Here is your complete Pharmacology Quick-Reference Exam Guide based on every topic in your PDF:
📋 PHARMACOLOGY QUICK-REFERENCE — EXAM PREP
🔵 SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS (Concepts)
| Topic | Key Points |
|---|
| Routes of admin | Oral (first-pass), IV (100% bioavailability), IM, SC, sublingual (bypasses first-pass), inhalation |
| Absorption | Passive diffusion (most drugs), active transport, lipid solubility ↑ = better absorption |
| Distribution | Vd = dose/plasma concentration; protein binding affects free drug levels |
| Metabolism | Liver microsomal (CYP450) enzymes; Phase I (oxidation/reduction/hydrolysis) → Phase II (conjugation) |
| Excretion | Kidneys (main); bile, lungs, sweat; renal failure → drug accumulation |
| Receptors | Agonist = activates; Antagonist = blocks; Partial agonist = partial activation |
| Types of drug action | Main, side, toxic, allergic, teratogenic, idiosyncratic |
| Synergism | Summation (1+1=2) or Potentiation (1+1>2) |
| Antagonism | Competitive (reversible), Non-competitive (irreversible), Chemical (antidotes) |
| Tolerance | Reduced effect with repeated dosing; tachyphylaxis = rapid tolerance |
| Drug dependence | Physical (withdrawal) + psychological; esp. opioids, benzodiazepines |
🔵 SECTION 2: CHOLINERGIC DRUGS
Acetylcholine & M/N-Cholinomimetics
| Drug | Mechanism | Uses | Side Effects |
|---|
| Acetylcholine | M+N receptor agonist | Research only (rapid hydrolysis) | Bradycardia, miosis, salivation, bronchospasm |
| Carbachol | M+N agonist (non-hydrolysable) | Glaucoma, bladder atony | Bradycardia, GI cramps |
| Pilocarpine | M-agonist | Glaucoma, dry mouth (Sjögren's) | Sweating, miosis, bradycardia |
M-Cholinoblockers (Anticholinergics)
| Drug | Mechanism | Uses | Side Effects |
|---|
| Atropine | M-receptor blocker | Bradycardia, pre-op, organophosphate poisoning, peptic ulcer | Dry mouth, tachycardia, mydriasis, urinary retention, constipation, confusion |
| Scopolamine | M-blocker | Motion sickness, pre-op sedation | Same as atropine + CNS depression |
| Ipratropium | M-blocker (inhaled) | COPD, asthma (bronchodilation) | Dry mouth, urinary retention |
| Platyphylline | M-blocker | Spasms, angina | Atropine-like |
Atropine poisoning treatment: Physostigmine (crosses BBB), supportive care
Muscarine/M-agonist poisoning symptoms: SLUDGE - Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis → Treat with Atropine
Ganglioblockers
| Drug | Mechanism | Uses | Side Effects |
|---|
| Pentamine, Benzohexonium | Block N-receptors in ganglia | Hypertensive crisis, pulmonary edema | Orthostatic hypotension, tachycardia, dry mouth, constipation |
Muscle Relaxants (Neuromuscular Blockers)
| Drug | Type | Mechanism | Reversal |
|---|
| Succinylcholine | Depolarizing | Persistent depolarization | No reversal (metabolized by pseudocholinesterase) |
| Tubocurarine, Atracurium, Rocuronium | Non-depolarizing | Competitive N-receptor block | Neostigmine (anticholinesterase) |
Anticholinesterase Agents
| Drug | Mechanism | Uses | Side Effects |
|---|
| Neostigmine (Proserin) | Reversible AChE inhibitor | Myasthenia gravis, reverse NMB, bladder atony | SLUDGE effects, muscle fasciculation |
| Physostigmine | Reversible, crosses BBB | Glaucoma, atropine poisoning | CNS effects, SLUDGE |
| Pyridostigmine | Reversible | Myasthenia gravis (longer acting) | SLUDGE |
Organophosphate Poisoning Treatment
| Drug | Mechanism | Uses |
|---|
| Atropine | M-blocker | Block muscarinic effects (SLUDGE) |
| Pralidoxime (PAM) | Cholinesterase reactivator | Reactivates AChE if given early (before "aging") |
🔵 SECTION 3: ADRENERGIC DRUGS
α-Adrenomimetics
| Drug | Mechanism | Uses | Side Effects |
|---|
| Norepinephrine | α1>α2, weak β1 | Shock (vasopressor) | Severe hypertension, reflex bradycardia, tissue necrosis if extravasation |
| Phenylephrine | α1 agonist | Nasal decongestant, hypotension | Hypertension, reflex bradycardia |
| Clonidine | α2 agonist (central) | Hypertension, opioid withdrawal | Dry mouth, sedation, rebound hypertension on withdrawal |
| Xylometazoline | α1 agonist | Nasal congestion | Rebound congestion |
β-Adrenomimetics
| Drug | Type | Uses | Side Effects |
|---|
| Dobutamine | β1 selective | Acute heart failure (inotrope) | Tachycardia, arrhythmia |
| Salbutamol (Albuterol) | β2 selective | Asthma, COPD (bronchodilator), preterm labor | Tremor, tachycardia, hypokalemia |
| Salmeterol, Formoterol | β2 (long-acting) | Asthma/COPD maintenance | Tremor, tachycardia |
α+β Adrenomimetics
| Drug | Mechanism | Uses | Side Effects |
|---|
| Epinephrine (Adrenaline) | α1,α2,β1,β2 agonist | Anaphylaxis (#1), cardiac arrest, local anesthetic adjunct | Tachycardia, hypertension, arrhythmia, anxiety |
| Norepinephrine | α1,α2,β1 | Septic shock | Hypertension, ischemia |
α-Blockers
| Drug | Type | Uses | Side Effects |
|---|
| Phentolamine | Non-selective α-blocker | Pheochromocytoma (pre-op), hypertensive crisis | Tachycardia, orthostatic hypotension |
| Prazosin, Doxazosin | Selective α1-blocker | Hypertension, BPH | First-dose orthostatic hypotension |
