Clinical pharmacology and prescribing
Safe prescribing, drug interactions, therapeutic drug monitoring and adverse effects. Australian drug names, scheduling and pregnancy categories differ from India.
High-yield points
Australia uses international non-proprietary names: adrenaline, paracetamol, salbutamol, glyceryl trinitrate, and newer spellings like furosemide, lidocaine and cefalexin.
Scheduling: S2 pharmacy medicine, S3 pharmacist only, S4 prescription only, S8 controlled drug (opioids, stimulants).
TGA pregnancy categories: A (safe), B1-B3, C, D, X. ACE inhibitors, isotretinoin, warfarin and valproate are classic ones to avoid.
Therapeutic monitoring: lithium, digoxin, gentamicin, vancomycin, phenytoin, and INR for warfarin.
Classic interactions: warfarin with many antibiotics; clarithromycin/erythromycin (CYP3A4) with statins; SSRIs with tramadol (serotonin syndrome); triple whammy (ACE inhibitor/ARB + diuretic + NSAID) causing AKI.
Opioid prescribing: use the lowest dose for the shortest time; check real-time prescription monitoring before prescribing S8s.
Report adverse drug reactions to the TGA.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Drug availability | Nimesulide, metamizole and many fixed-dose combinations are widely used. | Not available. Learn Australian names, e.g. paracetamol, adrenaline, frusemide/furosemide, glyceryl trinitrate. Check eTG and AMH. |
| Over-the-counter access | Antibiotics and many prescription drugs are often bought without a script. | Strict scheduling (S2, S3, S4, S8). Antibiotics are prescription only; codeine has been prescription-only since 2018. |
| Prescribing | Brand names are common on prescriptions. | Prescribe by active ingredient; pharmacists may substitute brands. PBS subsidy, some needing authority approval. |
| Opioids and S8 drugs | Tightly restricted under the NDPS Act, often under-prescribed. | Check real-time prescription monitoring before prescribing S8 drugs; rules and permits vary by state. |
Drug availability
India (MBBS)
Nimesulide, metamizole and many fixed-dose combinations are widely used.
Australia (AMC): what the exam expects
Not available. Learn Australian names, e.g. paracetamol, adrenaline, frusemide/furosemide, glyceryl trinitrate. Check eTG and AMH.
Over-the-counter access
India (MBBS)
Antibiotics and many prescription drugs are often bought without a script.
Australia (AMC): what the exam expects
Strict scheduling (S2, S3, S4, S8). Antibiotics are prescription only; codeine has been prescription-only since 2018.
Prescribing
India (MBBS)
Brand names are common on prescriptions.
Australia (AMC): what the exam expects
Prescribe by active ingredient; pharmacists may substitute brands. PBS subsidy, some needing authority approval.
Opioids and S8 drugs
India (MBBS)
Tightly restricted under the NDPS Act, often under-prescribed.
Australia (AMC): what the exam expects
Check real-time prescription monitoring before prescribing S8 drugs; rules and permits vary by state.
The Australian context
Many Indian drugs and fixed-dose combinations are not available in Australia (for example nimesulide and metamizole). Codeine has been prescription-only since 2018. Scripts must be written by active ingredient, and pharmacists can substitute an equivalent brand unless the prescriber marks otherwise. Always check eTG and the Australian Medicines Handbook (AMH).