External Pharmacist Exam Past Viva Questions and Answers (Original Book Copy)

Copyright Notice

The content displayed in this post, including all book pages, images, text, explanations, illustrations, and study materials, is the intellectual property of PharmaPrep Books and is protected by copyright laws.

This material is provided for online viewing only. Any unauthorized copying, downloading, screenshotting, recording, reproduction, distribution, sharing, printing, modification, or commercial use of any part of this content without prior written permission from PharmaPrep Books is strictly prohibited and may result in legal action.

By accessing this content, you agree to respect the intellectual property rights of PharmaPrep Books.

Introduction

This book is a viva practice guide for candidates of the External Pharmacist Examination. It is developed from past viva questions and frequently tested areas to help candidates improve confidence, accuracy, and clarity during viva examinations.

It contains over 150 viva sessions and more than 1,000 sub-questions, organized for systematic practice. Answers are concise, clear, and exam-oriented, allowing quick recall and effective responses.

The Viva Voce assesses practical knowledge, understanding, and communication skills in pharmacy practice. Questions cover prefabricated dosage forms, cosmetics, medical devices, and key areas of retail pharmacy, including pharmacology, regulatory affairs, patient care, and patient counselling.

This book helps candidates:Familiarize with frequently asked viva questions, Improve oral answering skills, Strengthen core pharmacy concepts, Reduce exam anxiety through repeated practice.

It serves as a practical companion for regular revision, mock viva sessions, and last-minute preparation, enabling candidates to approach the viva with confidence and competence.

Marking Scheme for Viva Voce (10% of total exam marks, out of 100 marks; minimum 30% to pass):

1. Dress Code – 4 marks

2. English Language Proficiency – 4 marks

3. Pharmacology – 16 marks

4. Pharmaceutics, Law, Ethics, and Management – 16 marks

Content

General Pharmacy Knowledge
Pharmacy Operations & Drug Management
Cardiovascular & Emergency Medications
Steroids & Inhalation Therapy
Prescription
Paracetamol
Depot Preparations & Contraceptives
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Prescription
Hypertension & Cardiovascular Medications
Prescription
Oral Rehydration Solution (ORS)
Diabetes & Insulin
Pharmaceutical Agents & Preparations
Antibiotics & Antimicrobials
Iodine
Life-Threatening & Essential Drugs
Storage & Vaccines
Anthelmintics & Parasitic Treatments
Tuberculosis (TB) Treatment
Co-trimoxazole Suspension
25% Dextrose
Diuretics
Vitamins & Minerals
Drug Information Sources & Jeewani
Water & Pharmaceutical Uses
Prescription
Calendar Packs & Contraceptives
Antiseptics & Preparation Handling
Pharmaceutical Packaging & Containers
Paracetamol Syrup
Neurology & Cardiovascular Drugs
Tablets & Laxatives
Diarrhea & ORS
Asthma & Respiratory Drugs
Oral Liquid Preparations & Elixirs
Sutures
Prescription
Mithuri Pack
Anthelmintic
Narcotics
External Semisolid Preparations
Prescription
Anti-Inflammatory Drugs
Antihistamines & Allergy Medications
Co-Amoxiclav Syrup
Androgens & Hormonal Preparations
Pyrantel Pamoate Suspension
IV Cannula
Adrenal Steroids & Cardiac Drugs
Candid-B Cream
Lugol’s Iodine
Steroid Preparations
Antimuscarinic & Drug Administration
Parenteral & Transdermal Dosage Forms
Drug Absorption & Metabolism
Povidone Iodine Ointment
Oral Antidiabetic Drugs
Asthma Medications & Inhalers
Combined Contraceptive Pills
Domperidone
Glyceryl Trinitrate (GTN)
Atropine Eye Drops
Cloxacillin
Tablet Dosage Forms & Coatings
Metformin Hydrochloride Extended Release 500 mg
Pharmacy Regulations & Licensing
Losartan
Diuretics & Capsules
Diclofenac Gel
Prescription
Clopidogrel
Atorvastatin 10mg (SPMC)
Prolene Suture
Paracetamol Syrup
Hydrocortisone Ointment USP 1% W/W
Carbamazepine
Ferrous Sulfate
Soft vs. Hard Gelatin Capsules
Prescription
Antihistamines
Corticosteroids
Pharmacokinetics & Drug Absorption
Medical Devices
Prednisolone
Diuretics
Insulin
Beta Blockers
Diclofenac Sodium Tablets
Prescription
Antiplatelet Drugs & Lipid-Lowering Agents
Implants
Thyroxine 50 mcg Tablets
Postinor-2
Gliclazide 80mg
Parenteral Preparations & Surgical Supplies
Gentamicin Eye/Ear Drops 0.3% W/V
Prescription
Lithium Carbonate
Prescription
Acyclovir (Cyclovir)
Pyrantel Suspension
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
Tablets & Excipients
Amoxicillin & Antibiotics
Promethazine & Tablet Coating
OTC (Over-The-Counter) Drugs & GTN (Glyceryl Trinitrate)
Cimetidine & Drug Interactions
Legal Requirements for Opening a Retail Pharmac
Dispensing Medications
Tablets & Implants
Alkaloids & Glycosides
Anticholinergic Drugs
Asthma & Related Drugs
Lipid-Lowering Drugs
Drug Registration
Ointment Bases
Antidiabetic Drugs
Griseofulvin & Antifungal Drugs
Nystatin
Diclofenac Sodium
Paracetamol
Emulsion & Oils
Drug Advertising & Regulations
Laxatives and Omeprazole
Surfactants
Drug Strength and Storage
Antiepileptic Drugs
Cimetidine
Legal Requirements for Opening a Retail Pharmacy
Dispensing Medications
Tablets & Implants
Alkaloids & Glycosides
Anticholinergic Drugs
Asthma & Related Drugs
Lipid-Lowering Drugs
Drug Registration
Ointment Bases
Antidiabetic Drugs
Griseofulvin & Antifungal Drugs
Nystatin & Drug Strength
TAC (Technical Advisory Committee)
Pharmaceutical Excipients
Beta-lactam Antibiotics
Streptomycin & TB Treatment
Deliquescent Substances
Devices in Pharmacy
Drug Half-life & Bioavailability
Prodrugs & Drug Excretion
Dosage Forms & Characteristics
Disintegration Time of Tablets
Tablet Coating & Forms
Injections & Devices
Adrenaline & Beta Agonists
Drug Stability & Water for Injection
Drug Quality & Disposal
Drugs from Plant Sources & Morphine
Antiemetic Drugs & Promethazine
Tablet Coating & Sampling
Drug Registration & Pharmacy Licensing
Pharmaceutical Containers & Packaging
Antimicrobial Agents & Special Considerations
Mechanism of Action & Drug Interactions
Drug Information & Reference Sources
Pharmaceutical Additives & Labeling
Controlled Substances & Narcotics
Pain Management & Antiplatelet Therapy
Drug Effects & Patient Education
Drug Storage Guidelines
Cardiovascular Drugs & Heart Failure Management
Salbutamol
Key Cardiovascular Drugs
Lipid-Lowering Drugs & Statins
Gastrointestinal Drugs
Diabetes Management
Insulin Therapy
Antidiabetic Drug Combinations
Antiepileptic Drugs
Sustained Release & Tablet Formulations
Sterilization & Aseptic Techniques
Surfactants & Antimicrobial Agents
Oral Hypoglycemic Agents & Narcotics
Oral Contraceptives & Reproductive Health
Diarrhea Management & ORS
Prescription & Drug Regulations
Tranquilizers & CNS Drugs
Drug Stability & Chemical Reactions
Suspensions & Dosage Forms
Insulin & Antidiabetic Drugs
Thyroid & Adrenal Hormones
Pharmacokinetics & Drug Absorp
Sustained Release & Tablet Coating
Drug Licensing & Regulations
Expanded Program on Immunization (EPI) & Vaccines
Regulatory & Dispensing Questions
Sulfonamides & Antimicrobials
Beta-lactams & Antibiotics
Antifungal & Antiprotozoal Drugs
Antidiabetic Drugs & Insulin
Probeta