| Tamsulosin | Selective α1A | BPH | Retrograde ejaculation |
β-Blockers
| Drug | Type | Uses | Side Effects |
|---|
| Propranolol | Non-selective (β1+β2) | HTN, angina, arrhythmia, thyrotoxicosis, migraine prophylaxis | Bronchospasm, bradycardia, fatigue, masking hypoglycemia |
| Metoprolol, Atenolol | Selective β1 | HTN, angina, heart failure, MI | Bradycardia, fatigue (less bronchospasm) |
| Carvedilol | α+β blocker | Heart failure, HTN | Orthostatic hypotension, bradycardia |
| Labetalol | α+β blocker | HTN in pregnancy, hypertensive urgency | Orthostatic hypotension |
🔵 SECTION 4: LOCAL ANESTHETICS
| Drug | Class | Uses | Side Effects |
|---|
| Lidocaine | Amide | Infiltration, nerve block, epidural, IV arrhythmia | CNS toxicity (seizures), cardiovascular depression |
| Bupivacaine | Amide (long-acting) | Epidural, spinal, nerve block | Severe cardiotoxicity |
| Procaine | Ester | Infiltration, spinal | Allergy (PABA metabolite) |
| Cocaine | Ester | ENT topical only | Vasoconstriction, CNS stimulation, abuse |
Mechanism: Block Na+ channels → inhibit membrane depolarization → no action potential
🔵 SECTION 5: GENERAL ANESTHESIA
Inhalation Anesthetics
| Drug | Features | Side Effects |
|---|
| Halothane | Potent, pleasant smell | Hepatotoxicity, malignant hyperthermia, arrhythmia |
| Isoflurane, Sevoflurane, Desflurane | Newer agents, less toxic | Airway irritation (desflurane), nausea |
| Nitrous Oxide (N2O) | Weak anesthetic, analgesic | Not complete anesthetic alone; megaloblastic anemia (B12 inactivation) |
Non-Inhalation (IV) Anesthetics
| Drug | Features | Uses | Side Effects |
|---|
| Propofol | Rapid onset/offset, antiemetic | Induction/maintenance, ICU sedation | Hypotension, "propofol infusion syndrome" |
| Ketamine | Dissociative (NMDA antagonist) | Pediatric, emergency, trauma | Hallucinations, hypertension, emergence delirium |
| Thiopental | Barbiturate, ultra-short | Induction | Respiratory depression, laryngospasm |
| Midazolam | Benzodiazepine | Pre-op sedation, procedural | Respiratory depression, amnesia |
Stages of anesthesia: I - Analgesia → II - Excitement → III - Surgical (planes 1-4) → IV - Medullary depression (toxic)
🔵 SECTION 6: CNS DRUGS
Hypnotics (Sleeping Pills)
| Drug | Mechanism | Uses | Side Effects |
|---|
| Diazepam, Nitrazepam | GABA-A receptor potentiation (Benzodiazepines) | Insomnia, anxiety, seizures | Dependence, daytime sedation, respiratory depression |
| Zolpidem, Zaleplon | GABA-A (Z-drugs, non-BZD) | Insomnia | Less dependence, sleepwalking |
| Phenobarbital | Barbiturate, GABA-A | Insomnia (less used), epilepsy | Dependence, respiratory depression, enzyme induction |
Antiepileptics
| Drug | Mechanism | Uses | Side Effects |
|---|
| Valproate | ↑GABA, ↓Na+, ↓Ca+ channels | All seizure types, bipolar | Hepatotoxicity, teratogenic (NTD), weight gain, tremor |
| Carbamazepine | Na+ channel blocker | Partial seizures, trigeminal neuralgia, bipolar | Diplopia, ataxia, aplastic anemia, SIADH |
| Phenytoin | Na+ channel blocker | Partial + tonic-clonic seizures | Gingival hyperplasia, hirsutism, ataxia, zero-order kinetics |
| Ethosuximide | Ca+ channel blocker (T-type) | Absence seizures ONLY | Nausea, GI distress |
| Lamotrigine | Na+ channel blocker | Partial, generalized | Stevens-Johnson syndrome |
| Benzodiazepines (Diazepam, Clonazepam) | ↑GABA | Status epilepticus (IV diazepam), absence | Sedation, dependence |
| Gabapentin, Pregabalin | ↓Ca2+ (α2δ subunit) | Neuropathic pain, partial seizures | Sedation, dizziness |
Antiparkinsonian Drugs
| Drug | Mechanism | Uses | Side Effects |
|---|
| Levodopa + Carbidopa | L-DOPA → dopamine; Carbidopa inhibits peripheral decarboxylase | Parkinson's (gold standard) | On-off fluctuations, dyskinesia, nausea, psychosis |
| Bromocriptine, Pramipexole, Ropinirole | DA receptor agonists | Parkinson's, restless legs | Hallucinations, nausea, compulsive behaviors |
| Selegiline | MAO-B inhibitor | Parkinson's (adjunct) | Insomnia, cheese reaction (high doses) |
| Amantadine | ↑DA release, NMDA antagonist | Early Parkinson's, drug-induced EPS | Livedo reticularis, ankle edema, confusion |
| Trihexyphenidyl, Benztropine | M-cholinoblocker | Drug-induced EPS, tremor-dominant Parkinson's | Dry mouth, confusion, urinary retention |
Analgesics
Opioids (Central)
| Drug | Features | Uses | Side Effects |
|---|
| Morphine | μ-opioid agonist (full) | Severe pain, pulmonary edema, MI | Respiratory depression, constipation, miosis, dependence, nausea |
| Codeine | Weak opioid (prodrug → morphine) | Mild pain, cough | Constipation, less potent |
| Tramadol | Weak opioid + SNRI | Moderate pain | Seizures, serotonin syndrome |
| Fentanyl | Very potent μ-agonist | Surgical analgesia, chronic pain patches | Respiratory depression, chest wall rigidity |
| Naloxone | Opioid receptor antagonist | Opioid overdose reversal | Precipitates withdrawal |
| Naltrexone | Opioid antagonist (oral, long-acting) | Opioid/alcohol dependence | GI upset |
Morphine overdose triad: Miosis + Respiratory depression + Coma → Treat with Naloxone IV
NSAIDs / Peripheral Analgesics
