosterol → disruption of fungal membranes
(fungistatic)

4. Candidiasis, Onychomycosis, Dermatophytosis

5. Headache, dizziness, pruritus

6.

Antimicrobials 13
 1. Griseofulvin

2. Antifungal drug (antibiotic → heterocyclic benzofuran)

3. interferes with mitosis by preventing separation of daughter cells

4. dermatophytosis, Athlete's foot (tinea pedis) (not effective in subcutaneous

mycoses)

5. GI disturbances, CNS symptoms, Perpheral neuritis

6. Pregnancy, SLE, Porphyria

1. Amphotericin B / L- AMB (inj. IV)

2. Antifungal drug → Antibiotic → Polyenes

3. Binds to ergosterol on fungal cell membrane → make pores → osmotic balance

is lost and cell dies

4. Infections caused by Candida albicans, Histoplasma capsulatum, cryptococcus

neoformans, Aspergillus

Leishmaniasis

Antimicrobials 14
 5. Nephrotoxicity, Fever and chills, Thrombophlebitis

6. Shouldn't be given with KTZ, Hypokalemia

Antimicrobials 15
 󾠰
Paper 3

Ferrous Ascorbate & Folic Acid, a synthetic form of iron and vitamin C is prescribed
for pregnant women to prevent spina bifida in an unborn fetus, to improve iron
utilization and to prevent folate or iron deficiency anemia.

Paper 3 1
 1. Digoxin

2. CHF drug → positive ionotropic drug → cardiac glycosides

3. binds and inhibits Na+K+ ATPase → increase of intracellular Na+ → Na+ Ca+
exchanger is inhibited → increase of intracellular Ca2+ → Increased contractility
of heart

4. Congestive heart failure , arrhythmias

5. Ventricular fibrillation, bradycardia, partial or complete heart block, cardiac

arrhythmia

6. Hypokalemia, MI

Paper 3 2
 1. Amlodipine

2. Calcium channel blockers → Dihydropyridines

3. Blocks voltage-sensitive L- type Ca channels → cause mainly smooth muscle

relaxation

4. Hypertension, Angina

5. Postural hypotension, reflex tachycardia

6. Cardiogenic shock, bradycardia

Paper 3 3
 1. Lignocaine

2. Class 1B antiarrhythmic drug (membrane stabilizing agents)

3. Block Na+ channel in inactivated state → Action potential duration is decreased.

4. ventricular tachycardia, premature ventricular contractions

5. Seizures, respiratory arrest

6. Heart block (2nd/3rd degree), after using amiodarone

Paper 3 4
 1. Spironolactone

Furosemide

2. Spironolactone - K+ sparing diuretics

Furosemide - High ceiling (loop) diuretics

3. Spironolactone - competitive binding of receptors at the aldosterone-dependent

sodium-potassium exchange site in the distal convoluted renal tubule → K+
excretion and Na+ reabsoption is prevented

Furosemide - binds and inhibits Na⁺ K⁺ 2 Cl⁻ cotransporter in ascending loop of

Henle and reduce Na⁺ K⁺ Cl⁻ reabsorption

4. Hypertension, CHF, Edema (spironolactone)

5. Spironolactone - Gynecomastia, Hyponatremia

Furosemide - Hypokalemia, Hypotension, Hyponatremia

Paper 3 5
 1. Dilitiazem

2. Calcium Channel blocker → Benzothiazepine

3. Blocks voltage-sensitive L- type Ca channels → action on both heart and

vessels

4. Hypertension, Angina

5. Postural hypotension, reflex tachycardia

Paper 3 6
 1. Atorvastatin

2. Hypolipidemic drug → HMG-CoA reductase inhibitor

3. Inhibit the HMG-CoA reductase enzyme (which convert HMG CoA to

mevalonate )→ Cholesterol synthesis is inhibited

4. First choice drugs for primary hyperlipidaemias with raised LDL and total
cholesterol levels
with or without raised triglyceride

