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🎯 MBBS PHARMACOLOGY - HIGH YIELD TOPIC MAP

Based on 30 Years PYQ Analysis | 100 Marks University Exam

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📊 EXAM PATTERN BREAKDOWN

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🔥 TIER-1: HIGHEST YIELD TOPICS (Almost Certain to Appear)

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⭐⭐⭐ 10 MARK LONG ESSAY - MOST LIKELY QUESTIONS

Pick ONE of these to prepare in depth. One of these appears almost every year.

1. Antitubercular Drugs (PH1.44) - Most frequently asked as 10-marker
   • DOTS regimen, first-line drugs (HRZE), mechanisms, side effects of each drug
   • INH: peripheral neuropathy (pyridoxine deficiency), hepatotoxicity
   • Rifampicin: enzyme inducer, orange urine, drug interactions
   • Pyrazinamide: hyperuricemia
   • Ethambutol: optic neuritis
2. Diabetes Mellitus - Oral Hypoglycemics (PH1.36)
   • Classify, MOA, doses, ADRs, contraindications
   • Metformin vs Sulfonylureas vs SGLT2 inhibitors vs GLP-1 agonists vs DPP-4 inhibitors
   • Insulin types and regimens
3. Corticosteroids (PH1.38)
   • Classification, MOA, pharmacological effects
   • ADRs (cushingoid features, adrenal suppression, osteoporosis)
   • Indications, contraindications, steroid sparing agents

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⭐⭐⭐ SHORT ESSAY (5M) - TOP 14 HIGH YIELD TOPICS

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⭐⭐ SHORT NOTES (3M) - TOP 5 HIGH YIELD TOPICS

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📝 COMPLETE TOPIC-WISE PREDICTED QUESTIONS

SECTION A - GASTROINTESTINAL DRUGS (PH1.34) 🔥

• "Describe the mechanism, uses, ADRs and contraindications of Proton Pump Inhibitors"
• "Classify antiemetics. Describe MOA and uses of Ondansetron"
• "Compare H2 blockers and PPIs in management of peptic ulcer"
• "Describe pharmacological management of GERD"
• "Write about drugs used in inflammatory bowel disease"

• Drug of choice for GERD: Omeprazole/PPIs
• Cimetidine - enzyme inhibitor (vs Ranitidine - no enzyme inhibition)
• Metoclopramide crosses BBB → Extrapyramidal effects
• Laxative used in hepatic encephalopathy: Lactulose
• 5-HT3 antagonist antiemetic: Ondansetron

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SECTION B - ANTITUBERCULAR DRUGS (PH1.44, PH1.45) 🔥🔥🔥

• "Describe first-line antitubercular drugs with their MOA, doses and ADRs"
• "What is DOTS? Describe the treatment regimen for new smear-positive pulmonary TB"
• "Describe drugs used in MDR-TB"

• INH: bactericidal, inhibits mycolic acid synthesis, ADR = peripheral neuropathy (give pyridoxine), hepatotoxic
• Rifampicin: enzyme inducer, colors secretions orange, bactericidal
• Pyrazinamide: active in acidic pH, ADR = hyperuricemia, gout
• Ethambutol: bacteriostatic, ADR = retrobulbar optic neuritis (test color vision)
• Streptomycin: aminoglycoside, ototoxicity, nephrotoxicity
• MDR-TB drugs: Bedaquiline, Linezolid, Levofloxacin, Clofazimine

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SECTION C - ANTIMICROBIALS (PH1.43) 🔥🔥

• "Classify penicillins. Describe MOA, spectrum, ADRs of amoxicillin"
• "Describe rational use of antibiotics and antibiotic stewardship"
• "What is MRSA? Drugs used in its treatment"
• "Describe MOA and uses of Fluoroquinolones"

• Beta-lactam MOA: inhibit cell wall synthesis (transpeptidase inhibition)
• Aminoglycosides ADR: ototoxicity + nephrotoxicity
• Drug causing photosensitivity: Tetracycline, Fluoroquinolones
• Drug contraindicated in pregnancy from antibiotics: Tetracycline, Fluoroquinolones, Aminoglycosides
• Antibiotic for MRSA: Vancomycin

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SECTION D - DIABETES DRUGS (PH1.36) 🔥🔥🔥

• "Classify oral hypoglycemic drugs. Describe MOA, ADRs and uses of Metformin"
• "Compare insulin types with onset and duration of action"
• "Describe mechanism of action of Sulfonylureas"

• Metformin MOA: activates AMPK → reduces hepatic gluconeogenesis
• Metformin ADR: lactic acidosis, contraindicated in renal failure
• Drug causing hypoglycemia: Sulfonylureas
• Insulin secretagogue: Sulfonylurea
• SGLT2 inhibitor example: Empagliflozin

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SECTION E - CORTICOSTEROIDS (PH1.38) 🔥🔥

• "Describe pharmacological effects and ADRs of corticosteroids"
• "What is steroid withdrawal syndrome? How will you prevent it?"