| Drug | Mechanism | Uses | Side Effects |
|---|
| Ibuprofen, Diclofenac, Indomethacin | Non-selective COX-1+2 inhibitor | Pain, fever, inflammation | GI ulcers, renal impairment, platelet dysfunction |
| Celecoxib | Selective COX-2 inhibitor | Arthritis (less GI risk) | Cardiovascular risk ↑ |
| Paracetamol (Acetaminophen) | COX inhibition (CNS>peripheral), exact mechanism unclear | Pain, fever | Hepatotoxicity in overdose (N-acetylcysteine is antidote) |
| Aspirin (low dose) | Irreversible COX-1 inhibitor → ↓TXA2 | Antiplatelet (MI/stroke prophylaxis) | GI bleeding, Reye's syndrome in children |
🔵 SECTION 7: PSYCHOTROPIC DRUGS
Anxiolytics (Tranquilizers)
| Drug | Mechanism | Uses | Side Effects |
|---|
| Diazepam, Alprazolam, Lorazepam | BZD - ↑GABA-A (↑Cl- influx, ↑frequency of channel opening) | Anxiety, panic, muscle relaxant, alcohol withdrawal | Sedation, dependence, amnesia, respiratory depression |
| Buspirone | 5-HT1A partial agonist | Generalized anxiety (no dependence) | Dizziness, no sedation (delayed onset 2 wks) |
Antipsychotics (Neuroleptics)
Typical (1st generation) - Phenothiazines:
| Drug | Uses | Side Effects |
|---|
| Chlorpromazine, Trifluoperazine | Schizophrenia, psychosis, nausea | EPS (acute dystonia, akathisia, parkinsonism, tardive dyskinesia), sedation, anticholinergic, hyperprolactinemia, QT prolongation |
Typical - Butyrophenones:
| Drug | Uses | Side Effects |
|---|
| Haloperidol | Schizophrenia, mania, delirium | Strong EPS, less sedation, NMS (neuroleptic malignant syndrome) |
Atypical (2nd generation) - D2+5HT2 block:
| Drug | Special Features | Side Effects |
|---|
| Clozapine | Most effective for treatment-resistant | Agranulocytosis (monitor CBC!), metabolic syndrome, seizures |
| Risperidone | | EPS less, hyperprolactinemia |
| Olanzapine | | Metabolic syndrome (weight gain, diabetes) |
| Quetiapine | Sedating | Metabolic syndrome |
NMS: High fever, rigidity, AMS, autonomic instability → Stop drug, give Dantrolene + Bromocriptine
Sedatives
| Drug | Mechanism | Uses | Side Effects |
|---|
| Valerian, Bromides | Various | Mild anxiety | Minimal |
| Phenobarbital | Barbiturate, GABA | Insomnia (rarely), epilepsy | Dependence, induction of CYP450 |
Nootropics
| Drug | Mechanism | Uses | Side Effects |
|---|
| Piracetam | ↑ATP synthesis, membrane fluidity | Cognitive impairment, dementia, post-stroke | Rare: insomnia, GI |
| Cinnarizine | Ca2+ blocker + antihistamine | Cerebrovascular disorders, vertigo | Sedation, EPS |
Analeptics (CNS Stimulants)
| Drug | Mechanism | Uses | Side Effects |
|---|
| Caffeine | Adenosine receptor antagonist | Fatigue, headache, respiratory stimulant in neonates | Insomnia, tachycardia, anxiety |
| Cordiamine (Nikethamide) | Stimulates respiratory center | Respiratory depression, shock | Convulsions (high dose) |
Caffeine on CVS: ↑Heart rate, ↑BP, ↑CO; vasodilation in periphery, vasoconstriction in cerebral vessels
Antidepressants
| Drug | Mechanism | Uses | Side Effects |
|---|
| TCAs (Amitriptyline, Imipramine) | Block NE+5-HT reuptake | Depression, neuropathic pain, enuresis | Anticholinergic, sedation, cardiotoxicity (QT↑), fatal in overdose |
| SSRIs (Fluoxetine, Sertraline) | Block serotonin reuptake | Depression, anxiety, OCD, PTSD | Sexual dysfunction, GI, serotonin syndrome, initial anxiety |
| SNRIs (Venlafaxine, Duloxetine) | Block 5-HT+NE reuptake | Depression, anxiety, neuropathic pain | HTN, sweating |
| MAOIs (Phenelzine) | Inhibit MAO-A/B | Atypical depression | Hypertensive crisis with tyramine ("cheese effect"), serotonin syndrome |
🔵 SECTION 8: CARDIOVASCULAR DRUGS
Cardiac Glycosides
| Drug | Mechanism | Uses | Side Effects |
|---|
| Digoxin | Inhibits Na+/K+-ATPase → ↑intracellular Ca2+ → (+)inotropy; ↑vagal tone → (-) chronotropy | Heart failure, AFib rate control | Narrow TI! Nausea, vomiting, visual (yellow-green halos), arrhythmia, bradycardia. ↑toxicity with hypokalemia |
Non-Glycoside Cardiotonics
| Drug | Mechanism | Uses |
|---|
| Dobutamine | β1 agonist | Acute HF, cardiogenic shock |
| Milrinone, Amrinone | PDE-3 inhibitors → ↑cAMP | Acute HF (short-term) |
| Levosimendan | Ca2+ sensitizer | Acute decompensated HF |
Antianginal Drugs
Organic Nitrates:
| Drug | Mechanism | Uses | Side Effects |
|---|
| Nitroglycerin (GTN) | → NO → ↑cGMP → venodilation (↓preload) → ↓O2 demand | Acute angina (sublingual), stable angina | Headache, flushing, tachycardia (reflex), hypotension, tolerance |
| Isosorbide dinitrate/mononitrate | Same as GTN (longer acting) | Angina prophylaxis | Same as GTN |
Calcium Channel Blockers:
| Drug | Type | Uses | Side Effects |
|---|
| Nifedipine, Amlodipine | Dihydropyridine (DHP) - vascular selective | HTN, angina (Prinzmetal's) | Headache, flushing, pedal edema, reflex tachycardia |
| Verapamil | Non-DHP (heart > vessels) | HTN, angina, SVT/AFib | Bradycardia, heart block, constipation, negative inotrope |
| Diltiazem | Non-DHP (intermediate) | HTN, angina, SVT | Bradycardia, heart block |
Verapamil: Most negative chronotropic CCB; used for rate control in SVT; AVOID with beta-blockers (complete heart block risk)
