NBME Pharmacology Exam Preparatory Guide
2025/2026: Comprehensive Question Bank
with Verified Detailed Solutions for First-
Attempt Success and Avoiding Resits
Direct-Acting Beta Agonists -
ANSWER//Dobutamine- B1 agonists treats heart
failure Isoproterenol- nonselective B agonists
Albuterol, metaproterenol- B2 agonists creates
bronchodilation Mixed Direct and indirect
sympathomimetics effects - ANSWER//Effects will
mimic SNS control Mixed Direct and indirect
sympathomimetics - ANSWER//Amphetamine- used
for ADHD, narcolepsy, (obesity) Ephedrine
Pseudoephedrine- selective for alpha used for nasal
decongestion Indirect acting sympathomimetic -
ANSWER//cocaine- stimulates NE release and
blocks NE and epinephrine reuptake Nonselective
Alpha Antagonists - ANSWER//Phenoxybenzamine-
irreversible inhibitor used to treat a tumor cell before
it can be removed Phentolamine- past use for
hypertensive crisis Alpha 1 Antagonists effect -
ANSWER//blocks vasoconstriction used for
hypertension and BPH Alpha 1 Antagonists -
ANSWER//Prazosin- hypertension Terazosin-
Hypertension and BPH Tamsulosin- BPH Beta 1
Antagonists effect - ANSWER//cardioselective
treats hypertension and other heart related issues
Beta 1 Antagonists - ANSWER//Acebutolol Atenolol
Betaxolol Esmolol Metoprolol Non selective B
antagnonists - ANSWER//Nadolol Pindolol
Propranolol Timolol Mixed Beta and Alpha 1
antagnonists - ANSWER//Carvedilol Labetalol More
,effective at treating hypertension Major beta blocker
adverse effects - ANSWER//Bradycardia
Bronchoconstriction- (use cardioselective) Heart
failure Fatigue Sexual dysfunction Dyslipidemia low
HDL high LDL and tryglycerides Delayed recovery
from hypoglycemia in diabetics on hypoglycemic
drugs Masks symptoms of hypoglycemia in
diabetics on hypoglycemic drugs NSAIDs and beta
blockers - ANSWER//NSAIDs can impair BP
lowering effects Cholinesterase inhibitor poisoning
(Acetylcholinesterase inhibitors) - ANSWER//SLUD-
BBAM Acetaminophen antidote - ANSWER//N-
acetylcystine (replenishes glutathione) AChE
inhibitor, organophosphate antidote -
ANSWER//atrophiine, pralidoxime Carbon
monoxide antidote - ANSWER//O2 Iron antidote -
ANSWER//Deferoxamine Methemoglobin antidote -
ANSWER//Methylene blue, Vitamin C Opioid
antidote - ANSWER//Naloxone Warfarin antidote -
ANSWER//Vitamin K Amphetamine antidote -
ANSWER//NH4CL Antimuscarinic, anticholinergic
agent antidote - ANSWER//Phygostigmine
salicylate Benzodiazepine antidote -
ANSWER//Flumazenil B-blocker antidote -
ANSWER//Glucagon Copper, arsenic, gold antidote
- ANSWER//penicillaimine Cyanide antidote -
ANSWER//Nitrite + thiosulfate, hydroxycobalamin
Digoxin antidote - ANSWER//Fab fragments
Heparin antidote - ANSWER//Protamine sulfate
Lead antidote - ANSWER//EDTA, dimercaprolol,
succimer, penicillamine Mercury, artsenic, gold
antidote - ANSWER//Dimercaprol (BAL), succimer
Methanol, ethylene glycol (antifreeze) -
,ANSWER//Fomeprizole > ethanol, dialysis
Salicylates (Asprin) - ANSWER//NaHCO3
(alkalinize urine), dialysis TCAs -
ANSWER//NaHCO3 (plasma alkalinization)
tachycardia, hypertension, fever, delirium, seizures,
psychosis, mydriasis, dry hot skin, urinary
rentention - ANSWER//Anticholinergic toxidrome
Anticholinergic type drugs -
ANSWER//antidepressants, muscle relaxants,
antihistamines, jimson weed bradycardia, seizures,
muscle paralysis, miosis, teary eyes, sweaty,
salivation, diarrhea - ANSWER//Cholinergic
Toxidrome Cholinergic type drugs -
ANSWER//Organophosphates hypothermia,
bradycardia, hypotension, bradypea,
lethargy/hyporeflexia, miosis, constipation -
ANSWER//Opioid Toxidrome fever, tachycardia,
hypertension, delirium, seizures, mydriasis, sweaty
skin, diarrhea - ANSWER//Sympathomimetic
Toxidrome Sympathomimetic type drugs -
ANSWER//stimulants, including cold preps, molly
and spice Inhibits Na+ channel, used to treat
seizures and arrhythmia, has zero orderkinetics -
