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📚 Pharmacology Mid-2 Flashcards

🫀 SECTION 1: Antihypertensives & Hypertensives (Test 8)

🃏 Card 1 Q: Patient on antihypertensive develops dry cough. Which drug? A: Enalapril (ACE inhibitor) 🧠 Trick: "Enalapril = Enough coughing!" — ACE inhibitors block bradykinin breakdown → dry cough is the classic side effect.

🃏 Card 2 Q: Hypertensive crisis in a patient with bronchial asthma. Best antihypertensive? A: Nifedipine (calcium channel blocker) 🧠 Trick: "In Asthma, Nifedipine is Nice — it won't cause bronchospasm like beta-blockers (Anaprilin) do."

🃏 Card 3 Q: Mechanism of Anaprilin (propranolol) in angina pectoris? A: Blockade of beta-adrenergic receptors → reduces myocardial oxygen demand 🧠 Trick: "Propranolol = Protects the heart by Blocking Beta, cutting oxygen demand."

🃏 Card 4 Q: Diabetic on insulin develops hypoglycemic coma after starting antihypertensive. Culprit? A: Anaprilin (propranolol) 🧠 Trick: "Beta-blockers mask hypoglycemia signs (tremor, tachycardia) AND potentiate insulin — diabetics BEWARE of propranolol."

🃏 Card 5 Q: Which antihypertensive works by inhibiting an enzyme? A: Enalapril (ACE inhibitor) 🧠 Trick: "ACE = Angiotensin-Converting Enzyme — Enalapril inhibits it. It's the only enzyme-blocker in the list."

🃏 Card 6 Q: Myocardial infarction with coronary thrombosis — which drug group restores blood flow? A: Fibrinolysis activators (thrombolytics) 🧠 Trick: "Thrombus = clot. Fibrinolysis busts the clot. Not beta-blockers, not ACE inhibitors."

🃏 Card 7 Q: Enalapril mechanism — does it block ACE directly or after metabolism? A: After metabolic transformation it becomes an ACE blocker (it's a prodrug → enalaprilat) 🧠 Trick: "Enalapril is a PRODrug — must be converted to enalaprilAT in the liver to work."

🃏 Card 8 Q: Mechanism of clonidine's hypotensive effect? A: Excitation of presynaptic alpha-2 adrenergic receptors of central neurons → ↓ sympathetic outflow 🧠 Trick: "Clonidine = Closes the central alpha-2 gate → less norepinephrine released → BP falls."

🃏 Card 9 Q: Hypertensive crisis, BP 220/120 — what to prescribe? A: Magnesium sulfate IV 🧠 Trick: "Crisis = Magic Magnesium IV — it rapidly vasodilates and prevents seizures."

🃏 Card 10 Q: Hypertension with high renin — preferred drug? A: Captopril (ACE inhibitor) 🧠 Trick: "High Renin = high angiotensin. Captopril caps angiotensin production — perfect match."

🃏 Card 11 Q: Drug with high affinity for angiotensin receptors, reduces Na⁺ resorption, causes myocardial regression? A: Losartan (ARB — Angiotensin Receptor Blocker) 🧠 Trick: "Losartan Losses angiotensin's grip on receptors — blocks AT1 receptors directly."

🃏 Card 12 Q: Losartan pharmacological property providing therapeutic effect? A: Angiotensin receptor blockade 🧠 Trick: "Sartan = Sartori-cut — cuts angiotensin II from binding. Sartans = ARBs."

🃏 Card 13 Q: Which antihypertensive stimulates central alpha-2 adrenergic receptors? A: Clonidine 🧠 Trick: "Clonidine = Closes the CNS tap. Central alpha-2 agonist → ↓ sympathetic tone."

🃏 Card 14 Q: Primary arterial hypotension — caffeine sodium benzoate mechanism? A: Blockade of adenosine receptors 🧠 Trick: "Caffeine blocks adenosine (the sleep/vessel-dilating molecule) → raises BP, increases alertness."

🃏 Card 15 Q: BP 90/60, hypotension — which drug to prescribe? A: Caffeine sodium benzoate 🧠 Trick: "LOW BP → need a stimulant that raises BP → Caffeine. Not captopril (lowers BP more!)"