ACE Inhibitors:
| Drug | Mechanism | Uses | Side Effects |
|---|
| Enalapril, Lisinopril, Ramipril, Captopril | Block ACE → ↓Angiotensin II → ↓aldosterone → ↓BP, ↓preload/afterload | HTN, HF, diabetic nephropathy, post-MI | Dry cough (#1 SE), hyperkalemia, angioedema (contraindicated in pregnancy) |
Angiotensin Receptor Blockers (ARBs):
| Drug | Mechanism | Uses | Side Effects |
|---|
| Losartan, Valsartan, Candesartan | Block AT1 receptor | HTN, HF, diabetic nephropathy (if ACE cough) | Hyperkalemia, angioedema (rare), contraindicated in pregnancy. NO cough |
Drugs improving cerebral blood flow:
| Drug | Uses |
|---|
| Pentoxifylline | Cerebrovascular insufficiency (↓blood viscosity) |
| Vinpocetine | Cerebral ischemia, vasodilation |
| Cinnarizine | Vertigo, cerebrovascular disorders |
Anti-Atherosclerotic Drugs (Statins)
| Drug | Mechanism | Uses | Side Effects |
|---|
| Atorvastatin, Rosuvastatin, Simvastatin | HMG-CoA reductase inhibitor → ↓cholesterol synthesis | Hypercholesterolemia, CAD prevention | Myopathy/rhabdomyolysis (especially with CYP3A4 inhibitors), ↑LFTs |
| Fibrates (Fenofibrate) | PPARα agonist → ↓TG | Hypertriglyceridemia | Myopathy, GI |
| Cholestyramine | Bile acid sequestrant | Hypercholesterolemia | GI bloating, ↓fat-soluble vitamin absorption |
| Ezetimibe | ↓Intestinal cholesterol absorption | Adjunct to statins | GI |
🔵 SECTION 9: DIURETICS
| Drug | Mechanism | Uses | Side Effects |
|---|
| Furosemide (Loop diuretic) | Blocks Na+/K+/2Cl- in thick ascending Loop of Henle | Edema (HF, cirrhosis), hypertensive crisis, pulmonary edema, hypercalcemia | Hypokalemia, hyponatremia, ototoxicity (high dose), dehydration |
| Hydrochlorothiazide (HCTZ) | Blocks NaCl cotransporter in DCT | HTN, mild edema, hypercalciuria (kidney stones) | Hypokalemia, hyperglycemia, hyperlipidemia, hyperuricemia |
| Indapamide | Thiazide-like | HTN | Hypokalemia (less metabolic effects than HCTZ) |
| Spironolactone | Aldosterone antagonist (K+-sparing) | HF, ascites, hyperaldosteronism, hirsutism | Hyperkalemia, gynecomastia (in men) |
| Amiloride, Triamterene | Block Na+ channels in collecting duct (K+-sparing) | Adjunct to loop/thiazide | Hyperkalemia |
| Mannitol (Osmotic) | Osmotic effect → water excretion | Cerebral edema, acute glaucoma, forced diuresis | Volume overload initially, hyponatremia |
🔵 SECTION 10: ANTIBIOTICS
Beta-Lactams
Penicillins:
| Drug | Spectrum | Uses | Side Effects |
|---|
| Benzylpenicillin (Pen G) | Narrow (Gram+, anaerobes, spirochetes) | Strep pharyngitis, syphilis, meningitis | Allergy (anaphylaxis!), neurotoxicity (high dose) |
| Amoxicillin | Extended (+ some Gram-) | RTI, UTI, H. pylori | Allergy, GI |
| Oxacillin, Cloxacillin | Penicillinase-resistant | MSSA | Allergy |
Inhibitor-protected:
| Drug | Extra | Uses |
|---|
| Amoxicillin-Clavulanate (Augmentin) | Clavulanate inhibits β-lactamase | Resistant infections, sinusitis, UTI |
| Piperacillin-Tazobactam | Broad spectrum including Pseudomonas | Severe hospital infections |
Cephalosporins:
| Generation | Drugs | Spectrum |
|---|
| 1st | Cefazolin, Cefalexin | Gram+ (surgical prophylaxis) |
| 2nd | Cefuroxime, Cefoxitin | Gram+/-, anaerobes |
| 3rd | Ceftriaxone, Cefotaxime | Gram- (meningitis, gonorrhea), less Gram+ |
| 4th | Cefepime | Gram+/-, Pseudomonas |
Side effects all: allergy (10% cross-react with penicillin), GI, C. difficile colitis
Carbapenems:
| Drug | Spectrum | Uses |
|---|
| Imipenem-Cilastatin, Meropenem | Ultra-broad (resistant bacteria) | Severe infections, ESBL+ organisms |
SE: Seizures (imipenem), allergy
Monobactams:
| Drug | Notes |
|---|
| Aztreonam | Gram- only; safe in penicillin allergy |
Aminoglycosides
| Drug | Mechanism | Uses | Side Effects |
|---|
| Gentamicin, Amikacin, Streptomycin | Bind 30S ribosome → mistranslation | Gram- severe infections, TB (streptomycin), plague | Nephrotoxicity, ototoxicity (irreversible), neuromuscular blockade |
Macrolides
| Drug | Mechanism | Uses | Side Effects |
|---|
| Azithromycin, Clarithromycin, Erythromycin | Bind 50S ribosome → block translocation | Atypical pneumonia (Mycoplasma, Chlamydia), STI, H. pylori | GI (especially erythromycin), QT prolongation, drug interactions (CYP3A4) |
Tetracyclines
| Drug | Mechanism | Uses | Side Effects |
|---|
| Doxycycline, Tetracycline | Bind 30S ribosome → block aminoacyl-tRNA | Atypical pneumonia, Lyme disease, malaria, Chlamydia, acne | Photosensitivity, discoloration of teeth/bones (avoid in children <8 and pregnancy), GI |
Lincosamides
| Drug | Mechanism | Uses | Side Effects |
|---|
| Clindamycin | Bind 50S ribosome | Anaerobes, skin/soft tissue (MRSA), pelvic infections | C. difficile colitis (high risk), GI |
Glycopeptides
| Drug | Mechanism | Uses | Side Effects |
|---|
| Vancomycin | Inhibits cell wall synthesis (binds D-Ala-D-Ala) | MRSA, C. difficile (oral), Gram+ resistant | Red man syndrome (infuse slowly!), nephrotoxicity, ototoxicity |
Polymyxins
| Drug | Mechanism | Uses | Side Effects |
|---|
| Colistin (Polymyxin E) | Disrupts bacterial membrane (Gram- only) | MDR Gram- (Pseudomonas, Acinetobacter) | Nephrotoxicity, neurotoxicity |