ANSWER//Phenytoin CYP2C9 substrate, inhibits
vitamin K clotting factors - ANSWER//Warfarin
Which enzyme metabolizes statins, analgesics,
antidepressants, antipsychotics, anti-cancer drugs,
Beta-adrenergic blockers, and codine -
ANSWER//CYP2D6 Used for TB treatment, is
metabolized by NAT, can bind to B6 causing
peripheral neuropathy - ANSWER//Isoniazid
Mutation in this enzyme causes favism, it produces
glutathion that detoxifies reactive species, problems
, with this enzyme lead to hemolysis and formation of
heinz bodies - ANSWER//G6PD in the innume
system it works to identify what is from t he body or
is foreign, mutations can lead to misidentification of
foreign substances - ANSWER//Human leukocyte
antigens (HLAs) Phenytoin metabolizing enzyme -
ANSWER//CYP2C9 Codine metabolizing enzyme -
ANSWER//CYP2D6 6-mercaptopurine, thioguanine,
azathioprine metabolizing enzyme -
ANSWER//TPMT Warfarin metabolizing enzymes -
ANSWER//CYP2C9, VKORC1 Rasburicase and
sulfamethoxone metabolizing enzyme -
ANSWER//G6PD Abacavir, carbamazepine
metabolizing enzyme - ANSWER//HLA Essential
frutosuria enzyme deficiency and symptoms -
ANSWER//Fructokinase Accumulation of fructose in
blood and urine Fructose intolerance enzyme
deficiency - ANSWER//Aldolase B Overall failure to
thrive, accumulation offructose 1-phosphate in liver
Galactokinase deficiency enzyme and symptoms -
ANSWER//Galactokinase deficiency Accymulation
of galactitol infantile cataracts Galactosemia
enzyme deficiency and symptoms -
ANSWER//Galactose 1-phosphate uridyltransferase
Accumulation of galactose 1-phosphate and
galactitol overall failure to thrive Pyruvate kinase
deficiency symptoms - ANSWER//hemolytic anemia
G6PD symptoms - ANSWER//hemolytic anemia
and heinz body formation Beriberi and Wernicke-
Korsakoff syndrome enzyme deficiency and
symptoms - ANSWER//Needs thiamine Riboflavin
Deficiency symptoms - ANSWER//cheilosis- lip
corners cracking Niacin deficiency -
2025/2026: Comprehensive Question Bank
with Verified Detailed Solutions for First-
Attempt Success and Avoiding Resits
Direct-Acting Beta Agonists -
ANSWER//Dobutamine- B1 agonists treats heart
failure Isoproterenol- nonselective B agonists
Albuterol, metaproterenol- B2 agonists creates
bronchodilation Mixed Direct and indirect
sympathomimetics effects - ANSWER//Effects will
mimic SNS control Mixed Direct and indirect
sympathomimetics - ANSWER//Amphetamine- used
for ADHD, narcolepsy, (obesity) Ephedrine
Pseudoephedrine- selective for alpha used for nasal
decongestion Indirect acting sympathomimetic -
ANSWER//cocaine- stimulates NE release and
blocks NE and epinephrine reuptake Nonselective
Alpha Antagonists - ANSWER//Phenoxybenzamine-
irreversible inhibitor used to treat a tumor cell before
it can be removed Phentolamine- past use for
hypertensive crisis Alpha 1 Antagonists effect -
ANSWER//blocks vasoconstriction used for
hypertension and BPH Alpha 1 Antagonists -
ANSWER//Prazosin- hypertension Terazosin-
Hypertension and BPH Tamsulosin- BPH Beta 1
Antagonists effect - ANSWER//cardioselective
treats hypertension and other heart related issues
Beta 1 Antagonists - ANSWER//Acebutolol Atenolol
Betaxolol Esmolol Metoprolol Non selective B
antagnonists - ANSWER//Nadolol Pindolol
Propranolol Timolol Mixed Beta and Alpha 1
antagnonists - ANSWER//Carvedilol Labetalol More
,effective at treating hypertension Major beta blocker
adverse effects - ANSWER//Bradycardia
Bronchoconstriction- (use cardioselective) Heart
failure Fatigue Sexual dysfunction Dyslipidemia low
HDL high LDL and tryglycerides Delayed recovery
from hypoglycemia in diabetics on hypoglycemic
drugs Masks symptoms of hypoglycemia in
diabetics on hypoglycemic drugs NSAIDs and beta
blockers - ANSWER//NSAIDs can impair BP
lowering effects Cholinesterase inhibitor poisoning
(Acetylcholinesterase inhibitors) - ANSWER//SLUD-