🃏 Card 16 Q: Antihypertensive causing lethargy, drowsiness, depression, and peptic ulcer? A: Reserpine 🧠 Trick: "Reserpine Resigns your mood — depletes catecholamines + serotonin → depression. Also raises gastric acid → ulcer."

🃏 Card 17 Q: Hypertension + gastric ulcer with hyperacid syndrome — which antihypertensive is NOT recommended? A: Reserpine 🧠 Trick: "Reserpine raises gastric acid → RESerpine + ulcer = wREStle (bad combo)."

🃏 Card 18 Q: Drug for hypertensive crisis, myotropic type of action? A: Dibazol 🧠 Trick: "Dibazol = Direct muscle relaxant (myotropic). Causes vasodilation directly on smooth muscle."

🃏 Card 19 Q: IV drug that causes brief BP rise before BP falls? A: Clonidine 🧠 Trick: "Clonidine IV first stimulates peripheral alpha-1 (brief rise) then central alpha-2 dominates (sustained fall)."

🃏 Card 20 Q: Anaprilin (propranolol) contraindicated in which concomitant disease? A: Bronchial asthma 🧠 Trick: "Propranolol blocks beta-2 in bronchi → bronchoconstriction → NEVER in asthma."

🃏 Card 21 Q: Antidote for magnesium sulfate side effects (BP crash)? A: Calcium chloride 🧠 Trick: "Mag vs. Calcium — they're antagonists. Calcium reverses Mg toxicity — same logic as tocolysis reversal."

🃏 Card 22 Q: Anaprilin in bronchitis → asthma attacks. Mechanism of side effect? A: Blockade of beta-2 adrenergic receptors of the bronchi → bronchoconstriction 🧠 Trick: "Beta-2 = Bronchi Bronchodilate. Block it → Bronchospasm."

🃏 Card 23 Q: Pheochromocytoma with hypertensive crises — which drug group? A: Alpha blockers (e.g., prazosin) 🧠 Trick: "Pheo releases excess adrenaline → alpha-1 drives the BP spike → Alpha-blocker is the fix."

🃏 Card 24 Q: Deoxycorticosterone-induced hypertension (mineralocorticoid excess) — which drug counteracts it? A: Spironolactone 🧠 Trick: "Spironolactone is an aldosterone antagonist — perfect for mineralocorticoid-excess hypertension."

🃏 Card 25 Q: Methyldopa mechanism? A: Impaired norepinephrine synthesis (false neurotransmitter — alpha-methylnorepinephrine formed) 🧠 Trick: "MethylDOPA = Depletes Original Production of Adrenaline-family → alpha-MeNE acts as false transmitter."

🃏 Card 26 Q: Controlled hypotension during surgery — which drug? A: Pentamin (ganglionic blocker) 🧠 Trick: "Pentamin = Ganglio-blocker → blocks all sympathetic ganglia → BP drops fast. Used for controlled hypotension in OR."

🃏 Card 27 Q: Toxic goiter → tachycardia — normalize heart rate with? A: Anaprilin (propranolol) 🧠 Trick: "Hyperthyroidism upregulates beta-receptors. Propranolol BLOCKS beta → slows heart rate."

🃏 Card 28 Q: Atenolol mechanism (used for heart pain + tachycardia + edema)? A: Blockade of the adenylate cyclase system (via beta-1 blockade) 🧠 Trick: "Beta-1 blockers → inhibit adenylate cyclase → ↓ cAMP → ↓ heart rate and contractility."

🃏 Card 29 Q: Clonidine — which drug is it inappropriate to combine with? A: Reserpine 🧠 Trick: "Both lower BP by depressing sympathetic activity — combined they cause severe hypotension/depression. Don't double-dip."

🃏 Card 30 Q: Antihypertensive causing dry mouth as side effect? A: Clonidine 🧠 Trick: "Clonidine's central alpha-2 agonism reduces salivary secretion → Clonidine = Clo-dry mouth."

🃏 Card 31 Q: Losartan mechanism of hypotensive action? A: Angiotensin II receptor blockade 🧠 Trick: "Sartan = Sart angiotensin II receptor. Blocks AT1 → no vasoconstriction."

🃏 Card 32 Q: Beta-1 selective blocker for dental patient with tachycardia + hypertension? A: Metoprolol 🧠 Trick: "Metropolol is selective for beta-1 (heart) — safe in asthma risk patients, only heart-targeted."

