I85PREP
⌘ K
TT Pharmacy Registration Exam study materials
TT Pharmacy Registration Exam study resources

TT Pharmacy Registration Exam practice questions

One question at a time. Build your TT Pharmacy Registration Exam understanding.

First 50 of 200 questions. Each one lists the choices, the correct answer, and an explanation. The checker at the top of this page saves progress in this browser when it is available.

Continue in the practice tool above to load more questions, 50 at a time.

Question 1Pharmaceutics and Pharmaceutical Technology

Which excipient is added to a tablet formulation primarily to promote disintegration of the tablet in the gastrointestinal tract?

  1. Glidant
  2. Binder
  3. Colorant
  4. Disintegrant Correct answer.

Explanation

A disintegrant promotes breakup of the tablet into particles when it contacts aqueous fluid, typically by swelling or wicking. Binders promote cohesion, glidants improve powder flow, and colorants serve identification.

Question 2Pharmaceutics and Pharmaceutical Technology

Which route of administration completely bypasses the hepatic first-pass effect for a drug absorbed from that site?

  1. Rectal (upper portion)
  2. Buccal
  3. Intravenous Correct answer.
  4. Oral

Explanation

Drug delivered intravenously enters the systemic circulation directly, so it avoids hepatic first-pass metabolism entirely. Oral and buccal absorption drain into the portal or systemic veins with some presystemic loss, and the upper rectum drains partly to the portal vein.

Question 3Pharmaceutics and Pharmaceutical Technology

A solution is described as saturated when it contains:

  1. No solute at all
  2. Less solute than it can dissolve at that temperature
  3. The maximum solute it can dissolve at that temperature Correct answer.
  4. More solute than it can dissolve at that temperature

Explanation

A saturated solution holds the maximum amount of solute that can dissolve at a given temperature in the presence of undissolved solute. Exceeding this amount yields a supersaturated or two-phase system.

Question 4Pharmaceutics and Pharmaceutical Technology

Which term describes the process by which a drug in solution passes across a biological membrane from a region of higher to lower concentration?

  1. Adsorption
  2. Passive diffusion Correct answer.
  3. Micellization
  4. Complexation

Explanation

Passive diffusion is driven by the concentration gradient across the membrane and requires no energy or carrier. It is the most common mechanism for absorption of small lipophilic drug molecules.

Question 5Pharmaceutics and Pharmaceutical Technology

In the context of pharmaceutical suspensions, what is sedimentation volume (F)?

  1. The rate at which particles settle
  2. The ratio of particle density to vehicle density
  3. The ratio of the volume of sediment to the total suspension volume Correct answer.
  4. The mass of sediment per unit volume

Explanation

Sedimentation volume F is the ratio of the final sediment volume to the original suspension volume. A value near 1 indicates a flocculated system that settles to a large, easily redispersed volume.

Question 6Pharmaceutics and Pharmaceutical Technology

Which unit operation is used to reduce the particle size of a solid by mechanical means such as impact and attrition?

  1. Milling Correct answer.
  2. Distillation
  3. Lyophilization
  4. Filtration

Explanation

Milling applies mechanical forces such as impact, attrition, or shear to break down particles. It is a standard size-reduction operation in pharmaceutical manufacturing.

Question 7Pharmaceutics and Pharmaceutical Technology

Which type of emulsion is formed when water is the internal (dispersed) phase and oil is the continuous phase?

  1. Water-in-oil (w/o) Correct answer.
  2. Multiple emulsion w/o/w
  3. Oil-in-water (o/w)
  4. Microemulsion with equal phases

Explanation

In a water-in-oil emulsion, water droplets are dispersed throughout a continuous oil phase. The first-named phase in the abbreviation denotes the internal phase.

Question 8Pharmaceutics and Pharmaceutical Technology

A drug has a half-life of 6 hours. Assuming first-order elimination, approximately what fraction of the drug remains in the body 18 hours after an intravenous bolus?