BBAM Acetaminophen antidote - ANSWER//N-
acetylcystine (replenishes glutathione) AChE
inhibitor, organophosphate antidote -
ANSWER//atrophiine, pralidoxime Carbon
monoxide antidote - ANSWER//O2 Iron antidote -
ANSWER//Deferoxamine Methemoglobin antidote -
ANSWER//Methylene blue, Vitamin C Opioid
antidote - ANSWER//Naloxone Warfarin antidote -
ANSWER//Vitamin K Amphetamine antidote -
ANSWER//NH4CL Antimuscarinic, anticholinergic
agent antidote - ANSWER//Phygostigmine
salicylate Benzodiazepine antidote -
ANSWER//Flumazenil B-blocker antidote -
ANSWER//Glucagon Copper, arsenic, gold antidote
- ANSWER//penicillaimine Cyanide antidote -
ANSWER//Nitrite + thiosulfate, hydroxycobalamin
Digoxin antidote - ANSWER//Fab fragments
Heparin antidote - ANSWER//Protamine sulfate
Lead antidote - ANSWER//EDTA, dimercaprolol,
succimer, penicillamine Mercury, artsenic, gold
antidote - ANSWER//Dimercaprol (BAL), succimer
Methanol, ethylene glycol (antifreeze) -
,ANSWER//Fomeprizole > ethanol, dialysis
Salicylates (Asprin) - ANSWER//NaHCO3
(alkalinize urine), dialysis TCAs -
ANSWER//NaHCO3 (plasma alkalinization)
tachycardia, hypertension, fever, delirium, seizures,
psychosis, mydriasis, dry hot skin, urinary
rentention - ANSWER//Anticholinergic toxidrome
Anticholinergic type drugs -
ANSWER//antidepressants, muscle relaxants,
antihistamines, jimson weed bradycardia, seizures,
muscle paralysis, miosis, teary eyes, sweaty,
salivation, diarrhea - ANSWER//Cholinergic
Toxidrome Cholinergic type drugs -
ANSWER//Organophosphates hypothermia,
bradycardia, hypotension, bradypea,
lethargy/hyporeflexia, miosis, constipation -
ANSWER//Opioid Toxidrome fever, tachycardia,
hypertension, delirium, seizures, mydriasis, sweaty
skin, diarrhea - ANSWER//Sympathomimetic
Toxidrome Sympathomimetic type drugs -
ANSWER//stimulants, including cold preps, molly
and spice Inhibits Na+ channel, used to treat
seizures and arrhythmia, has zero orderkinetics -
ANSWER//Phenytoin CYP2C9 substrate, inhibits
vitamin K clotting factors - ANSWER//Warfarin
Which enzyme metabolizes statins, analgesics,
antidepressants, antipsychotics, anti-cancer drugs,
Beta-adrenergic blockers, and codine -
ANSWER//CYP2D6 Used for TB treatment, is
metabolized by NAT, can bind to B6 causing
peripheral neuropathy - ANSWER//Isoniazid
Mutation in this enzyme causes favism, it produces
glutathion that detoxifies reactive species, problems
, with this enzyme lead to hemolysis and formation of
heinz bodies - ANSWER//G6PD in the innume
system it works to identify what is from t he body or
is foreign, mutations can lead to misidentification of
foreign substances - ANSWER//Human leukocyte
antigens (HLAs) Phenytoin metabolizing enzyme -
ANSWER//CYP2C9 Codine metabolizing enzyme -
ANSWER//CYP2D6 6-mercaptopurine, thioguanine,
azathioprine metabolizing enzyme -
ANSWER//TPMT Warfarin metabolizing enzymes -
ANSWER//CYP2C9, VKORC1 Rasburicase and
sulfamethoxone metabolizing enzyme -
ANSWER//G6PD Abacavir, carbamazepine
metabolizing enzyme - ANSWER//HLA Essential
frutosuria enzyme deficiency and symptoms -
ANSWER//Fructokinase Accumulation of fructose in
blood and urine Fructose intolerance enzyme
deficiency - ANSWER//Aldolase B Overall failure to
thrive, accumulation offructose 1-phosphate in liver
Galactokinase deficiency enzyme and symptoms -
ANSWER//Galactokinase deficiency Accymulation
of galactitol infantile cataracts Galactosemia
enzyme deficiency and symptoms -
ANSWER//Galactose 1-phosphate uridyltransferase
Accumulation of galactose 1-phosphate and
galactitol overall failure to thrive Pyruvate kinase
deficiency symptoms - ANSWER//hemolytic anemia
G6PD symptoms - ANSWER//hemolytic anemia
and heinz body formation Beriberi and Wernicke-
Korsakoff syndrome enzyme deficiency and
symptoms - ANSWER//Needs thiamine Riboflavin
Deficiency symptoms - ANSWER//cheilosis- lip
corners cracking Niacin deficiency -