🃏 Card 33 Q: 3rd-generation selective beta-blocker? A: Nebivolol (Nebilet) 🧠 Trick: "Nebivolol = New generation — also releases NO (nitric oxide) for extra vasodilation."

🃏 Card 34 Q: 3rd-generation non-selective beta-blocker? A: Carvedilol or Labetalol 🧠 Trick: "Carvedilol = Cardio + alpha-block. Labetalol = Labelled both alpha and beta blocker."

🃏 Card 35 Q: 1st-generation beta-blocker? A: Propranolol 🧠 Trick: "Propranolol = Prototype/first. Non-selective. The OG beta-blocker."

🃏 Card 36 Q: 2nd-generation beta-blocker? A: Bisoprolol 🧠 Trick: "Bisoprolol = Big on selectivity — beta-1 selective. Second gen = selective."

💊 SECTION 2: Sedatives, Diabetes Drugs & NSAIDs

🃏 Card 37 Q: Primary use of sedatives? A: To induce relaxation or sleep 🧠 Trick: "Sedative = Latin sedare = to calm/settle."

🃏 Card 38 Q: Which is NOT a type of sedative: Benzodiazepine, Barbiturate, Opioid, or Stimulant? A: Stimulant CNS 🧠 Trick: "Stimulants DO THE OPPOSITE of sedating. The others all sedate."

🃏 Card 39 Q: Sedative least likely to cause respiratory depression? A: Melatonin receptor agonist 🧠 Trick: "Melatonin is gentle — it just adjusts the sleep clock. No resp. depression unlike barbs/opioids/benzos."

🃏 Card 40 Q: Characteristic sign of physical dependence on a substance? A: Both tolerance AND withdrawal 🧠 Trick: "Physical dependence = body adapted. Remove the drug = withdrawal. Keep using = need more = tolerance."

🃏 Card 41 Q: Diabetic patient, unconscious after insulin injection — blood sugar result? A: 1.5 mmol/L (severe hypoglycemia — normal is 5.5, coma <2.8) 🧠 Trick: "1.5 = Lifeless sugar — dangerously low. Insulin caused it, brain starves."

🃏 Card 42 Q: Soporous patient, sweating, acetone breath, glucose 22.43 mmol/L — hyperglycemic coma. Drug? A: Insulin with SHORT duration of action 🧠 Trick: "DKA emergency → need fast-acting insulin NOW. Long-acting won't help fast enough."

🃏 Card 43 Q: Elderly type 2 diabetic with obesity, atherosclerosis, CAD, and basal hyperinsulinemia — best treatment? A: Metformin (biguanides group) → Wait, the answer given is (E) Aspirin in the OCR, but contextually the correct pharmacological answer for type 2 DM + obesity is Metformin. However per exam answer: the question asks about Q40's answer (E) = Aspirin as anti-platelet for CAD prevention. 🧠 Trick: "Elderly diabetic + CAD + atherosclerosis → aspirin for anti-platelet protection. Glibenclamide (sulfonylurea) would worsen hyperinsulinemia."

🃏 Card 44 Q: Treatment that affects mechanisms of disease development = what type? A: Pathogenetic 🧠 Trick: "Pathogenetic = attacks the pathology's pathway. Etiotropic = kills the cause. Symptomatic = just hides symptoms."

🃏 Card 45 Q: Treatment acting on individual symptoms of disease? A: Symptomatic 🧠 Trick: "Symptomatic = treats symptoms only. No root cause tackled."

🃏 Card 46 Q: Drug group that blocks cyclooxygenase (COX) → disrupts prostaglandin formation? A: NSAIDs (Non-steroidal anti-inflammatory drugs) 🧠 Trick: "NSAID = No Steroids, Arrests Inflammatory Damage — blocks COX → no prostaglandins."

🃏 Card 47 Q: Mechanism of Paracetamol? A: Blocks COX-1 and COX-2 mainly in the CNS, affecting pain and thermoregulation centers 🧠 Trick: "Paracentral = Paracetamol works centrally on the brain's pain/fever centers. That's why it's anti-pain AND anti-fever but NOT anti-inflammatory (no peripheral COX block)."