  1. One-half
  2. One-eighth Correct answer.
  3. One-quarter
  4. One-sixteenth

Explanation

Eighteen hours corresponds to three half-lives, so the remaining fraction is (1/2)^3 = 1/8. Each half-life halves the amount present.

Question 9Pharmaceutics and Pharmaceutical Technology

A tablet is manufactured by direct compression and shows poor powder flow into the die. Which excipient would most directly improve flow?

  1. Microcrystalline cellulose
  2. Magnesium stearate
  3. Colloidal silicon dioxide Correct answer.
  4. Sodium starch glycolate

Explanation

Colloidal silicon dioxide is a glidant that reduces interparticle friction and improves powder flow. Microcrystalline cellulose acts mainly as a diluent/binder, sodium starch glycolate as a disintegrant, and magnesium stearate as a lubricant.

Question 10Pharmaceutics and Pharmaceutical Technology

A pharmacist prepares a 2% w/w hydrocortisone cream but needs to dispense it as a 0.5% w/w cream. What is the most appropriate method to obtain the desired concentration?

  1. Add more drug to the 2% cream
  2. Add a preservative to the cream
  3. Heat the cream to evaporate water
  4. Dilute the 2% cream with three parts of a compatible base Correct answer.

Explanation

Diluting one part of 2% cream with three parts base yields a 0.5% concentration (2% / 4 = 0.5%). The dilution must use a compatible base to preserve consistency and stability.

Question 11Pharmaceutics and Pharmaceutical Technology

Which factor most increases the rate of drug release from a hydrophilic matrix tablet?

  1. Increasing the polymer molecular weight
  2. Increasing the polymer content
  3. Decreasing the tablet porosity
  4. Increasing the drug solubility in the matrix fluid Correct answer.

Explanation

Higher drug solubility increases the driving force for dissolution and diffusion out of the hydrated matrix. Higher polymer molecular weight, higher polymer content, and lower porosity all slow release.

Question 12Pharmaceutics and Pharmaceutical Technology

A drug has a pKa of 4.5 as a weak acid. At pH 6.5, what is the approximate ratio of ionized to unionized drug?

  1. 1:100
  2. 1:1
  3. 100:1 Correct answer.
  4. 10:1

Explanation

For a weak acid, pH - pKa = log([ionized]/[unionized]). Here 6.5 - 4.5 = 2, so the ratio is 10^2 = 100:1 in favor of the ionized form.

Question 13Pharmaceutics and Pharmaceutical Technology

Which statement best describes the purpose of a coating applied to an enteric tablet?

  1. To mask the taste of a bitter drug
  2. To increase the tablet's mechanical strength
  3. To protect the drug from gastric acid and release it in the intestine Correct answer.
  4. To provide immediate drug release in the stomach

Explanation

Enteric coatings are insoluble in gastric acid but dissolve at the higher pH of the intestine, protecting acid-labile drugs or the gastric mucosa. This delays release until the tablet reaches the intestine.

Question 14Pharmaceutics and Pharmaceutical Technology

A pharmacist needs to prepare 500 mL of a 0.9% w/v sodium chloride solution. What mass of sodium chloride is required?

  1. 45 g
  2. 0.45 g
  3. 4.5 g Correct answer.
  4. 9.0 g

Explanation

0.9% w/v means 0.9 g per 100 mL. For 500 mL, the required mass is 0.9 g × 5 = 4.5 g.

Question 15Pharmaceutics and Pharmaceutical Technology

Which physical instability is characterized by the irreversible aggregation of dispersed droplets in an emulsion?

  1. Phase inversion
  2. Coalescence Correct answer.
  3. Creaming
  4. Flocculation

Explanation

Coalescence is the fusion of dispersed droplets into larger droplets, leading to irreversible separation of the emulsion. Creaming and flocculation are generally reversible if the system is redispersed.

