M4 Set B (April 2026) ⭐☘️

Phenelzine (MPITS, MAOI)

Tyramine rich food:

IgG

Immunoglobulin from mother to baby ata

Antibody available in newborn from mother

B. MESNA

Rescue drug of Ifosfamide:

A. Leucovorin

B. MESNA

C. Dexrazoxane

D. Amifostine

A. Pagets

Biphosphonates use:

A. Pagets

B. Mayers

Azines = aromatic 6-membered ring containing nitrogen(s)

Pyridazine

Pyrimidine

Pyrazine

Triazine

Azine derivatives

B. Tocilizumab

Tocilizumab - “mab”s are Monoclonal Antibodies

Additional info - used to prevent cytokine storm -> severe and deadly complication of severe COVID-19 infection

Monoclonal antibody for COVID-19,

A. Remdesivir, B. Tocilizumab

A. Thalidomide

Thalidomide: phocomelia/limb deformities

Teratogenic agent responsible for limb defects

A. Thalidomide

B. Retinol

CK-MB (heart)

Muscle cell release pag may acute MI:

Lithium carbonate

for Mania

Zero order: t1/2= Co/2k

First order: t1/2= 0.693/k

(3 questions) Half-life computation for zero and first order

Pseudoephedrine

Nasal decongestant

Class IV (Angina at Rest)

Classification of angina pectoris

Vit D

Cholecalciferol

Tamoxifen

Tx for breast cancer

API, Dosage form, salts and ester

Pharmaceutical equivalents have the same

non ionized, lipid soluble

Form of drugs favorable absorbed

non polar, lipophilic

LUNA

Form of drugs will cross cell membranes easily:

Attapulgite

HIPED Antidiarrheal / adsorbent

MOA: Adsorbs toxins, bacteria, and excess fluid in the GI tract.

non-ionized form at an acidic environment

Which of the following is TRUE regarding acidic drugs? They exist in a

⭐ Most important CYP INDUCERS

Rifampin ⭐

Carbamazepine

Phenytoin

Phenobarbital

St. John’s wort

Smoking

INDUCER → drug level ↓

INHIBITOR → drug level ↑

Enzyme inhibition/induction mechanism

TRUE - Tyrosine

LOVE

DOES

NOT

EXIST

synthesis of cathecolamines, precursor:

Osmotic diuretic

Drug class of mannitol 

IbuPROfen

Drug causing cross sensitivity with aspirinIbuprofen

Atracurium

Neuromuscular blocker

ANTIcholinergic = blocks ACh → DRY, HOT, BLIND, FAST, FULL

(dry mouth, mydriasis, tachycardia, urinary retention)

ANTIcholinesterase = DUMB BELLS

prevents breakdown of ACh → WET + SLOW

(salivation, lacrimation, diarrhea, urination, bradycardia)

Anticholinergic vs Anticholinesterase

SSRI = “S” only → Serotonin

Fluoxetine, Sertraline, Paroxetine

SNRI = “S + N” → Serotonin + Norepinephrine

Venlafaxine, Duloxetine

SNRI vs SSRI difference & examples of drugs

block ENaC

risk of renal stone

Triamterene

CAIs (PCT) - Acetazolamide - ↓ HCO₃⁻ reabsorption(Metabolic acidosis)

Loop diuretics ( TAL) - Furosemide - Blocks Na⁺-K⁺-2Cl⁻

Thiazide (DCT) - HCTZ - Blocks Na⁺-Cl⁻

K-sparing ( Collecting duct) - Spironolactone/Amiloride - Blocks aldosterone/Blocks ENaC

⭐ Must remember

Loop: strongest diuretic → loses Ca²⁺ + K⁺

Thiazide: saves Ca²⁺, loses K⁺

K⁺-sparing: saves K⁺ → risk hyperkalemia

Acetazolamide: causes metabolic acidosis

Mannitol: osmotic diuretic → used for cerebral edema

DIURETICS CONCEPTS

Liver

What organ to monitor if taking -statins

rhabdomyolysis

statins

Thiopental

Methohexital

THI METO

Ultra-short-acting Barbiturates

Entropy = disorder/randomness

📈 Entropy INCREASES (ΔS ↑)

