Pharmacology Rapid Lightning Revision — NEET MDS

Autonomic NS

• Cholinergic agonist: Pilocarpine (glaucoma), Bethanechol (urinary retention)

• Anticholinergic: Atropine (mydriasis), Glycopyrrolate (pre-anesthetic)

• Adrenergic agonist: Epinephrine, Norepinephrine (shock), Dobutamine (heart failure)

• Beta-blockers: Propranolol (non-selective), Metoprolol (β1), Labetalol (α+β)

• Repeated: Receptor types, glaucoma, pre-anesthetic drugs

Cardiovascular

• ACEi: Captopril, Enalapril (↓Ang II, cough)

• ARBs: Losartan (AT1 blocker)

• Ca-channel blockers: Amlodipine, Verapamil (gingival hyperplasia)

• Diuretics: Thiazides (HCTZ), Loop (Furosemide), K-sparing (Spironolactone)

• Anti-anginal: Nitrates, Beta-blockers, Ca-blockers

• Anti-arrhythmic: Amiodarone (frequent exam)

• Repeated: HTN+DM: ACEi; HF drugs

CNS

• Benzodiazepines: Diazepam, Lorazepam (anxiolytic, SE: sedation)

• Antidepressants: SSRIs (Fluoxetine), SNRIs (Venlafaxine), TCA (Amitriptyline)

• Antipsychotics: Typical (Haloperidol), Atypical (Olanzapine)

• Antiepileptics: Phenytoin, Carbamazepine, Valproate, Levetiracetam

• Repeated: Status epilepticus → IV BZD → Phenytoin; antidepressant of choice MDD

Antimicrobials

• Beta-lactams: Penicillin, Amoxicillin, Cephalosporins

• Aminoglycosides: Gentamicin (nephrotoxic, ototoxic)

• Macrolides: Erythromycin, Azithromycin

• Fluoroquinolones: Ciprofloxacin

• Anti-TB: Isoniazid (neuropathy), Rifampicin (orange urine), Pyrazinamide, Ethambutol (optic neuritis)

• Repeated: First-line TB drugs, Rifampicin interactions

NSAIDs & Analgesics

• NSAIDs: Ibuprofen, Diclofenac (gastric ulcer)

• Opioids: Morphine, Codeine (resp depression)

• Dental: Acute dental pain → Ibuprofen + Paracetamol

Endocrine

• Insulin: Rapid (Lispro), Intermediate (NPH), Long (Glargine)

• Oral hypoglycemics: Metformin, Sulfonylureas, Pioglitazone

• Thyroid: Levothyroxine, PTU, Methimazole (PTU 1st trimester)

• Repeated: Type 2 DM → Metformin; Thyroid in pregnancy → PTU

Gastrointestinal

• Antacids: Al(OH)3, Mg(OH)2

• H2 blockers: Ranitidine, Famotidine

• PPIs: Omeprazole, Pantoprazole

• Laxatives: Bulk, Osmotic, Stimulant

• Repeated: Peptic ulcer → PPI+Amox+Clarithromycin

Chemotherapy & Oncology

• Alkylating: Cyclophosphamide (hemorrhagic cystitis)

• Antimetabolites: Methotrexate, 5-FU

• Plant alkaloids: Vincristine, Vinblastine, Paclitaxel

• Targeted: Imatinib, Monoclonal antibodies

• Repeated: Myelosuppression, leukemia drugs

🔥 GENERAL PHARMACOLOGY (Ultra High-Yield)

📌 Pharmacokinetics

• Bioavailability ↓ by first-pass metabolism (e.g., propranolol, morphine)

• Zero order kinetics → PEAT drugs
  Phenytoin, Ethanol, Aspirin (high dose), Theophylline

• Volume of distribution high → lipid soluble drugs (e.g., diazepam)

• Enzyme inducers → Rifampicin, Phenytoin, Carbamazepine, Phenobarbital

• Enzyme inhibitors → Erythromycin, Ketoconazole, Cimetidine

💊 AUTONOMIC NERVOUS SYSTEM

🟢 Cholinergic

• Pilocarpine → drug of choice in xerostomia

• Atropine toxicity → “Hot as a hare, blind as a bat…”

• Neostigmine → Myasthenia gravis

• Organophosphate poisoning → Atropine + Pralidoxime

🔵 Adrenergic

• Adrenaline → anaphylaxis drug of choice

• Noradrenaline → shock

• Propranolol → non-selective β blocker

• Metoprolol/Atenolol → β1 selective

• Labetalol → pregnancy HTN

🧠 CNS DRUGS

Antiepileptics

• Phenytoin → gingival hyperplasia (IMPORTANT for dentists!)

• Valproate → neural tube defect

• Carbamazepine → trigeminal neuralgia

• Status epilepticus → IV Lorazepam

Local Anaesthetics (VERY IMPORTANT)

• Most commonly used in dentistry → Lidocaine

• Maximum dose with adrenaline → 7 mg/kg

• Bupivacaine → cardiotoxic

• Prilocaine → methemoglobinemia

🦠 ANTIMICROBIALS (EXTREMELY IMPORTANT)

🧫 Antibiotic Prophylaxis (Infective Endocarditis)

• Drug of choice → Amoxicillin

• Penicillin allergy → Clindamycin

🦷 Dental Infections

• First line → Amoxicillin

• Anaerobes → Metronidazole

• Severe infection → Amoxicillin + Clavulanic acid

🧬 Tuberculosis

• First line (HRZE) → Isoniazid, Rifampicin, Pyrazinamide, Ethambutol

• INH toxicity → Peripheral neuropathy (give Pyridoxine)

💉 ANALGESICS & NSAIDs

• Paracetamol → safest in pregnancy

• Aspirin → Reye’s syndrome

• Ibuprofen → DOC mild dental pain

• Opioid antagonist → Naloxone

• Tramadol → serotonin syndrome risk

🩸 CARDIOVASCULAR

• ACE inhibitors → Cough (↑ bradykinin)

• Nitroglycerin → angina

• Heparin → monitored by aPTT

• Warfarin → monitored by INR

• Antidote Warfarin → Vitamin K

💊 ENDOCRINE

• Insulin → hypoglycemia most common side effect

• Metformin → lactic acidosis (rare but important)

• Steroids long-term → adrenal suppression

• Oral contraceptives → risk of thrombosis

🦴 DRUGS IMPORTANT FOR DENTISTS

• Bisphosphonates → Osteonecrosis of jaw

• Tetracycline → tooth discoloration

• Chlorhexidine → staining of teeth

• Phenytoin → gingival hyperplasia

• Nifedipine → gingival hyperplasia

• Cyclosporine → gingival hyperplasia

🎯 MOST REPEATED NEET MDS QUESTIONS

• Drug causing xerostomia → Anticholinergics

• DOC anaphylaxis → Adrenaline

• DOC trigeminal neuralgia → Carbamazepine

• Gingival hyperplasia drugs → Phenytoin, Nifedipine, Cyclosporine

• Max dose lignocaine with adrenaline → 7 mg/kg

• Antibiotic prophylaxis IE → Amoxicillin