Fluoroquinolones
| Drug | Mechanism | Uses | Side Effects |
|---|
| Ciprofloxacin (gen 2) | Inhibit DNA gyrase + topoisomerase IV | UTI, GI infections, Pseudomonas | Tendon rupture (Achilles), avoid in children, QT prolongation, CNS effects |
| Levofloxacin, Moxifloxacin (gen 3-4) | Same | Community-acquired pneumonia, atypical pneumonia, TB | Same + phototoxicity |
Sulfonamides + Co-trimoxazole
| Drug | Mechanism | Uses | Side Effects |
|---|
| Sulfamethoxazole | PABA analog → inhibit dihydropteroate synthase | UTI, nocardia | Allergy, crystalluria, kernicterus (neonates) |
| Co-trimoxazole (TMP-SMX / Biseptol) | TMP blocks dihydrofolate reductase + SMX; sequential block of folate synthesis | UTI, PCP pneumonia (HIV), Toxoplasma, Nocardia | Bone marrow suppression, rash, Stevens-Johnson, hyperkalemia (TMP) |
Anti-TB Drugs (First line - RIPE)
| Drug | Mechanism | Side Effects |
|---|
| Rifampicin (R) | Inhibit RNA polymerase | Orange urine/secretions, hepatotoxicity, enzyme inducer (↓OCP, warfarin) |
| Isoniazid/INH (I) | Inhibit mycolic acid synthesis | Peripheral neuropathy (give B6/pyridoxine!), hepatotoxicity, SLE-like |
| Pyrazinamide (P) | Unknown (targets mycobacterial fatty acid) | Hepatotoxicity, hyperuricemia (gout) |
| Ethambutol (E) | Inhibit arabinosyl transferase | Optic neuritis (color blindness, visual field defects) |
| Streptomycin | 30S binding | Ototoxicity, nephrotoxicity |
Isoniazid (GINK derivative) + Ftivazid - both inhibit mycolic acid synthesis; peripheral neuropathy prevented by Vitamin B6
Nitrofurans
| Drug | Uses | Side Effects |
|---|
| Nitrofurantoin | UTI (lower) | Pulmonary toxicity, peripheral neuropathy, hemolysis (G6PD) |
| Furazolidone | GI infections | GI, disulfiram-like reaction |
🔵 SECTION 11: ANTIVIRAL DRUGS
| Drug | Mechanism | Uses | Side Effects |
|---|
| Acyclovir | Inhibits viral DNA polymerase (after activation by viral thymidine kinase) | Herpes simplex, Varicella-Zoster | Nephrotoxicity (hydrate well!), neurotoxicity |
| Valacyclovir | Prodrug of acyclovir | Herpes (oral, better bioavailability) | Same as acyclovir |
| Oseltamivir (Tamiflu) | Neuraminidase inhibitor | Influenza A+B treatment + prophylaxis | Nausea, vomiting |
| Amantadine, Rimantadine | Block M2 protein (influenza A only) | Influenza A prophylaxis; Parkinson's (amantadine) | GI, CNS, resistance common |
| Interferons (α, β, γ) | Induce antiviral state, immunomodulation | Viral hepatitis (B/C), MS (IFN-β), hairy cell leukemia | Flu-like syndrome, depression, leukopenia |
| Interferon inducers (Tilorone) | Stimulate endogenous IFN | Viral infections | GI |
🔵 SECTION 12: ANTIFUNGALS
| Drug | Mechanism | Uses | Side Effects |
|---|
| Fluconazole, Itraconazole, Voriconazole (Azoles) | Inhibit ergosterol synthesis (14α-demethylase) | Candida, Aspergillus (vori), Cryptococcus | Drug interactions (CYP450), hepatotoxicity, QT prolongation |
| Amphotericin B | Binds ergosterol → pores in fungal membrane | Systemic/severe mycoses (Aspergillus, Cryptococcal meningitis) | Nephrotoxicity (major!), infusion reactions (fever, chills), hypokalemia |
| Caspofungin (Echinocandin) | Inhibits β-glucan synthesis (cell wall) | Invasive Aspergillus, Candida | Histamine release, liver enzyme elevation |
| Griseofulvin | Inhibits microtubule polymerization | Dermatophytes (tinea) | Photosensitivity, GI, teratogenic |
| Terbinafine | Inhibits squalene epoxidase → ergosterol ↓ | Onychomycosis, dermatophytes | Hepatotoxicity, taste disturbance |
| Nystatin | Binds ergosterol (like AmB) | Topical Candida (oral, vaginal) - too toxic for systemic | GI (oral), local irritation |
🔵 SECTION 13: METRONIDAZOLE
| Feature | Detail |
|---|
| Mechanism | Pro-drug → activated by anaerobic organisms → damages DNA |
| Spectrum | Anaerobes (Bacteroides), protozoa (Giardia, Trichomonas, Entamoeba, H. pylori) |
| Uses | C. difficile, bacterial vaginosis, Giardia, amoebiasis, H. pylori (triple therapy) |
| Side effects | Metallic taste, GI, peripheral neuropathy, disulfiram-like reaction with alcohol |
🔵 SECTION 14: ENDOCRINE PHARMACOLOGY
Calcium-Phosphorus Metabolism
| Drug | Uses | Side Effects |
|---|
| Calcitonin | Hypercalcemia, osteoporosis, Paget's | Nausea, flushing, antibody development |
| Vitamin D (Cholecalciferol) | Rickets, osteoporosis, hypoparathyroidism | Hypercalcemia (overdose) |
| Bisphosphonates (Alendronate) | Osteoporosis, Paget's, hypercalcemia | Esophageal irritation, osteonecrosis of jaw |
| Teriparatide | Recombinant PTH | Severe osteoporosis |
Thyroid Drugs
| Drug | Mechanism | Uses | Side Effects |
|---|
| Levothyroxine (T4) | Thyroid hormone replacement | Hypothyroidism | Angina, arrhythmia (overdose), osteoporosis |
| Liothyronine (T3) | Faster-acting thyroid hormone | Myxedema coma | Cardiac toxicity |
| Propylthiouracil (PTU) | Inhibits thyroid peroxidase + blocks T4→T3 conversion | Hyperthyroidism, thyroid storm (preferred in pregnancy) | Agranulocytosis, hepatotoxicity (severe), rash |
| Methimazole (Thiamazole) | Inhibits thyroid peroxidase | Hyperthyroidism | Agranulocytosis, rash (less hepatotoxic than PTU) |