Solid → Liquid → Gas

More gas molecules → higher entropy

More particles / more freedom of movement → higher entropy

Temperature ↑ → entropy generally ↑

Enthalpy and Entropy

B. Exothermic

Significance of enthalpy:

a. spontaneous

b. exothermic

Acidosis → “BLOW OFF CO₂” 🌬

→ Hyperventilate → CO₂ ↓ → pH rises

Alkalosis → “HOLD CO₂”

→ Hypoventilate → CO₂ ↑ → pH falls

Metabolic Acidosis vs Alkalosis — Compensation

HYPO- KOM

HYPER- CAL

Digoxin toxicity

Rapid: L-A-G → Lispro, Aspart, Glulisine

Short: Regular

Intermediate: NPH

Long: Glar-gine / Detemir

Ultra-long: Degludec

Types of insulin

Protein

insulin is a protein, carbohydrate, fat, storage?

B. Muscle stimulant

Isoxuprine is a?

A. Muscle relaxant

B. Muscle stimulant

3 Ps = Pee, Pour, Plate

Pee = Polyuria

Pour = Polydipsia

Plate = Polyphagia

Which of the following is/are signs and symptoms of Diabetes

Pee - Polyuria

frequent urination

Pour - Polydipsia

excessive thirst

Plate - Polyphagia

excessive hunger

Metformin (s/e: Lactic Acidosis)

Which antidiabetic drugs causes fluctuation of lactate

PPI + Clarithomycin+ Amoxicillin (14 days)

⭐ Bismuth Quadruple Therapy

PPI + Bismuth + Tetracycline + Metronidazole

H. pylori Therapy (Morse type)

Thyroid procedure

Lugol’s Solution

1st gen

Cefazolin

Piperazine

Levocetirizine (2nd gen/ less sedating)

GABA = Gamma-Aminobutyric Acid

➡ Main inhibitory neurotransmitter in the CNS 🧠

GABA-A

Ligand-gated Cl⁻ channel

Cl⁻ enters neuron → hyperpolarization

Fast inhibition

Target of benzodiazepines + barbiturates

GABA-B

G-protein coupled receptor (Gi)

↑ K⁺ efflux + ↓ Ca²⁺ influx

Slow inhibition

Example: Baclofen

Description of GABA (morse-type)

CNS depressants → sedation, hypnosis, anesthesia

↑ duration of Cl⁻ channel opening

Narrow therapeutic index

respiratory depression

BASTA NOT SAFE

Barbiturates properties

Aliskiren = “A-liskiren → A = blocks Angiotensin pathway at the start”

RENIN ↓ → Ang II ↓ → Aldosterone ↓

Use: Hypertension

Avoid in pregnancy

Does NOT cause cough

Aliskiren characteristics

simple diffusion

Exchange of CO2 and o2 in the lungs

Lidocaine

Topical anesthetic used in treating skin

B. lidocaine

Which of

the ffg is a benzoic acid derivative

(should be esters)

a. procaine

b.Lidocaine

c. Bupivacaine.

Classification of antidiabetes

PRESS = Preserve water” → DesmoPRESSin (ADH agonist)

“VAPTAN = Water OUT” → TolVAPTAN (ADH antagonist)

Classification of anti diuretics + moa

reversible, competitive, non specific

Characteristics ng mga plasma binding protein (morse)

ergometrine

Ergot derivative that is oxytocic?

Thiazolidinedione (e.g.Rosiglitazone, Pioglitazone)

Anti-DM that acts as PPAR-Gamma agonist

Amantadine

Anti-dementia + antiviral?

bipolar disorder

Lithium Carbonate

Dextromethorphan - Antitussive

Guiafenosin - expectorant or cough

Diff between dextromethorphan and guiafenosin

Class I (High S + High P): Metoprolol, Propranolol

Class II (Low S + High P): Phenytoin, Diazepam

Class III (High S + Low P): Acyclovir, Cimetidine

Class IV (Low S + Low P): Hydrochlorothiazide, Furosemide

Master BCS Classifications

ion trapping di maeexcrete

Effect ng weak base na drug sa breast milk

A + A = UNIONIZED / NON-IONIZED

Weak acidic drug sa acidic urine

norepinephrine

Which of the ffg is a vasopressor

Baking soda is an example of an antacid.

Which of the ff is/are true regarding antacids?

I. They combine with receptors to produce their effect

II. They act by suppressing the production of gastric acid

III. Baking soda is an example of an antacid.