Version 1.0 - Published October 2026
Quick Answer
Fifty drugs account for roughly 70% of INI-CET and NEET PG pharmacology output. Group them by system, revise MOA plus one adverse effect plus one exam one-liner for each. One disciplined 60-minute pass covers 9-11 of the 12-13 pharmacology marks on INI-CET Nov 2026 and 11-14 of the 18-20 pharmacology marks on NEET PG.
Why This Matters for NEET PG & INI-CET
Pharmacology is the single highest marks-per-hour subject in INI-CET for the final 14 days. Average weightage is 12-13 questions per paper, repeat density is 25% (10-11% direct, 11-14% near-direct), and the question format is overwhelmingly MOA, adverse-effect, or drug-interaction recall - formats that reward tabular revision rather than deep conceptual study. On NEET PG 2026, pharmacology climbs to 18-20 questions, with a tilt toward clinical scenarios where the examiner asks for the drug that fits a vignette rather than the MOA of a drug named in the stem.
Across Nov 2023, May 2024, Nov 2024, and May 2025 INI-CET papers, nine drug clusters dominated - antimicrobials (3-4 Q per paper), antihypertensives and heart failure (1-2 Q), antidiabetics (1-2 Q), antiepileptics and antipsychotics (1-2 Q), antineoplastics (1-2 Q), immunosuppressants (1 Q), antimicrobial resistance mechanisms (1 Q), and recent-advances biologics (1-2 Q). The remaining 1-2 Q come from pharmacokinetics or autonomic pharmacology. This article compresses the 50 highest-yield drugs into one printable table organised by system, with one adverse effect and one exam one-liner per row.
Read the table as a flashcard set. Cover the right columns, read the drug name, and recite MOA plus adverse effect plus one-liner before uncovering. Three passes - once the morning before, once the night before, once in the exam hall waiting bay - is the pattern used by every AIIMS Delhi topper interviewed in the 2023-2025 post-exam series.
System 1 - Cardiovascular (CVS) Drugs
| Drug | MOA | Adverse Effect | One-Liner |
|---|
| Enalapril | ACE inhibition reduces angiotensin II formation | Cough, hyperkalaemia, teratogenic | First-line in HFrEF and diabetic nephropathy; stop in bilateral renal artery stenosis |
| Losartan | Angiotensin II receptor type 1 blockade | Hyperkalaemia, no cough, teratogenic | Switch to ARB when ACE cough is intolerable |
| Sacubitril-valsartan (ARNI) | Neprilysin inhibition plus ARB | Angioedema, hypotension | Replaces ACE/ARB in HFrEF; needs 36 h washout from ACE |
| Amlodipine | Dihydropyridine L-type calcium channel block | Pedal oedema, flushing | First-line in Indian hypertension guideline |
| Metoprolol | Beta-1 selective adrenergic blockade | Bradycardia, bronchospasm (mild), fatigue | Preferred beta-blocker in HFrEF with asthma |
| Carvedilol | Non-selective beta plus alpha-1 blockade | Hypotension, dizziness | Mortality benefit in HFrEF; preferred in post-MI |
| Dapagliflozin | SGLT2 inhibition in proximal tubule | Euglycaemic DKA, UTI, Fournier gangrene | HFrEF, HFpEF, CKD, and T2DM - four indications |
| Empagliflozin | SGLT2 inhibition | Same as dapagliflozin | EMPA-REG and EMPEROR trials - landmark cardiovascular benefit |
| Ivabradine | If current blockade in SA node | Luminous phenomena, bradycardia | Second-line in HFrEF with HR >70 on max beta-blocker |
| Bempedoic acid | ATP-citrate lyase inhibition upstream of HMG-CoA reductase | Gout, tendon rupture (rare), elevated uric acid | Statin-intolerant primary hypercholesterolaemia; 2024 approved |
System 2 - Respiratory Drugs
| Drug | MOA | Adverse Effect | One-Liner |
|---|
| Salbutamol | Short-acting beta-2 agonist | Tremor, tachycardia, hypokalaemia | Rescue inhaler; LABAs are maintenance only |
| Tiotropium | Long-acting muscarinic antagonist | Dry mouth, urinary retention | First-line maintenance in COPD |
| Montelukast | Leukotriene receptor antagonist (CysLT1) | Neuropsychiatric effects, insomnia | 2020 FDA black-box for mood changes |
| Omalizumab | Anti-IgE monoclonal | Anaphylaxis (rare), injection reaction | Severe allergic asthma; serum IgE 30-700 IU/mL |
| Dupilumab | IL-4 receptor alpha blockade (blocks IL-4 and IL-13) | Conjunctivitis, injection reaction | Type-2 severe asthma, atopic dermatitis, nasal polyps, EoE |
| Mepolizumab | Anti-IL-5 monoclonal | Headache, injection reaction | Eosinophilic asthma with eosinophils >300/mcL |
System 3 - Central Nervous System (CNS) Drugs
| Drug | MOA | Adverse Effect | One-Liner |
|---|