Pituitary Hormones
| Hormone | Drug Examples | Uses |
|---|
| Anterior: GH | Somatropin | GH deficiency, Turner syndrome |
| Anterior: TSH | Thyrotropin alfa | Thyroid cancer diagnosis |
| Anterior: ACTH | Tetracosactide | Adrenal insufficiency diagnosis |
| Gonadotropins: FSH/LH | Menotropins, Choriogonadotropin | Infertility |
| Posterior: Oxytocin | Synthetic oxytocin | Labor induction, postpartum bleeding |
| Posterior: ADH/Vasopressin | Desmopressin | Diabetes insipidus, hemophilia A, enuresis |
Insulin
| Type | Onset | Duration | Example |
|---|
| Ultra-short | 15 min | 3-5 h | Lispro, Aspart, Glulisine |
| Short | 30 min | 6-8 h | Regular insulin |
| Intermediate | 1-2 h | 12-18 h | NPH (Isophane) |
| Long-acting | 1-2 h | 20-24+ h | Glargine, Detemir |
Mechanism: Binds insulin receptor (tyrosine kinase) → GLUT4 translocation → ↓blood glucose
Side effects: Hypoglycemia, lipodystrophy, weight gain, hypokalemia
Oral Hypoglycemics
| Drug | Class | Mechanism | Uses | Side Effects |
|---|
| Metformin | Biguanide (sensitizer) | Activates AMPK → ↓hepatic glucose production | T2DM (1st line) | Lactic acidosis (rare), GI, B12 deficiency, NO hypoglycemia |
| Pioglitazone, Rosiglitazone | Thiazolidinediones (sensitizer) | PPARγ agonist → ↑insulin sensitivity | T2DM | Weight gain, fluid retention, heart failure, bladder cancer (pio) |
| Glibenclamide, Glipizide | Sulfonylureas (secretagogue) | Block K+-ATP channels → insulin release | T2DM | Hypoglycemia, weight gain |
| Repaglinide, Nateglinide | Meglitinides (secretagogue) | Same as sulfonylureas (shorter acting) | T2DM, elderly | Hypoglycemia (less than SU) |
| Sitagliptin, Saxagliptin | DPP-4 inhibitors (incretinomimetics) | ↑GLP-1 levels → ↑insulin, ↓glucagon | T2DM | Nasopharyngitis, pancreatitis |
| Exenatide, Liraglutide | GLP-1 agonists (incretinomimetics) | Glucose-dependent insulin ↑, ↓appetite | T2DM, obesity | Nausea, pancreatitis, thyroid C-cell tumor (liraglutide) |
Glucocorticoids
| Drug | Uses | Side Effects |
|---|
| Prednisolone, Dexamethasone, Hydrocortisone | Inflammation, asthma, autoimmune, shock, adrenal insufficiency | Cushing's syndrome (moon face, buffalo hump), hyperglycemia, osteoporosis, immunosuppression, peptic ulcer, hypertension, adrenal suppression (abrupt withdrawal → Addisonian crisis) |
Sex Hormones
| Drug | Mechanism | Uses | Side Effects |
|---|
| Estrogens (Estradiol) | ER agonist | HRT, contraception, hypogonadism | DVT/PE, breast/uterine cancer risk, nausea |
| Progestogens (Progesterone, Medroxyprogesterone) | PR agonist | HRT, contraception, endometriosis | Weight gain, depression, thrombosis |
| Combined OCP | ↓FSH/LH → no ovulation | Contraception, dysmenorrhea, acne | DVT, hypertension, migraine, stroke (esp. smokers >35) |
| Testosterone | AR agonist | Male hypogonadism | Polycythemia, hepatotoxicity, prostate effects |
| Anabolic steroids (Nandrolone) | AR agonist (anabolic > androgenic) | Cachexia, aplastic anemia, osteoporosis | Hepatotoxicity, virilization, dyslipidemia, premature epiphyseal closure |
🔵 SECTION 15: COAGULATION DRUGS
Antiplatelets
| Drug | Mechanism | Uses | Side Effects |
|---|
| Aspirin (low dose) | Irreversible COX-1 inhibitor → ↓TXA2 | MI/stroke prophylaxis | GI bleeding |
| Clopidogrel, Ticagrelor | ADP (P2Y12) receptor antagonist | ACS, post-stent, stroke | Bleeding, TTP (clopidogrel) |
| Abciximab, Tirofiban | GP IIb/IIIa receptor antagonist | ACS, PCI | Thrombocytopenia, bleeding |
Anticoagulants
| Drug | Mechanism | Uses | Side Effects |
|---|
| Heparin (unfractionated) | Activates Antithrombin III → inhibits thrombin + Xa | DVT/PE treatment, ACS, surgery | Bleeding, HIT (heparin-induced thrombocytopenia), osteoporosis |
| LMWHs (Enoxaparin, Dalteparin) | Activates AT-III → mainly anti-Xa | DVT prophylaxis/treatment | Less HIT, bleeding; cannot be fully reversed |
| Warfarin | Inhibits Vit K epoxide reductase → ↓II, VII, IX, X | AF, DVT, mechanical valves | Bleeding, teratogenic, many drug interactions; reversal = Vit K + FFP |
| Dabigatran | Direct thrombin inhibitor | AF, DVT | Bleeding; reversal = Idarucizumab |
| Rivaroxaban, Apixaban | Direct factor Xa inhibitor | AF, DVT/PE | Bleeding; reversal = Andexanet alfa |
Fibrinolytics (Thrombolytics)
| Drug | Mechanism | Uses | Side Effects |
|---|
| Streptokinase | Activates plasminogen → plasmin → clot lysis | STEMI, massive PE, DVT | Bleeding, allergy/anaphylaxis, cannot repeat (antibodies) |
| Alteplase (tPA) | Recombinant tPA → activates plasminogen | STEMI, ischemic stroke (within 4.5h), PE | Bleeding (esp. intracranial hemorrhage) |
Antifibrinolytics (stop fibrinolysis): Tranexamic acid, Aminocaproic acid - used in surgical/traumatic bleeding
🔵 SECTION 16: ANEMIA DRUGS
| Drug | Uses | Side Effects |
|---|
| Ferrous sulfate/fumarate (oral iron) | Iron-deficiency anemia (hypochromic) | GI upset, constipation, black stools |
| Iron sucrose, Iron dextran (IV) | Severe IDA, malabsorption | Anaphylaxis (IV), flushing |