Question 16Pharmaceutics and Pharmaceutical Technology

A drug follows one-compartment first-order kinetics with a volume of distribution of 40 L and a clearance of 4 L/h. What is the elimination half-life?

  1. 6.9 h Correct answer.
  2. 2.8 h
  3. 10 h
  4. 1.0 h

Explanation

Half-life equals 0.693 × Vd / CL = 0.693 × 40 / 4 = 6.93 h. Clearance and volume of distribution together determine the elimination rate constant.

Question 17Pharmaceutics and Pharmaceutical Technology

Which excipient is most likely to cause a tablet to adhere to the punch faces during compression?

  1. Increase in tablet hardness
  2. Addition of a hydrophobic lubricant
  3. Excessive moisture in the granules Correct answer.
  4. Use of a glidant

Explanation

Excess moisture makes granules sticky and promotes sticking or picking on punch faces. Lubricants reduce adhesion, glidants improve flow, and hardness relates to compression force rather than stickiness.

Question 18Pharmaceutics and Pharmaceutical Technology

Which statement about the Noyes-Whitney equation is correct?

  1. It describes sedimentation rate as proportional to particle diameter
  2. It describes dissolution rate as proportional to surface area and concentration gradient Correct answer.
  3. It describes drug absorption as proportional to partition coefficient
  4. It describes diffusion through a membrane as proportional to thickness

Explanation

The Noyes-Whitney equation states that dissolution rate is proportional to the surface area of the solid and the concentration gradient across the diffusion layer, and inversely proportional to diffusion layer thickness. Reducing particle size increases surface area and thus dissolution rate.

Question 19Pharmaceutics and Pharmaceutical Technology

A sustained-release formulation is designed to release drug over 12 hours. Which property of the drug is most favorable for this design?

  1. Extensive first-pass metabolism
  2. Very short biological half-life
  3. High aqueous solubility Correct answer.
  4. Large dose requirement

Explanation

Good aqueous solubility supports dissolution-controlled release from a sustained-release dosage form. Very short half-lives, large doses, and extensive first-pass metabolism make sustained-release design difficult.

Question 20Pharmaceutics and Pharmaceutical Technology

Which sterilization method is most appropriate for a heat-labile aqueous ophthalmic solution in a sealed ampoule?

  1. Dry heat sterilization at 160 °C
  2. Sterilization by filtration through a 0.22 µm membrane Correct answer.
  3. Moist heat autoclaving at 121 °C
  4. Gamma irradiation

Explanation

Filtration through a 0.22 µm membrane removes microorganisms without exposing the heat-labile solution to destructive heat. It is the method of choice for thermolabile solutions that cannot be autoclaved.

Question 21Pharmaceutics and Pharmaceutical Technology

A powder blend is found to have a very low bulk density relative to its tapped density. What does this most likely indicate?

  1. Uniform particle size distribution
  2. High moisture content
  3. Poor flow due to high interparticle cohesion Correct answer.
  4. Excellent flow properties

Explanation

A large difference between bulk and tapped density gives a high Carr's index or low Hausner ratio, indicating poor flow and high interparticle cohesion. Well-flowing powders show little change on tapping.

Question 22Pharmaceutics and Pharmaceutical Technology

A drug is to be formulated as a lipophilic suppository base. Which property of the drug most favors rapid release from the base?

  1. High water solubility Correct answer.
  2. High lipid solubility
  3. High melting point
  4. High molecular weight

Explanation

A drug with high water solubility partitions readily from the lipophilic base into the aqueous rectal fluid, promoting release. High lipid solubility favors retention in the base and slows release.

Question 23Pharmaceutics and Pharmaceutical Technology

Which statement about the effect of particle size on the bioavailability of a poorly soluble BCS Class II drug is correct?