• Most potent topical steroid: Clobetasol
• Steroid that doesn't cause sodium retention: Dexamethasone, Betamethasone
• HPA suppression occurs with: prolonged systemic steroid use
• Drug used to replace steroids: Hydrocortisone (physiological replacement)

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SECTION F - ORAL CONTRACEPTIVES (PH1.39) 🔥🔥

• "Describe mechanism of action, types, benefits and adverse effects of combined oral contraceptive pills"
• "Describe emergency contraception"

• OCP failure rate: <1%
• OCP containing only progesterone: Mini-pill (good for lactating mothers)
• Emergency contraception: Levonorgestrel (within 72 hrs)
• OCP increases risk of: DVT (thromboembolism)

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SECTION G - UTERINE DRUGS (PH1.41) 🔥🔥

• "Describe uterine stimulants with their MOA and clinical uses"
• "Describe uses and ADRs of Oxytocin"
• "What are tocolytics? Describe Ritodrine/Nifedipine in preterm labour"

• Drug of choice to induce labour: Oxytocin
• Drug used to ripen cervix: Misoprostol (PGE1)
• Drug to stop preterm labour: Ritodrine, Nifedipine, Atosiban
• Ergometrine contraindicated in: toxemia/hypertension

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SECTION H - ANTIMALARIALS (PH1.47) 🔥🔥

• "Describe mechanism and uses of Chloroquine. Why is resistance developing?"
• "Describe treatment of severe falciparum malaria"
• "Write about Artemisinin and ACT therapy"

• Drug for radical cure of P. vivax: Primaquine (kills hypnozoites)
• Chloroquine ADR: retinopathy
• DOC for severe falciparum malaria: Artesunate IV
• Primaquine causes hemolysis in: G6PD deficiency

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SECTION I - ANTICANCER DRUGS (PH1.49) 🔥

• "Classify anticancer drugs. Describe MOA and ADRs of Methotrexate"
• "Describe MOA of Alkylating agents"

• Cell-cycle non-specific drug: Alkylating agents, antibiotics
• Methotrexate MOA: inhibits DHFR
• Rescue agent with Methotrexate: Leucovorin (folinic acid)
• Vinca alkaloids cause: peripheral neuropathy, not myelosuppression (mainly)
• Bleomycin causes: pulmonary fibrosis

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SECTION J - LEPROSY DRUGS (PH1.46) 🔥

• "Describe MOA, doses and ADRs of drugs used in leprosy"
• "What is Multi-Drug Therapy (MDT) for leprosy?"

• PB leprosy: Dapsone + Rifampicin x 6 months
• MB leprosy: Dapsone + Rifampicin + Clofazimine x 12 months
• Dapsone ADR: hemolytic anemia, methemoglobinemia
• Clofazimine ADR: skin discoloration (reddish-brown)

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SECTION K - HIV/ANTIRETROVIRALS (PH1.48) 🔥

• "Classify antiretroviral drugs with examples"
• "What is HAART? Describe ART used in India"

• First-line ART in India: TDF + 3TC + Efavirenz (TLE regimen)
• NRTI that causes lactic acidosis: Stavudine
• Drug used in HIV prophylaxis (PrEP): Tenofovir
• Integrase inhibitor: Raltegravir, Dolutegravir

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SECTION L - POISONING (PH1.52, PH1.53) 🔥

• "Describe management of organophosphate poisoning"
• "Write about heavy metal poisoning and chelating agents"

• Antidote for OP poisoning: Atropine + Pralidoxime
• Chelator for lead poisoning: EDTA, DMSA
• Antidote for iron poisoning: Desferrioxamine
• Antidote for paracetamol overdose: N-acetylcysteine

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🎯 PREDICTED MCQ LIST (20 MCQs - High Probability)

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📌 LAST-MINUTE REVISION PRIORITY (80+ marks strategy)

Prepare THESE in full depth (covers 60+ marks):

1. Antitubercular drugs - full HRZE + MDR (10M potential)
2. Oral hypoglycemics + Insulin (10M potential)
3. Corticosteroids (5M certain)
4. Oral contraceptives (5M certain)
5. Antimalarials (5M certain)
6. Penicillins + Antibiotic stewardship (5M certain)
7. PPIs / GI drugs (5M + MCQs)
8. Anticancer drugs - Methotrexate (5M)
9. Uterine stimulants - Oxytocin (5M)
10. OP poisoning management (3M certain)
11. MDT for leprosy (3M)
12. Antiretroviral drugs (3M)

For MCQs: Focus on

• Antidotes (OP, iron, paracetamol, lead, cyanide)
• Drug-specific ADRs (Ethambutol→optic neuritis, Rifampicin→orange urine, Bleomycin→pulmonary fibrosis)
• Drug of choice questions across all topics

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⚠️ TOPICS TO SKIP (Low yield, complex, rarely asked for marks)

• Pharmacoeconomics/Pharmacogenomics (PH1.60) - MCQ only
• Geriatric/Pediatric pharmacology (PH1.56) - at best 1 short note
• Drug regulations/Acts (PH1.63-64) - very rare
• Clinical trials detail (PH1.64) - 1 MCQ at most

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