It doesn't matter who goes first, Zombie. The game's already decided which is going to win, and the cakes, kunais and whatnot that get tossed around are just to build the suspense.
Don't let the One Pill axiom cloud common sense, boys and girls. If your Brandon is going up against an enemy Aldo and both clan bonuses are in effect, you're already at double his base of 4. 4+8(Junkz bonus)-12, min. 8 (Montanas bonus). Add one pill, or even two, and you're not actually changing your attack at all.
On the other hand, just because your opponent is at two health and your Mario (again, with Clan bonus) has 1.5 times the power of your pilless opponent's Tank doesn't mean you should save your last pill to improve your score. I don't care what the official odds on her winning are, it's a total coin flip on if your saving that pill will cost you the KO-and with her 5 damage, it might cost you your win completely. Especially when it's anybody's game on that last round, try to ensure a Sure Shot.
I don't really agree with this strategy, i've tried using it, i really did, you can never be sure to know if that card has any pills or none at all so i just usually use a strong card against a weak card with no pills. and the damage goes through, though then if i'm wrong i lost my strong card but it doesn't usually affect my game because when someone pills they either pill pretty high or none at all. (when i say high, 4-5 pills, for 2-4 damage.