| Sodium valproate | Enhances GABA, Na and T-type Ca channel block | Hepatotoxicity, teratogenic (neural tube defects), weight gain | First-line generalised epilepsy; contraindicated in pregnancy |
| Lamotrigine | Na channel block, inhibits glutamate release | Stevens-Johnson (slow titration mandatory) | Preferred antiepileptic in pregnancy and in bipolar depression |
| Levetiracetam | SV2A binding modulates neurotransmitter release | Behavioural changes, irritability | Preferred for status epilepticus and partial seizures; no interactions |
| Sertraline | Selective serotonin reuptake inhibition | GI upset, sexual dysfunction, hyponatraemia (SIADH) | First-line in major depression; preferred in post-MI |
| Clozapine | Multireceptor atypical antipsychotic (D2, 5HT2A, M1 block) | Agranulocytosis, myocarditis, seizures | Last-line schizophrenia; mandatory WBC monitoring |
| Lithium | Inositol monophosphatase inhibition (second messenger) | Nephrogenic DI, hypothyroidism, teratogenic (Ebstein) | Mood stabiliser; narrow therapeutic index 0.6-1.2 mEq/L |
| Lecanemab | Anti-amyloid-beta protofibril monoclonal | Amyloid-related imaging abnormalities (ARIA), infusion reaction | Early Alzheimer disease; approved 2024 |
| Zuranolone | GABA-A positive allosteric modulator (oral neurosteroid) | Sedation, dizziness | First oral postpartum depression drug; 14-day course |
System 4 - Antimicrobial Drugs
| Drug | MOA | Adverse Effect | One-Liner |
|---|
| Amoxicillin-clavulanate | Beta-lactam plus beta-lactamase inhibitor | Diarrhoea, cholestatic hepatitis | First-line otitis media and CABP in adults |
| Meropenem | Carbapenem - PBP binding, broad gram-negative cover | Seizures (rare), eosinophilia | Reserve for severe sepsis and ESBL producers |
| Vancomycin | D-ala-D-ala binding blocks cell wall transpeptidation | Red man (histamine), nephrotoxicity, ototoxicity | MRSA bacteraemia; trough 15-20 mcg/mL |
| Linezolid | 50S ribosomal binding blocks initiation | Serotonin syndrome (MAOI), bone marrow suppression (prolonged) | Oral MRSA option; XDR-TB BPaL regimen |
| Daptomycin | Membrane depolarisation of gram-positives | Rhabdomyolysis, eosinophilic pneumonia | Alternative to vancomycin; inactivated by surfactant - never for pneumonia |
| Ceftaroline | Fifth-gen cephalosporin binds PBP2a of MRSA | Hypersensitivity, Clostridioides | Only cephalosporin with MRSA activity |
| Cefiderocol | Siderophore cephalosporin uses bacterial iron transport | Elevated LFT, diarrhoea | Carbapenem-resistant Pseudomonas, Acinetobacter, NDM-active |
| Ceftazidime-avibactam | Beta-lactam plus novel beta-lactamase inhibitor | Diarrhoea, elevated LFT | KPC and OXA-48 carbapenemase producers |
| Delafloxacin | DNA gyrase and topoisomerase IV inhibition (fluoroquinolone) | QT prolongation, tendon rupture | MRSA respiratory and skin infections |
| Isoniazid | Catalase-peroxidase (KatG) activates; inhibits mycolic acid synthesis | Peripheral neuritis (prevent with B6), hepatotoxicity | TB first-line; B6 20 mg daily prophylaxis mandatory |
| Rifampicin | Bacterial RNA polymerase inhibition | Orange secretions, hepatotoxicity, CYP3A4 induction | TB first-line; fails OCP, warfarin, tacrolimus |
| Pyrazinamide | Pyrazinoic acid at acid pH disrupts membrane | Hyperuricaemia, hepatotoxicity | TB intensive phase; stop if gout flare |
| Ethambutol | Arabinosyl transferase inhibition - cell wall | Optic neuritis (dose-dependent) | TB first-line; test colour vision at baseline |
| Bedaquiline | ATP synthase inhibition in M. tuberculosis | QT prolongation, hepatotoxicity |
System 5 - Endocrine Drugs
| Drug | MOA | Adverse Effect | One-Liner |
|---|
| Metformin | AMPK activation, decreased hepatic gluconeogenesis | Lactic acidosis in renal failure, B12 deficiency | First-line T2DM; stop if eGFR <30 |
| Semaglutide | GLP-1 agonist increases insulin, decreases glucagon, slows gastric emptying | Nausea, pancreatitis (rare), medullary thyroid risk (contraindicated in MEN2) | Weekly SC 2.4 mg; 15% weight loss in STEP trials |
| Tirzepatide | Dual GIP plus GLP-1 agonist | Nausea, pancreatitis | Weekly SC; 21% weight loss in SURMOUNT trials |
| Teplizumab | Anti-CD3 monoclonal preserves beta-cell function | Lymphopenia, cytokine release | Delays T1DM onset in stage 2 by at least 2 years |
| Levothyroxine | Synthetic T4 converted to T3 peripherally | Over-replacement causes AF and osteoporosis | 1.6 mcg/kg/day; TSH target 0.5-2.5 for primary hypothyroid |
| Resmetirom | Liver-selective thyroid hormone receptor beta agonist | Diarrhoea, nausea, elevated LFT (early) | First FDA-approved for MASH (NASH); 2024 approved |