  1. Reducing particle size increases surface area and can increase dissolution rate and absorption Correct answer.
  2. Particle size has no effect on dissolution of poorly soluble drugs
  3. Increasing particle size increases dissolution rate and absorption
  4. Reducing particle size decreases surface area and reduces absorption

Explanation

For a dissolution rate-limited drug, reducing particle size increases the specific surface area available for dissolution, which can raise the dissolution rate and improve absorption. This is the rationale for micronization and nanocrystal formulations.

Question 24Pharmaceutics and Pharmaceutical Technology

A drug has a hepatic extraction ratio of 0.85 and is given orally. What is the approximate oral bioavailability assuming complete absorption and no gut metabolism?

  1. 0.50
  2. 0.15 Correct answer.
  3. 0.30
  4. 0.85

Explanation

For a drug with high hepatic extraction, oral bioavailability is approximately 1 minus the extraction ratio, i.e., 1 - 0.85 = 0.15. Most of the absorbed dose is removed during first pass through the liver.

Question 25Pharmacology and Pharmacotherapeutics

Which mechanism of action best describes metformin's primary glucose-lowering effect?

  1. Reduction of hepatic gluconeogenesis and improved peripheral insulin sensitivity Correct answer.
  2. Blockade of renal sodium-glucose cotransport
  3. Inhibition of intestinal alpha-glucosidase enzymes
  4. Direct stimulation of pancreatic beta-cell insulin secretion

Explanation

Metformin is a biguanide that mainly suppresses hepatic glucose production and enhances insulin sensitivity in peripheral tissues. It does not stimulate insulin release, so it rarely causes hypoglycemia when used alone.

Question 26Pharmacology and Pharmacotherapeutics

A patient with an acute asthma exacerbation is given salbutamol by inhalation. Which receptor-mediated effect produces the desired bronchodilation?

  1. Beta-2 adrenergic receptor agonism relaxing bronchial smooth muscle Correct answer.
  2. Leukotriene receptor antagonism reducing airway inflammation
  3. Muscarinic M3 receptor antagonism reducing vagal tone
  4. Histamine H1 receptor blockade decreasing mucus secretion

Explanation

Salbutamol is a short-acting beta-2 agonist that relaxes bronchial smooth muscle, rapidly relieving bronchospasm. Its selectivity for beta-2 receptors underlies both efficacy and its tremor and tachycardia adverse effects.

Question 27Pharmacology and Pharmacotherapeutics

Which laboratory parameter requires routine monitoring in a patient starting long-term amiodarone therapy?

  1. Thyroid function tests Correct answer.
  2. Plasma metanephrines
  3. Serum amylase
  4. Serum creatine kinase

Explanation

Amiodarone is iodine-rich and can cause both hypo- and hyperthyroidism, so thyroid function should be checked at baseline and periodically. It also warrants monitoring of liver enzymes, pulmonary status, and ocular examination.

Question 28Pharmacology and Pharmacotherapeutics

A patient taking warfarin is prescribed a course of fluconazole. What is the most likely consequence and its mechanism?

  1. Increased INR because fluconazole inhibits warfarin metabolism via CYP2C9 Correct answer.
  2. Decreased INR because fluconazole induces warfarin metabolism
  3. No change because fluconazole is not hepatically metabolized
  4. Increased INR because fluconazole displaces warfarin from albumin without affecting clearance

Explanation

Fluconazole inhibits CYP2C9, the enzyme responsible for metabolizing S-warfarin, reducing warfarin clearance and raising INR and bleeding risk. Close INR monitoring and possible dose reduction are needed during such therapy.

Question 29Pharmacology and Pharmacotherapeutics

Which adverse effect is most characteristic of ACE inhibitor therapy and results from accumulation of bradykinin?

  1. Peripheral edema
  2. Hyperkalemia
  3. Dry persistent cough Correct answer.
  4. Reflex tachycardia

Explanation

ACE inhibitors block the breakdown of bradykinin, which accumulates and triggers a dry cough in susceptible patients. Switching to an angiotensin receptor blocker usually avoids this effect.