🃏 Card 48 Q: Mechanism of Naproxen? A: Non-selective inhibition of COX → reduces prostaglandin synthesis 🧠 Trick: "Naproxen = Non-selective — hits both COX-1 and COX-2 peripherally."

🃏 Card 49 Q: NSAIDs are inhibitors of which enzyme? A: Cyclooxygenase (COX) 🧠 Trick: "NSAID = No Steroids, And Inhibits COX-ase Directly."

🃏 Card 50 Q: Analgesic mechanism of non-narcotic analgesics? A: Inhibition of prostaglandin synthesis 🧠 Trick: "No prostaglandins = pain receptors not sensitized = less pain. NSAIDs cut the sensitization at the source."

🃏 Card 51 Q: Drug reducing joint pain, morning stiffness, swelling, post-traumatic pain? A: Diclofenac 🧠 Trick: "Diclofenac = Directed against inflammation of joints. The classic NSAID for arthritis/post-op pain."

🫁 SECTION 3: Respiratory System Drugs (Tests 11 & 12)

🃏 Card 52 Q: Chronic bronchitis with thick purulent sputum — best drug? A: Ambroxol (mucolytic) 🧠 Trick: "Ambroxol Ameliorates mucus — thins sputum for easy expectoration. NOT codeine (suppresses cough)."

🃏 Card 53 Q: Newborn in asphyxia — drug to stimulate breathing? A: Etimizole 🧠 Trick: "Etimizole = Etiology of breathing = stimulates the respiratory center. Safe for neonates."

🃏 Card 54 Q: Respiratory stimulant for mild barbiturate poisoning? A: Bemegrid 🧠 Trick: "Bemegrid = Barbiturate Emergency Medication — specific analeptic for barbiturate overdose."

🃏 Card 55 Q: Drug with sulfhydryl group that depolymerizes sputum glycoproteins? A: Acetylcysteine 🧠 Trick: "Acetyl-CYSTEINE has an -SH (sulfhydryl) group that breaks disulfide bonds in mucus → liquid sputum."

🃏 Card 56 Q: Expectorant that causes vomiting as side effect? A: Thermopsis herb infusion 🧠 Trick: "Thermopsis works by reflux vomiting reflex — irritates stomach → reflex bronchial secretion → vomiting is the overshoot."

🃏 Card 57 Q: Bronchodilator that can provoke hypertensive crisis? A: Ephedrine hydrochloride 🧠 Trick: "Ephedrine stimulates both alpha (vasoconstriction = BP↑) and beta receptors. Bad for hypertensives."

🃏 Card 58 Q: Salbutamol mechanism in obstructive bronchitis? A: Mainly stimulates beta-2 adrenergic receptors → bronchodilation 🧠 Trick: "Salbutamol = Selective beta-2 → Salvation for bronchospasm. Spares beta-1 (heart)."

🃏 Card 59 Q: Codeine antitussive mechanism? A: Central action (depresses cough center in medulla) 🧠 Trick: "Codeine = Central opioid — shuts off the cough CENTER in the brain."

🃏 Card 60 Q: Drug used first-line for bronchial asthma attack via individual inhaler? A: Salbutamol 🧠 Trick: "Salbutamol = Speed-opener. First-line rescue inhaler for acute asthma. Fast-acting beta-2 agonist."

🃏 Card 61 Q: Cold with poorly discharged sputum — which drug helps bring sputum up? A: Ambroxol (mucolytic/expectorant) 🧠 Trick: "Ambroxol Amplifies mucus clearance — stimulates surfactant + thins mucus."

🃏 Card 62 Q: Euphyllin (aminophylline) biochemical mechanism in asthma? A: Phosphodiesterase blockade → ↑ cAMP → bronchodilation 🧠 Trick: "Euphyllin = Euphoric bronchi! Blocks PDE → cAMP builds up → bronchi relax."

🃏 Card 63 Q: Cromolyn sodium mechanism (asthma prophylaxis)? A: Stabilization of mast cell membranes 🧠 Trick: "Cromolyn = Crowns/protects mast cells. Prevents degranulation → no histamine → no attack."

🃏 Card 64 Q: Asthma + angina pectoris — inhaled drug causing palpitations + chest pain? A: Izadrin (isoprenaline) 🧠 Trick: "Izadrin = non-selective beta-agonist — hits beta-1 (heart) too → tachycardia + angina flare."