secondary hypercholesterolemia

5. Headache, nausea

6. Absolute liver disease

Paper 3 7
 1. isosorbide mononitrate

2. vasodilators (venodilator) → nitrates → long-acting nitrates

3. release NO → activates Guanylyl cyclase → increase cAMP → activation of

PKG → MLCK deactivation → relaxation of vascular smooth muscles

4. Angina, CHF

5. headache, Methemoglobinemia, nervousness, orthostatic hypotension

6. shouldn't be used with sildenafil, bradycardia, methemoglobinemia

Paper 3 8
 1. Enalapril

2. ACE inhibitors

3. Prevention of conversion of Angiotensin I into angiotensin II by inhibiting

Angiotensin-converting enzyme → RAS system is inhibited and BP reduced

4. Hypertension, CHF,

5. Cough, Angioedema, teratogenicity, hypotension

6. Pregnancy, renal artery stenosis

Paper 3 9
 󾠱
Paper 4

1. Salbutamol (inhalational, tablets/oral)

2. Anti asthmatic drug, Bronchodilator, B2 agonist

3. Binds to B2 receptors on bronchial smooth muscles → stimulate AC to make

more cAMP → activate PkA → phosphorylation of MLCK and its inactivation →
smooth muscle relaxation

4. Bronchial Asthma, COPD

5. Palpitations, tremors, hyperglycemia, hypokalemia, Tolerance

6. CVS diseases, pregnancy

Paper 4 1
 1. Ipratropium bromide (inhalational)

2. Anti-asthmatic drug, Bronchodilator, anticholinergic drug (muscarinic

antagonists)

3. Reversible competitive inhibition of Ach at M3 receptors → No Ach induced

bronchoconstriction

4. Bronchial Asthma, COPD

5. Dryness of mouth, dizziness, nausea

6. Closed-angle glaucoma, urinary bladder blockade

Paper 4 2
 1. Theophylline (tablets) Aminophylline (IV)

2. Anti asthmatic drug, Bronchodilator, methylxanthines

3. Inhibit phosphodiesterase 4 → high cAMP → high pkA → phosphorylation and

inactivation of MLCK → smooth muscle relaxation

Inhibit adenosine receptors

4. Bronchial asthma, COPD

5. Narrow safety margin, Seizures, Nausea, Vomiting, anorexia

6. Peptic ulcer, Hypersensitivity

Paper 4 3
 1. Fexofenadine

2. 2nd Generation antihistamine

3. block histaminic receptors (H1) (do not pass the blood-brain barrier)

4. allergic rhinitis, hay fever, conjuctivitis

5. QT prolongation, dizziness

6.

1. Promethazine

2. Antihistaminics → 1st generation → highly sedative

3. block histaminic receptors (H1)

4. rhinitis, allergic conjunctivitis, parkinsonism, motion sickness

5. sedation, drowsiness, slowed heart rate

6.

Paper 4 4
 1. Isoniazid, Rifampicin, pyrazinamide, ethambutol

2. anti TB drugs → 1st line drugs

3. Isoniazid→ Inhibit biosynthesis of mycolic acid

Resistance - Mutaion of Inh A gene , Mutation in the catalase-peroxidase

gene (KatG)

Rifampicin → Inhibit DNA dependent RNA polymerase

Resistance- Mutation in rpoB gene

Pyrazinamide → Inhibits mycolic acid synthesis by interacting with a different

fatty acid synthase encoding gene.
Resistance- Mutation in PnCA gene

Ethambutol - Inhibit arbinoglycan synthesis (obstructing the formation of cell wall)

Paper 4 5
 5. ADRs

Isoniazid→ Peripheral neuritis, Hepatotoxicity

Rifampicin → Hepatotoxicity, Respiratory syndrome

Pyrazinamide → Hepatotoxicity, Hyperuricemia, Gout

Ethambutol - Optic neuritis

Paper 4 6
 🔢
Miscellaneous

1. Morphine (Injection - IV, IM)

2. Opiate (narcotic) analgesics

3. Opioid agonists

Miscellaneous 1
 4. Preanesthetic medication, management of moderate to severe pain

5. Miosis, sedation, respiratory depression, hypotension

6. Bronchial asthma, pregnancy, emphysema, shock

Miscellaneous 2