M4 Set B (Nov 2025) ⭐☘️

Naloxone

Opioid toxicity antidote

COX 1 and 2

Dexketoprofen inhibits

gliptins

DPP4

pilocarpine

Xeromastia is treated by

Higher affinity in beta than alpha

- beta effect at low dose

- alpha effect at high dose

Affinity = ability of a drug to bind to its receptor.

High affinity → drug binds strongly/tightly to receptor.

Low affinity → drug binds weakly.

Affinity mainly determines binding, not whether the drug produces a response.

Note:

Increasing potency = Increasing D2 affinity,

decrease HAM affinity

Affinity concept

adrenaline

(Lumabas sa M3 and M4)

Epinephrine is also known as

Laxative

Phenylpropanolamine use

Appetite suppressant

Sibutramine

alpha 2 agonist

Methyldopa classification

possess affinity only

- Antagonism: 1+1 = 0 à cancellation of effects

a) Mechanism of Action

b) Duration of Action

c) Surmountability

1. Functional antagonism - physiologic antagonism, 2 ligands acting on different targets producin opposite effects

2. Receptor antagonism - Pharmacologic antagonism, 2 ligands acting on the same target producing opposite effects

3. Chemical antagonism- Neutralization, chelation

Reversible, safe 24 hrs, fast

Irreversible - more weeks, toxic, slow

Types of antagonist (definition)

zero-order kinetics

Rate is independent on the remaining concentration

Aspartate aminotransferase AST

Alanine aminotransferase ALT

AST and ALT

indirect-acting sympathomimetic

NE release

inhibits VMAT2

Reverses/blocks NET & DAT

MOA of amphetamine (morse type)

iodine

Used for diagnosis of thyroid condition

metformin

Insulin sensitizer

Opioids cause constipation because they activate μ-opioid receptors in the GI tract → ↓ intestinal motility and ↓ intestinal secretions → hard, slow stools.

So, laxatives are used to prevent/treat opioid-induced constipation (OIC).

Ex. senna, bisacodyl, polyethylene glycol (PEG).

Why is laxative used for chronic opioid use?

PPI

Irreversible antagonist of drugs for GERD

Limited efficacy, especially in preventing gastric ulcer

Definition of antacid

mu receptors

Opioids work at

First pass effect and bioavailability concepts

high uric acid

Indication for prescribing Febuxostat

CAI: in PCT, convert CO₂ and water into carbonic acid/bicarbonate, and the reaction can also run in reverse.

↓ HCO₃⁻ reabsorption → ↑ bicarbonate in urine → metabolic acidosis.

Definition of carbonic anhydrase

immiscibility

Which of the following is NOT a chemical incompatibility

Clozapine(2nd gen) or Haloperidol(1st gen)

Drug for schizophrenia

Anticonvulsant / antiepileptic drug (AED)

Levetiracetam classification

Piperazine → high potency → ↑ EPS

Examples: Fluphenazine, Trifluoperazine

Brand names that may sound unfamiliar

Fluphenazine → Prolixin

Trifluoperazine → Stelazine

Perphenazine → Trilafon

Thioridazine → Mellaril

Antipsychotics classifications

Metabolic acidosis: ↓ HCO₃⁻ → ↓ pH

Metabolic alkalosis: ↑ HCO₃⁻ → ↑ pH

Metabolic alkalosis vs metabolic acidosis

vasodilator

Hydralazine use

Skeletal muscle

Which of the following parts is associated with statins?

Dextromethorphan

Which type of antitussive suppresses cough by acting on the cough center in the brain?

carbocisteine

Which of the following is a mucolytic

inhibits protein synthesis

Clindamycin MOA -

warfarin

Which of the following enters the placenta

human insulin

Which of the following is produced first by recombinant DNA

DMII

Non-insulin dependent diabetes mellitus

Preferred in pregnancy =

High molecular weight + high protein binding + low lipid solubility

Madaming lumabas sa which of the following properties is preferred para sa mga buntis (morse type) 2 or 3 questions

Carbamazepine

Which of the following causes SLE-like (lupus-like) symptoms

antineoplastic

Examples of drugs:

Cyclophosphamide → hemorrhagic cystitis

Cisplatin → nephrotoxicity + ototoxicity

Methotrexate → DHFR inhibitor

5-FU → thymidylate synthase inhibitor

Doxorubicin → cardiotoxicity

Bleomycin → pulmonary fibrosis

Vincristine → neuropathy

Vinblastine → myelosuppression

Paclitaxel → stabilizes microtubules

Tamoxifen → SERM

Trastuzumab → HER2

Imatinib → BCR-ABL

Classification of anticancer drugs

smoking cessation

Bupropion is used for

I. Active metabolites are formed

III. Parent drug is a prodrug that requires activation by the DME

Pharmacokinetic variations in Drug Metabolizing Enzymes are considered significant if

I. Active metabolites are formed

II. The drug has a very wide margin of safety

III. Parent drug is a prodrug that requires activation by the DME

BCS category

metoprolol, paracetamol /acetaminophen ang lumabas 2 questions

B. Passive diffusion

Transdermal drug absorption occurs primarily through which process?

A. Active process

B. passive diffusion

C. Both

D. osmosis

contrast media

Use of barium sulfate

folic acid

Spina bifida is attributed to what type of vitamin

nephrotoxic (nakakalito to may choice na nephro and oto but nephro sagot)

Gentamicin

taken orally

Mebendazole

H2 blocker

Cimetidine MOA

copper poisoning

Wilson’s disease

mannitol

Used for intracranial pressure

Diffusion - moving of solute from HIGH conc to low conc.

“Solute moves down its concentration gradient.”

Osmosis - moving of Solvent from LOW conc to high conc across a semipermeable membrane

“Water follows solute.”

Diffusion = SOLUTE

Osmosis = WATER

Osmosis vs diffusion – 2 questions definitions

carvedilol

Mixed acting beta blocker and alpha blocker

semaglutide

Which of the following causes weight loss?

alpha glucosidase inhibitor

MOA of acarbose

increased absorption

Griseofulvin and fatty food

leucovorin

Antidote of Methotrexate poisoning

flumazenil

Antidote for BDZ poisoning

dipyridamole

Which of the following is an antiplatelet

dexamethasone

Steroid that has the lowest salt retention property

hyPOkalemia

Toxicity of digoxin is aggravated by what condition?

A. Irbesartan (irBESTsartan)

Which of the following angiotensin II receptors blockers has the greatest bioavailability?

A. Irbesartan (irBESTsartan)

B. Losartan

C. Candersartan

D. Olmesartan

Calcium channel blocker

MOA of verapamil

Lovastatin

First ever statin

used for rare conditions

Orphan drug definition

Regular insulin

The only insulin approved for intravenous use

intrathecal

Methotrexate ROA

quinolones

Nalidixic acid classification

I. High serum creatinine

III. High BUN

Indicator of renal damage – hindi nakamorse type pero same choices

I. High serum creatinine

II. Low serum creatinine

III. High BUN

IV. Low BUN