Question 30Pharmacology and Pharmacotherapeutics

Which statement correctly describes the pharmacokinetic concept of a drug's half-life?

  1. The time required for plasma concentration to fall by half during elimination Correct answer.
  2. The time required to reach maximum plasma concentration after dosing
  3. The fraction of an administered dose that reaches systemic circulation
  4. The volume of plasma cleared of drug per unit time

Explanation

Half-life is the time for plasma concentration to decline by 50 percent during the elimination phase. It determines dosing interval and time to steady state, which is roughly four to five half-lives.

Question 31Pharmacology and Pharmacotherapeutics

A patient develops muscle pain and dark urine while taking a statin. Which finding would most support statin-induced rhabdomyolysis?

  1. Elevated serum bilirubin
  2. Low serum phosphate
  3. Prolonged prothrombin time
  4. Markedly elevated creatine kinase Correct answer.

Explanation

Statin-induced myopathy with muscle breakdown releases creatine kinase, and severe cases cause myoglobinuria with dark urine. Creatine kinase measurement is central to confirming rhabdomyolysis.

Question 32Pharmacology and Pharmacotherapeutics

Which antibiotic class acts by inhibiting bacterial 50S ribosomal subunit protein synthesis?

  1. Beta-lactams
  2. Aminoglycosides
  3. Macrolides Correct answer.
  4. Fluoroquinolones

Explanation

Macrolides bind the 50S ribosomal subunit and block translocation during protein synthesis. Aminoglycosides act on the 30S subunit, while beta-lactams and fluoroquinolones target cell wall and DNA gyrase respectively.

Question 33Pharmacology and Pharmacotherapeutics

Which counseling point is most important for a patient starting isotretinoin?

  1. Two forms of contraception are required because of teratogenicity Correct answer.
  2. The drug must be taken with dairy products to enhance absorption
  3. Sun exposure should be maximized to improve skin response
  4. Liver function tests are unnecessary if the dose is low

Explanation

Isotretinoin is highly teratogenic, so pregnancy prevention with dual contraception and pregnancy testing is mandatory. Baseline and periodic liver function and lipid monitoring are also required.

Question 34Pharmacology and Pharmacotherapeutics

Which drug is a recognized cause of serotonin syndrome when combined with a selective serotonin reuptake inhibitor?

  1. Metformin
  2. Amlodipine
  3. Tramadol Correct answer.
  4. Ranitidine

Explanation

Tramadol inhibits serotonin reuptake and can precipitate serotonin syndrome when combined with an SSRI. Features include agitation, tremor, hyperthermia, and clonus.

Question 35Pharmacology and Pharmacotherapeutics

Which reversal agent is appropriate for a patient with significant bleeding on warfarin and an elevated INR?

  1. Naloxone
  2. Intravenous vitamin K plus a prothrombin complex concentrate Correct answer.
  3. Protamine sulfate
  4. Idarucizumab

Explanation

For major warfarin-related bleeding, vitamin K restores synthesis of clotting factors while prothrombin complex concentrate rapidly replaces them. Fresh frozen plasma is an alternative when concentrate is unavailable.

Question 36Pharmacology and Pharmacotherapeutics

Which mechanism explains the antiemetic effect of ondansetron in chemotherapy-induced nausea?

  1. Dopamine D2 receptor blockade in the chemoreceptor trigger zone
  2. 5-HT3 receptor antagonism in the gut and central vomiting centers Correct answer.
  3. Histamine H1 receptor blockade in the vestibular apparatus
  4. Neurokinin-1 receptor antagonism in the brainstem

Explanation

Ondansetron blocks serotonin 5-HT3 receptors on vagal afferents and in the area postrema, reducing chemotherapy-induced emesis. This accounts for its efficacy in acute chemotherapy-induced nausea.

Question 37Pharmacology and Pharmacotherapeutics

Which monitoring is essential for a patient receiving lithium carbonate?