| Vitamin B12 (Cyanocobalamin) | B12-deficiency (megaloblastic/hyperchromic) anemia, pernicious anemia | Rarely toxic; pain at injection site |
| Folic acid | Folate-deficiency anemia, pregnancy (NTD prevention) | Non-toxic; may mask B12 deficiency |
| Erythropoietin (Epoetin) | Stimulates RBC production | Anemia of chronic disease, CKD, chemotherapy |
🔵 SECTION 17: GI DRUGS
Gastric Acid Reduction
| Drug | Mechanism | Uses | Side Effects |
|---|
| Omeprazole, Pantoprazole (PPIs) | Irreversibly inhibit H+/K+-ATPase (proton pump) | PUD, GERD, H. pylori, Zollinger-Ellison | Hypomagnesemia, B12 deficiency, C. diff risk, fractures (long-term) |
| Ranitidine, Famotidine (H2 blockers) | Competitive H2 receptor antagonists → ↓acid | PUD, GERD, stress ulcer prophylaxis | Ranitidine withdrawn (NDMA); headache, confusion in elderly (cimetidine) |
| Antacids (Mg(OH)2, Al(OH)3, CaCO3) | Neutralize HCl | Symptomatic relief of heartburn | Mg = diarrhea; Al = constipation; Ca = milk-alkali syndrome |
GI Motility / Protection
| Drug | Mechanism | Uses | Side Effects |
|---|
| Metoclopramide | D2 blocker + 5-HT4 agonist (prokinetic) | Nausea, GERD, gastroparesis | EPS, tardive dyskinesia (long-term) |
| Ondansetron | 5-HT3 antagonist | Chemotherapy nausea, post-op nausea | QT prolongation, constipation |
| Domperidone | D2 blocker (peripheral) | Nausea, gastroparesis | Less EPS than metoclopramide, QT prolongation |
| Sucralfate | Forms protective barrier over ulcer | PUD, stress ulcer | Constipation, ↓drug absorption |
| Bismuth subsalicylate | Gastroprotective + antibacterial | PUD, H. pylori, diarrhea | Black tongue/stool |
| Misoprostol | PGE1 analog → ↑mucus/bicarbonate, ↓acid | NSAID-induced ulcer prevention, ulcer healing | Diarrhea, cramping; ABORTIFACIENT |
Hepatoprotectors
| Drug | Uses | Side Effects |
|---|
| Silymarin (Milk thistle) | Hepatoprotection, toxic hepatitis | Rare GI |
| Ademetionine (SAMe) | Cholestatic liver disease | GI |
| Ursodeoxycholic acid | Primary biliary cirrhosis, gallstones | Diarrhea |
| Essentiale (phospholipids) | Chronic liver disease | Rare |
Choleretics (Bile Production) vs Cholekinetics (Bile Flow)
| Drug | Type | Uses |
|---|
| Allochol, Cholenzyme | Choleretic | Biliary dyskinesia |
| Magnesium sulfate | Choleretic + cholekinetic | Biliary dyskinesia |
| Ursodeoxycholic acid | Choleretic | Gallstone dissolution |
Pancreatic Enzymes
| Drug | Uses | Side Effects |
|---|
| Pancreatin, Creon (Pancrelipase) | Exocrine pancreatic insufficiency (chronic pancreatitis, CF, post-pancreatectomy) | GI, hyperuricemia (high dose) |
Laxatives
| Type | Drugs | Mechanism | Uses |
|---|
| Bulk-forming | Psyllium, Methylcellulose | Absorb water → ↑bulk | Constipation, IBS |
| Osmotic | Lactulose, Polyethylene glycol | Draw water into lumen | Constipation, hepatic encephalopathy (lactulose) |
| Stimulant | Bisacodyl, Senna | Stimulate colon motility | Acute constipation |
| Stool softener | Docusate | Emulsify stool | Constipation |
| Saline | Magnesium sulfate | Osmotic | Acute constipation, bowel prep |
🔵 SECTION 18: RESPIRATORY DRUGS
Bronchodilators
| Drug | Mechanism | Uses | Side Effects |
|---|
| Salbutamol, Terbutaline (SABA) | β2 agonist (short-acting) | Acute asthma/COPD | Tremor, tachycardia |
| Salmeterol, Formoterol (LABA) | β2 agonist (long-acting) | Maintenance asthma/COPD | Tremor, tachycardia; NEVER as monotherapy in asthma |
| Ipratropium (SAMA) | M-blocker (inhaled) | COPD, acute asthma adjunct | Dry mouth |
| Tiotropium (LAMA) | M-blocker (long-acting) | COPD maintenance | Dry mouth, urinary retention |
| Theophylline | PDE inhibitor → ↑cAMP (bronchodilation) | Asthma/COPD (adjunct) | Narrow TI! Nausea, arrhythmia, seizures; monitor levels |
Anti-Inflammatory (Asthma)
| Drug | Mechanism | Uses | Side Effects |
|---|
| Inhaled corticosteroids (ICS): Budesonide, Beclometasone, Fluticasone | Reduce airway inflammation | Asthma controller (1st line) | Oral candidiasis (rinse mouth!), dysphonia, systemic effects with high dose |
| Montelukast (Antileukotriene) | CysLT1 receptor antagonist | Asthma, allergic rhinitis | Neuropsychiatric effects (depression, suicidal ideation) |
| Cromolyn (Membrane stabilizer) | Inhibits mast cell degranulation | Asthma prophylaxis (less used now) | Minimal; local irritation |
Antihistamines (H1 Blockers)
| Generation | Drugs | Features | Uses | Side Effects |
|---|
| 1st | Diphenhydramine, Chlorphenamine, Promethazine | Cross BBB, sedating | Allergy, motion sickness, sleep | Sedation, anticholinergic, urinary retention |
| 2nd | Loratadine, Cetirizine, Fexofenadine | Non-sedating, no anticholinergic | Allergic rhinitis, urticaria | Minimal |
Antitussives (Cough Suppressants)
| Drug | Mechanism | Uses | Side Effects |
|---|
| Codeine | Opioid - depresses cough center | Dry/nonproductive cough | Constipation, dependence |
| Dextromethorphan | Non-opioid (NMDA antagonist) | Dry cough | Abuse potential (high dose), serotonin syndrome |
| Butamirate | Peripheral + central | Dry cough | Drowsiness |
Expectorants/Mucolytics
| Drug | Mechanism | Uses | Side Effects |
|---|