🃏 Card 65 Q: Asthma attacks rare but angina worse after new drug — which drug? A: Izadrin 🧠 Trick: "Izadrin opens bronchi BUT also fires up the heart via beta-1. Trade one problem for another."

🃏 Card 66 Q: Libexin antitussive mechanism? A: Anesthetizes the mucous membrane of the respiratory tract (local action) 🧠 Trick: "Libexin = Local inhibition of bronchial excitation — peripheral, not central like codeine."

🃏 Card 67 Q: Why is salbutamol preferred over orciprenaline? A: Less impact on the cardiovascular system (more selective beta-2) 🧠 Trick: "Salbutamol = Safe for the heart — beta-2 selective. Orciprenaline = non-selective → heart side effects."

🃏 Card 68 Q: Ephedrine mechanism in chronic bronchitis? A: Stimulation of norepinephrine release into the synaptic cleft (indirect sympathomimetic) 🧠 Trick: "Ephedrine = indirect — pushes out stored norepinephrine. Doesn't bind receptors itself."

🃏 Card 69 Q: Drug inhaled for pulmonary edema foam (acute heart failure)? A: Ethyl alcohol (30%) — reduces surface tension of foam bubbles 🧠 Trick: "Alcohol defoams = lowers surface tension → converts frothy edema fluid into liquid → easier gas exchange."

🃏 Card 70 Q: Mucolytic drug group — which of bromhexine/codeine/thermopsis/libexin is a mucolytic? A: Bromhexine 🧠 Trick: "Bromhexine = Brokes up mucus. Codeine = antitussive. Libexin = local anesthetic. Thermopsis = expectorant."

🏥 SECTION 4: Digestive System Drugs (Tests 9 & additional MCQ)

🃏 Card 71 Q: Chronic cholecystitis — acute right hypochondrium pain (biliary colic) — best drug? A: No-spa (drotaverine hydrochloride) — antispasmodic 🧠 Trick: "No-spa = No spasm — antispasmodic. Allochol/Holenzyme are choleretics (would worsen biliary obstruction)."

🃏 Card 72 Q: Gastrocepin mechanism (for heartburn + hunger pain)? A: Decreased secretion of hydrochloric acid and gastrin (M1-cholinergic blocker = pirenzepine) 🧠 Trick: "Gastrocepin = Gastro-protects by blocking M1 cholinergic receptors → less acid secreted."

🃏 Card 73 Q: Liver cirrhosis from alcohol toxicity — hepatoprotective drug? A: Essentiale (essential phospholipids) 🧠 Trick: "Essentiale = gives Essential phospholipids to repair hepatocyte membranes damaged by alcohol."

🃏 Card 74 Q: Famotidine molecular substrate of action? A: H2-histamine receptors 🧠 Trick: "Famotidine — all tidines (ranitidine, famotidine, cimetidine) = H2 blockers."

🃏 Card 75 Q: Acute pancreatitis — which drug is used pathogenetically first? A: Contrikal (protease inhibitor — blocks trypsin, chymotrypsin) 🧠 Trick: "Pancreatitis = own enzymes digesting pancreas. Contrikal CONtrols (inhibits) these enzymes."

🃏 Card 76 Q: After deworming, which laxative speeds up evacuation of intestinal contents? A: Magnesium sulfate (saline laxative) 🧠 Trick: "Magnesium sulfate = Magic salt — osmotically pulls water into colon → fast evacuation."

🃏 Card 77 Q: Chronic gastritis with increased secretory function — drug to reduce secretion? A: Pirenzepine (selective M1-cholinergic blocker) 🧠 Trick: "Pirenzepine = pirates M1 cholinergic receptors in stomach → less acid."

🃏 Card 78 Q: Patient on ulcer therapy develops trembling hands, increased muscle tone, stiffness — which drug? A: Metoclopramide (cerucal) — extrapyramidal side effects 🧠 Trick: "Metroclopramide blocks dopamine D2 receptors (even in brain) → extrapyramidal movement effects."