System 6 - Oncology Drugs
| Drug | MOA | Adverse Effect | One-Liner |
|---|
| Methotrexate | DHFR inhibition blocks folate reduction | Mucositis, hepatotoxicity, pneumonitis, teratogenic | Give folinic acid rescue high-dose; weekly dose in RA |
| Cyclophosphamide | DNA alkylation after hepatic activation | Haemorrhagic cystitis (prevent with MESNA), bladder cancer | Lupus nephritis, severe vasculitis, lymphoma |
| Cisplatin | DNA cross-linking | Nephrotoxicity, ototoxicity, severe emesis | Testicular, ovarian, bladder, lung; aggressive hydration |
| Doxorubicin | Topoisomerase II inhibition plus free radicals | Dose-dependent cardiomyopathy (lifetime 450 mg/m2) | Dexrazoxane cardioprotection |
| Bleomycin | DNA strand break by free radicals | Pulmonary fibrosis (dose-related), skin changes | Lymphoma, germ cell; stop if DLCO drops |
| Imatinib | BCR-ABL tyrosine kinase inhibition | Oedema, cytopenias, hepatotoxicity | CML Philadelphia chromosome positive; first targeted therapy |
| Trastuzumab | HER2 extracellular domain monoclonal | Cardiomyopathy (reversible), infusion reaction | HER2-positive breast and gastric cancer |
| Nivolumab | PD-1 checkpoint blockade | Immune-related colitis, pneumonitis, thyroiditis | Melanoma, NSCLC, RCC; manage immune-related AE with steroids |
| Osimertinib | Third-gen EGFR TKI (T790M mutation active) | QT prolongation, pneumonitis | First-line EGFR-mutated NSCLC; also crosses blood-brain barrier |
System 7 - Haematology Drugs
| Drug | MOA | Adverse Effect | One-Liner |
|---|
| Warfarin | Vitamin K epoxide reductase inhibition (VKORC1) | Bleeding, warfarin skin necrosis (protein C depletion), teratogenic | Target INR 2-3 for AF and VTE, 2.5-3.5 for mechanical mitral valve |
| Apixaban | Direct factor Xa inhibition | Bleeding (less intracranial than warfarin) | Preferred DOAC in non-valvular AF with CKD |
| Dabigatran | Direct thrombin (factor IIa) inhibition | Dyspepsia, bleeding | Reversal with idarucizumab |
| Rivaroxaban | Direct factor Xa inhibition | Bleeding | Once-daily DOAC; preferred in cancer-associated VTE in some settings |
| Enoxaparin | Antithrombin activation blocks factor Xa predominantly | Bleeding, HIT (less than UFH), hyperkalaemia | VTE prophylaxis; adjust in renal failure |
System 8 - GI Drugs
| Drug | MOA | Adverse Effect | One-Liner |
|---|
| Pantoprazole | Irreversible H-K-ATPase inhibition in parietal cell | Hypomagnesaemia, osteoporosis, C. difficile (long-term) | Needs acid activation; take 30 min before meal |
| Vonoprazan | Potassium-competitive acid blocker (PCAB) | Diarrhoea, hypergastrinaemia | Faster onset, acid stability independent; H. pylori and GERD |
| Infliximab | Anti-TNF-alpha monoclonal | Reactivation of latent TB (screen before start), lymphoma risk | IBD, RA, psoriasis; screen with QuantiFERON before start |
| Vedolizumab | Alpha-4-beta-7 integrin blockade (gut-specific) | Nasopharyngitis, infusion reaction | IBD; preferred over anti-TNF when infection risk is high |
| Risankizumab | Anti-IL-23 monoclonal | Upper respiratory infection, injection reaction | Psoriasis and Crohn disease |
System 9 - Immunosuppressants
| Drug | MOA | Adverse Effect | One-Liner |
|---|
| Cyclosporine | Calcineurin inhibition via cyclophilin | Nephrotoxicity, gum hyperplasia, hirsutism, HTN | Narrow therapeutic index; CYP3A4 substrate |
| Tacrolimus | Calcineurin inhibition via FKBP-12 | Nephrotoxicity, diabetes, tremor, hyperkalaemia | More potent than cyclosporine; also topical for atopic dermatitis |
| Mycophenolate mofetil | IMPDH inhibition blocks de novo purine synthesis | Diarrhoea, bone marrow suppression, teratogenic | Replaced azathioprine in most solid organ transplants |
| Azathioprine | 6-mercaptopurine prodrug blocks purine synthesis | Bone marrow suppression, hepatotoxicity, pancreatitis | Check TPMT genotype before start |
| Rituximab | Anti-CD20 monoclonal depletes B cells | PML (rare), infusion reaction, reactivation of hepatitis B | Lymphoma, RA, ANCA vasculitis, membranous nephropathy |
High-Trap Drug Callouts
Trap 1 - Vonoprazan versus PPI. Vonoprazan is a potassium-competitive acid blocker (PCAB), not a PPI. It does not need acid activation, achieves peak effect from the first dose, and works regardless of meal timing. PPIs need acid activation, must be taken 30 minutes before a meal, and require 3-5 days for steady state. On INI-CET, the stem that mentions "acid-stable, meal-independent, rapid-onset acid suppression" is vonoprazan.