  1. Serum calcium and phosphate only
  2. Serum amylase and lipase only
  3. Complete blood count only
  4. Serum lithium levels and renal and thyroid function Correct answer.

Explanation

Lithium has a narrow therapeutic index and is renally excreted, so serum levels plus renal and thyroid function require regular monitoring. Dehydration and NSAID use can raise levels and precipitate toxicity.

Question 38Pharmacology and Pharmacotherapeutics

A patient with type 2 diabetes and heart failure is being considered for empagliflozin. Which benefit is supported beyond glycemic control?

  1. Reduction of intestinal glucose absorption
  2. Reversal of peripheral insulin resistance
  3. Increased insulin secretion from beta cells
  4. Reduced risk of heart failure hospitalization Correct answer.

Explanation

SGLT2 inhibitors such as empagliflozin reduce heart failure hospitalizations and cardiovascular events, independent of glucose lowering. This has made them important in heart failure management.

Question 39Pharmacology and Pharmacotherapeutics

Which opioid effect does naloxone reverse?

  1. Respiratory depression Correct answer.
  2. Muscle relaxation from benzodiazepines
  3. Miosis induced by pilocarpine
  4. Bradycardia from beta-blockers

Explanation

Naloxone is a competitive opioid receptor antagonist that rapidly reverses opioid-induced respiratory depression and sedation. Repeated dosing may be needed because its duration is shorter than many opioids.

Question 40Pharmacology and Pharmacotherapeutics

Which pharmacokinetic principle explains why a drug with first-pass metabolism has higher oral bioavailability when taken with grapefruit juice?

  1. Increased gastric pH improves drug dissolution
  2. Increased plasma protein binding prolongs circulation
  3. Inhibition of intestinal CYP3A4 reduces presystemic metabolism Correct answer.
  4. Enhanced gastric emptying accelerates absorption

Explanation

Grapefruit juice inhibits intestinal CYP3A4, decreasing first-pass metabolism of susceptible drugs and raising systemic exposure. This can increase both efficacy and toxicity for drugs with narrow therapeutic indices.

Question 41Pharmacology and Pharmacotherapeutics

Which drug is most appropriate for rapid relief of acute angina pectoris?

  1. Oral metoprolol
  2. Oral ramipril
  3. Sublingual glyceryl trinitrate Correct answer.
  4. Oral atorvastatin

Explanation

Sublingual glyceryl trinitrate provides rapid venodilation and coronary vasodilation for acute anginal attacks. Its sublingual route avoids first-pass metabolism and gives quick onset.

Question 42Pharmacology and Pharmacotherapeutics

Which mechanism underlies the anticoagulant effect of heparin?

  1. Direct blockade of the glycoprotein IIb/IIIa receptor
  2. Activation of antithrombin III to inactivate thrombin and factor Xa Correct answer.
  3. Irreversible inhibition of platelet cyclooxygenase
  4. Direct inhibition of vitamin K epoxide reductase

Explanation

Heparin binds antithrombin III and accelerates its inactivation of thrombin and factor Xa. Its effect is monitored with the activated partial thromboplastin time.

Question 43Pharmacology and Pharmacotherapeutics

A patient on isoniazid therapy for tuberculosis develops peripheral neuropathy. Which vitamin deficiency explains this adverse effect?

  1. Cobalamin (vitamin B12)
  2. Thiamine (vitamin B1)
  3. Pyridoxine (vitamin B6) Correct answer.
  4. Folic acid

Explanation

Isoniazid interferes with pyridoxine metabolism, and supplementation with vitamin B6 prevents or treats the resulting peripheral neuropathy. This is especially important in malnourished or diabetic patients.

Question 44Pharmacology and Pharmacotherapeutics

Which statement about the therapeutic index of a drug is correct?