| Acetylcysteine (NAC) | Breaks disulfide bonds in mucus → ↓viscosity | COPD, cystic fibrosis; also antidote for paracetamol overdose | Bronchospasm (inhaled), GI (oral) |
| Ambroxol, Bromhexine | ↑surfactant production, ↓mucus viscosity | Productive cough | Nausea |
| Potassium iodide | Irritant expectorant | Chronic bronchitis | Metallic taste, hypothyroidism |
🔵 SECTION 19: UTERINE DRUGS
Uterotonics (Increase uterine contractions)
| Drug | Mechanism | Uses | Side Effects |
|---|
| Oxytocin | Oxytocin receptor agonist | Labor induction, postpartum hemorrhage | Uterine hyperstimulation, fetal distress, water retention |
| Ergometrine (Methylergometrine) | α-agonist + 5-HT agonist | Postpartum hemorrhage | Sustained uterine contraction, vasospasm, hypertension |
| Misoprostol | PGE1 analog | Postpartum hemorrhage, cervical ripening | Fever, shivering, diarrhea |
| Dinoprostone | PGE2 analog | Cervical ripening, labor induction | GI, fever |
Tocolytics (Inhibit uterine contractions)
| Drug | Mechanism | Uses | Side Effects |
|---|
| Salbutamol (Ritodrine) | β2 agonist | Preterm labor | Tachycardia, hypokalemia, pulmonary edema |
| Indomethacin | COX inhibitor → ↓prostaglandins | Preterm labor (<32 weeks) | Premature closure of ductus arteriosus, oligohydramnios |
| Nifedipine | CCB → ↓uterine contractions | Preterm labor | Hypotension, headache |
| Magnesium sulfate | ↓Ca2+ → ↓uterine contractility | Preterm labor (also seizure prophylaxis in preeclampsia) | Toxicity: loss of reflexes → respiratory arrest (antidote: Ca gluconate) |
| Atosiban | Oxytocin receptor antagonist | Preterm labor (Europe) | Injection site reaction |
🔵 SECTION 20: EMERGENCY DRUGS
Anaphylactic Shock
- Epinephrine IM (0.5mg, 1:1000) - 1st line
- Antihistamines (Diphenhydramine IV)
- Glucocorticoids (Hydrocortisone IV)
- Salbutamol (if bronchospasm persists)
- IV fluids
Pulmonary Edema
- Furosemide IV (↓preload, diuresis)
- Morphine IV (venodilation, anxiolysis)
- Nitroglycerin (↓preload)
- O2
- Positive pressure ventilation
- Dobutamine (if cardiogenic shock)
Hypertensive Crisis
- Sodium nitroprusside IV (direct NO donor, arteriolar + venous dilator)
- Labetalol IV (α+β blocker)
- Enalaprilat IV (ACE inhibitor)
- Nifedipine sublingual (now less preferred - too rapid drop)
- Clonidine (central α2 agonist)
Angina Attack Treatment
- Acute relief: Sublingual nitroglycerin (GTN)
- Prophylaxis: Long-acting nitrates, β-blockers, CCBs
- Unstable angina/ACS: Aspirin + Clopidogrel + Heparin + β-blocker
🔵 SECTION 21: MISCELLANEOUS
Antitumor Drug Side Effects (Overview)
| Category | Examples | Key Side Effects |
|---|
| Alkylating agents | Cyclophosphamide, Cisplatin | Hemorrhagic cystitis (cyclophos), nephrotoxicity (cisplatin), myelosuppression, nausea |
| Antimetabolites | Methotrexate, 5-FU | Bone marrow suppression, mucositis, hepatotoxicity |
| Antitumor antibiotics | Doxorubicin | Cardiotoxicity (cumulative), myelosuppression |
| Vinca alkaloids | Vincristine, Vinblastine | Peripheral neuropathy (vincristine), myelosuppression (vinblastine) |
| Taxanes | Paclitaxel | Peripheral neuropathy, myelosuppression |
H. pylori Eradication
Triple therapy (standard):
- PPI + Clarithromycin + Amoxicillin (or Metronidazole) × 10-14 days
Quadruple therapy (if resistant):
- PPI + Bismuth + Metronidazole + Tetracycline
Atypical Pneumonia Treatment
- Macrolides (Azithromycin, Clarithromycin) - 1st choice
- Doxycycline - alternative
- Fluoroquinolones (Levofloxacin, Moxifloxacin) - respiratory quinolones
Pseudomonas aeruginosa (Anti-pseudomonal agents)
- Piperacillin-Tazobactam, Ceftazidime, Cefepime
- Carbapenems (Imipenem, Meropenem)
- Ciprofloxacin (most active oral FQ vs Pseudomonas)
- Aminoglycosides (Gentamicin, Amikacin)
- Colistin (MDR strains)
Pseudomembranous Enterocolitis (C. difficile)
- Metronidazole (mild-moderate)
- Oral Vancomycin (severe)
- Fidaxomicin (recurrent)
- Cause: C. difficile toxin after broad-spectrum antibiotic use
⚡ QUICK MEMORY AIDS
| Mnemonic | Meaning |
|---|
| SLUDGE | Cholinergic toxidrome: Salivation, Lacrimation, Urination, Defecation, GI, Emesis |
| RIPE | First-line TB drugs: Rifampicin, Isoniazid, Pyrazinamide, Ethambutol |
| ACE cough → ARB | Switch from ACE inhibitor to ARB if dry cough develops |
| Digoxin toxicity ↑ with ↓K+ | Hypokalemia potentiates digoxin toxicity |
| Furosemide = "frusemide LOSES K+" | Loop diuretics cause hypokalemia |
| Spiro SPARES K+ | Spironolactone is K+-sparing |
| Atropine = ANTI-SLUDGE | Blocks all muscarinic (SLUDGE) effects |
| Morphine OD = Pinpoint pupils + resp depression | Classic opioid triad; reverse with Naloxone |
| Statins = Myopathy monitor | Check CK if muscle pain; ↑ risk with CYP3A4 inhibitors |
| Warfarin reversal = Vit K + FFP | For urgent reversal |
| Isoniazid → give B6 (pyridoxine) | Prevents peripheral neuropathy |
| Metformin = no hypoglycemia | Does not cause hypoglycemia alone |
| Clozapine = agranulocytosis | Mandatory CBC monitoring |
This guide covers all topics from your exam PDF across 7 pages. Each drug class has mechanism, uses, and side effects in a concise format ideal for rapid review. Good luck on your exam! 🎯