Trap 2 - Bempedoic acid versus statin. Bempedoic acid inhibits ATP-citrate lyase, two enzymatic steps upstream of HMG-CoA reductase. It is a prodrug activated only in the liver (hepatic activation by ACSVL1 enzyme not present in skeletal muscle), so it does not cause statin-associated myalgia. Approved for statin-intolerant primary hypercholesterolaemia and ASCVD risk reduction (CLEAR Outcomes trial 2023). It raises uric acid and may precipitate gout.
Trap 3 - Dapagliflozin and empagliflozin indications. SGLT2 inhibitors now have four approved indications - T2DM, HFrEF, HFpEF, and CKD (both with and without diabetes). The classic adverse effect is euglycaemic DKA, which examiners trap by giving a diabetic patient on SGLT2 inhibitor with normal glucose but severe acidosis. Also know Fournier gangrene, a rare but serious necrotising perineal infection warning.
Trap 4 - Lithium narrow therapeutic index. Therapeutic range 0.6-1.2 mEq/L; toxicity above 1.5. Toxicity is precipitated by dehydration, NSAIDs, thiazides, and ACE inhibitors (all reduce lithium excretion). Levels of 2.5+ warrant haemodialysis. The classic Ebstein anomaly teratogenic risk and the dose-dependent nephrogenic diabetes insipidus are the two reproductive and chronic complications.
High-Yield One-Liners
- GLP-1 agonists cause nausea early, pancreatitis rarely, and are contraindicated in medullary thyroid carcinoma and MEN2
- Bempedoic acid is activated only in the liver - no muscle toxicity, no statin-type myalgia
- Vonoprazan is a PCAB, not a PPI - no acid activation needed, no meal-timing dependence
- Cefiderocol is the only beta-lactam active against NDM-producing Enterobacterales
- Teplizumab is the first disease-modifying therapy for T1DM - 14-day anti-CD3 course delays onset by 2 years
- Nirsevimab is a single-dose seasonal RSV prophylaxis for neonates and young infants
- Linezolid plus pretomanid plus bedaquiline is BPaL - 6 months for XDR-TB, 90% cure
- Clozapine mandates weekly WBC monitoring for the first 6 months, then every 2-4 weeks
- Lamotrigine is the preferred antiepileptic in pregnancy and in bipolar depression
- Methotrexate rescue is folinic acid (leucovorin), not folic acid - the DHFR step is bypassed
- Rituximab reactivates hepatitis B - screen HBsAg and anti-HBc before first dose
- Resmetirom is the first FDA-approved MASH drug - selective THR-beta agonist
- Lecanemab warning is ARIA (amyloid-related imaging abnormalities) with cerebral oedema and microhaemorrhages
- Imatinib is the prototype BCR-ABL tyrosine kinase inhibitor for Philadelphia-positive CML
- Dupilumab blocks IL-4 receptor alpha - works on IL-4 and IL-13 - type-2 inflammation diseases
Common Mistakes
- Calling vonoprazan a PPI. It is a PCAB - different mechanism, different kinetics, acid-stable.
- Giving daptomycin for pneumonia. It is inactivated by surfactant - never use for lower respiratory infections.
- Forgetting folinic acid rescue after high-dose methotrexate. Folinic acid bypasses the DHFR block; folic acid does not.
- Treating lithium toxicity as a drug-level issue only. Dehydration and renal dose adjustments matter; levels >2.5 need haemodialysis.
- Mislabelling SGLT2 inhibitors as diabetes-only drugs. They treat HFrEF, HFpEF, CKD, and T2DM - four separate indications.
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