🃏 Card 79 Q: Chernobyl radiation patient with sudden vomiting — which drug? A: Metoclopramide (cerucal) — blocks D2 in CTZ → antiemetic 🧠 Trick: "Radiation-induced vomiting → Cerucal/Metoclopramide blocks the Chemoreceptor Trigger Zone."

🃏 Card 80 Q: Peptic ulcer + constipation tendency — which antacid? A: Magnesium oxide (has laxative effect) 🧠 Trick: "Aluminum hydroxide = CONSTIPATES. Magnesium = LAXATES. Patient has constipation → choose Magnesium."

🃏 Card 81 Q: Chronic constipation from hypotonic large intestine — best drug? A: Prozerin (neostigmine — cholinesterase inhibitor → stimulates gut motility) 🧠 Trick: "Prozerin = Promotes peristalsis — stimulates acetylcholine → gut moves."

🃏 Card 82 Q: Remove water-soluble, non-caustic poison from GI (conscious patient)? A: Sodium sulfate (saline laxative — rapid GI clearance) 🧠 Trick: "Non-caustic + conscious = safe to flush it out with saline laxative. Castor oil = oil-soluble poisons."

🃏 Card 83 Q: Acute pancreatitis conservative treatment — pathogenetically justified drug? A: Contrikal (anti-enzyme/protease inhibitor) 🧠 Trick: "Pancreatitis PATH = auto-digestion by proteases. Contrikal CONTRA-acts them."

🃏 Card 84 Q: Chronic gastroenterocolitis + hepatocholecystitis — improve digestion with? A: Festal (enzyme complex with bile acids + pancreatic enzymes) 🧠 Trick: "Festal = Festive digestion — has everything: lipase, amylase, protease, bile. Best combo enzyme."

🃏 Card 85 Q: Duodenal ulcer with dry mouth and blurred vision after treatment — drug? A: Gastrocepin (pirenzepine) — anticholinergic side effects 🧠 Trick: "DUMB = anticholinergic side effects: Dry mouth, Urinary retention, Mydriasis (blurred vision), Bowel constipation."

🃏 Card 86 Q: Ranitidine mechanism? A: Blocks H2 histamine receptors in the stomach 🧠 Trick: "Ranitidine = Really Acid Neutralizer Inhibits H2."

🃏 Card 87 Q: Drug containing pancreatic enzymes? A: Creon (pancrelipase) 🧠 Trick: "Creon = Complete Replacement Enzyme for pancreas ON board."

🃏 Card 88 Q: Drug containing bile acids? A: Allochol 🧠 Trick: "Allochol = Allows cholesterol bile flow — contains dried bile + garlic."

🃏 Card 89 Q: Drugs that stimulate bile formation (bile acid synthesis)? A: Choleretics 🧠 Trick: "Chole-retics = make more bile. Cholekinetics = squeeze out bile. -retics = secretion."

🃏 Card 90 Q: Drugs that stimulate bile secretion/ejection? A: Cholekinetics 🧠 Trick: "Kinetics = motion — cholekinetics move/eject bile from the gallbladder."

🃏 Card 91 Q: De-Nol mechanism? A: Forms a protective film over the ulcerative defect (gastroprotector) 🧠 Trick: "De-Nol = Deposits New Overlayer of bismuth film = Layer protecting ulcer."

🃏 Card 92 Q: Which antacid has a cytoprotective effect? A: Phosphalugel (aluminum phosphate) 🧠 Trick: "Phosphalugel = not just neutralizes acid but coats mucosa = cytoprotection bonus."

🃏 Card 93 Q: Which enzyme drug contains pepsin + hydrochloric acid? A: Panzinorm 🧠 Trick: "Panzinorm = pancreatic + zimase (enzyme). Contains HCl + pepsin for hypoacid gastritis."

🃏 Card 94 Q: Domperidone (Motilium) mechanism? A: Blocks peripheral dopamine D2 receptors → enhances gastric motility + antiemetic 🧠 Trick: "Domperidone = Dominates D2 peripherally. Doesn't cross BBB much → fewer extrapyramidal effects than metoclopramide."

🃏 Card 95 Q: Apomorphine hydrochloride mechanism? A: Stimulates the vomiting center in the brain (D2 agonist in CTZ) 🧠 Trick: "Apomorphine = Activates Projectile Output — D2 agonist in chemoreceptor trigger zone = controlled vomiting induction."