  1. A low therapeutic index indicates a narrow margin between effective and toxic doses Correct answer.
  2. Therapeutic index is determined solely by the route of administration
  3. A low therapeutic index indicates a wide margin between effective and toxic doses
  4. Therapeutic index is the ratio of clearance to volume of distribution

Explanation

Therapeutic index compares the toxic dose to the effective dose, so a low value means toxicity can occur close to therapeutic concentrations. Such drugs require therapeutic drug monitoring.

Question 45Pharmacology and Pharmacotherapeutics

Which adverse effect is associated with long-term systemic corticosteroid therapy?

  1. Hyperkalemia and hypertension
  2. Hypoglycemia and weight loss
  3. Osteoporosis and hyperglycemia Correct answer.
  4. Bradycardia and hypothermia

Explanation

Chronic glucocorticoid excess causes bone loss and impaired glucose tolerance along with other effects such as skin thinning and adrenal suppression. Tapering and bone protection are often required.

Question 46Pharmacology and Pharmacotherapeutics

Which drug interaction requires caution when levodopa is co-administered with a nonselective monoamine oxidase inhibitor?

  1. Hypertensive crisis from reduced catecholamine breakdown Correct answer.
  2. Profound bradycardia from vagal stimulation
  3. Increased anticoagulant effect from protein displacement
  4. Severe hypoglycemia from enhanced insulin release

Explanation

Nonselective MAO inhibitors block catecholamine metabolism, and combining them with levodopa can cause a hypertensive crisis. MAO-B selective inhibitors are used cautiously in Parkinson disease, but nonselective agents are avoided.

Question 47Pharmacology and Pharmacotherapeutics

Which mechanism accounts for the diuretic action of furosemide?

  1. Inhibition of carbonic anhydrase in the proximal tubule
  2. Blockade of sodium channels in the distal convoluted tubule
  3. Antagonism of aldosterone receptors in the collecting duct
  4. Inhibition of the sodium-potassium-chloride cotransporter in the loop of Henle Correct answer.

Explanation

Furosemide inhibits the NKCC2 cotransporter in the thick ascending limb, producing powerful diuresis. This mechanism also predisposes to hypokalemia and ototoxicity.

Question 48Pharmacology and Pharmacotherapeutics

A patient with chronic kidney disease has an eGFR of 25 mL/min/1.73 m2. Which adjustment is generally appropriate for a renally cleared drug with a narrow therapeutic index?

  1. Increase the dose to overcome reduced absorption
  2. Reduce the dose or extend the dosing interval with monitoring Correct answer.
  3. Double the dose and monitor less frequently
  4. Maintain the usual dose because renal function does not affect clearance

Explanation

Reduced renal clearance leads to drug accumulation, so dose reduction or interval extension is needed for renally eliminated drugs, especially those with narrow therapeutic indices. Therapeutic drug monitoring guides individualization.

Question 49Pharmacology and Pharmacotherapeutics

Which mechanism best explains the analgesic action of paracetamol?

  1. Direct activation of opioid receptors
  2. Peripheral inhibition of cyclooxygenase-1 in inflamed tissue
  3. Central inhibition of prostaglandin synthesis Correct answer.
  4. Blockade of voltage-gated sodium channels in peripheral nerves

Explanation

Paracetamol reduces prostaglandin synthesis predominantly within the central nervous system, contributing to its analgesic and antipyretic effects. It has little peripheral anti-inflammatory activity.

Question 50Pharmacology and Pharmacotherapeutics

Which class of drugs is first-line for the long-term management of asthma in a patient requiring daily controller therapy?

  1. Long-acting beta-2 agonists
  2. Leukotriene receptor antagonists
  3. Inhaled corticosteroids Correct answer.
  4. Oral corticosteroids

Explanation

Inhaled corticosteroids are the most effective long-term controller medication for asthma because they reduce airway inflammation. Long-acting beta-2 agonists are not used as monotherapy due to safety concerns, and oral corticosteroids are reserved for severe exacerbations.