🃏 Card 96 Q: Herbal laxative? A: Senna leaf (or castor oil) 🧠 Trick: "Senna = Send it out — anthraquinone glycosides stimulate colon. Chamomile = anti-spasm/anti-inflammatory, not laxative."

🃏 Card 97 Q: Saline laxative? A: Magnesium sulfate 🧠 Trick: "Salt pulls water → Magnesium sulfate = osmotic flood in colon."

🃏 Card 98 Q: Antidiarrheal acting through intestinal opiate receptors? A: Imodium (loperamide) 🧠 Trick: "Loperamide = Locks peristalsis via mu-opioid receptors in gut wall → no more running."

🃏 Card 99 Q: Antidiarrheal drug of biological origin with no side effects? A: Bactisubtil (probiotic) 🧠 Trick: "Bactisubtil = Bacteria-based — natural, no systemic side effects. Just good bacteria restoring flora."

🃏 Card 100 Q: Drug for alimentary obesity? A: Orlistat (Xenical) 🧠 Trick: "Orlistat = Orally inhibits lipase → fat not absorbed → weight loss. 'X' in Xenical = blocks fat."

🃏 Card 101 Q: Which medicinal plant is in hepatoprotective drug Karsil? A: Milk thistle (Silybum marianum — contains silymarin) 🧠 Trick: "Karsil = Kareful Silymarin = Milk Thistle protects the liver with silymarin."

🃏 Card 102 Q: Active ingredient in Heptral? A: Ademetionine (S-adenosyl methionine) 🧠 Trick: "Heptral = Hepatocyte Treatment by Real methyl donor = Ademetionine."

🃏 Card 103 Q: What stabilizes hepatocyte membranes? A: Silymarin (from Karsil) / also Essentiale (phospholipids) 🧠 Trick: "Silymarin = Silly-proof membrane stabilizer — antioxidant that locks hepatocyte membranes."

🃏 Card 104 Q: Drug containing ursodeoxycholic acid used to dissolve bile stones? A: Ursosan / Henofalk / Livodeksa / Exhol (all of the above) 🧠 Trick: "Urso= bear in Latin — bear bile was the original UDCA source. Now all Urso-drugs dissolve bile stones."

🃏 Card 105 Q: Which drug increases endogenous nitrogen (NO) inside vessels? A: Mildronate 🧠 Trick: "Mildronate = mild vasodilator via NO boosting — also used as a cardioprotective/metabolic drug."

🔁 QUICK REFERENCE TRICK TABLE

Drug	Class	Key Trick
Enalapril	ACE inhibitor	Prodrug → enalaprilat; dry cough
Losartan	ARB	Sartan = blocks AT1 receptor
Clonidine	Central α2 agonist	Brief BP rise IV, then sustained fall; dry mouth
Propranolol	Non-selective β-blocker (1st gen)	OG beta-blocker; contraindicated asthma
Metoprolol	Selective β1-blocker (2nd gen)	Metro = heart only
Bisoprolol	Selective β1-blocker (2nd gen)	Big selectivity
Nebivolol	Selective β-blocker (3rd gen)	Also releases NO
Carvedilol	Non-selective β+α-blocker (3rd gen)	α+β combo
Spironolactone	Aldosterone antagonist	For mineralocorticoid hypertension
Reserpine	Sympatholytic	Depression + peptic ulcer side effects
Salbutamol	Selective β2 agonist	Rescue inhaler; spares heart
Acetylcysteine	Mucolytic	-SH group breaks mucus disulfide bonds
Ambroxol	Mucolytic	Stimulates surfactant + thins sputum
Metoclopramide	D2 blocker	Extrapyramidal side effects
Omeprazole	Proton pump inhibitor	Blocks H⁺/K⁺-ATPase
Ranitidine/Famotidine	H2 blocker	All -tidines block H2
Pirenzepine	M1 blocker	Dry mouth + blurred vision
Loperamide	Opioid (gut)	Locks peristalsis via mu-receptors
Contrikal	Protease inhibitor	Pancreatitis — stops self-digestion
Essentiale	Phospholipids	Hepatoprotection — membrane repair

The document covers 4 main test topics across ~64 pages. These 105 flashcards with memory tricks cover every testable concept. Study them by section, then use the Quick Reference Table for final review.

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