______________________________________________________________________________________________________

General Pharmacy Knowledge

1. What is the name of your master pharmacist?

My master pharmacist is Mr./ Mrs./ Miss xxxxxxx

2. Where is your pharmacy located?

The pharmacy is located in xxxxxxx

3. What are your working hours?

The pharmacy operates daily from xxx am to xxx pm. I am working full time in the pharmacy.

4. Are you still working?

Yes, I am currently working in the pharmacy under supervision of my master pharmacist.

5. How many leave days can you take per year?

xx days

6. What do you learn while working in the pharmacy?

I learn dispensing, prescription interpretation, drug storage, patient counseling, inventory management, and professional ethics.

7. Describe the setting of your pharmacy.

The pharmacy is clean, well-organized, and properly ventilated, with separate areas for dispensing, storage, and patient counseling.

Pharmacy Operations & Drug Management

1. What sterile products are available in your pharmacy?

Sterile products available include injections, infusions, eye drops, ophthalmic ointments, and some irrigation fluids.

2. What types of drugs are available in your pharmacy?

The pharmacy stocks prescription-only medicines, over-the-counter (OTC) medicines, and limited controlled drugs as permitted by regulations.

3. How are drugs arranged in your pharmacy?

Drugs are arranged systematically according to pharmacological class with separate storage for refrigerated and controlled medicines.

4. How do you maintain temperature control in your pharmacy?

Temperature is maintained using air conditioning, thermometers, regular temperature monitoring.

5. What is the room temperature and refrigerator temperature in your pharmacy?

Room temperature is maintained between 20–25 °C, and refrigerator temperature is maintained between 2–8 °C.

6. What packaging types are available in your pharmacy?

Packaging types include blister packs, strip packs, bottles, vials, ampoules, sachets, tubes, and cartons.

7. What measures do you take to prevent insect and dust contamination in your pharmacy?

Regular cleaning, pest control, proper sealing of doors and windows, covered shelves, and correct waste disposal are practiced.

8. What actions will you take in case of a drug quality failure?

The affected drug is isolated, dispensing is stopped, the supplier or authority is informed, and the incident is documented.

9. What will you do when a drug’s expiration date is near?

Near-expiry drugs are identified, prioritized for dispensing if allowed, or returned to the supplier according to policy.

10. How did you study your handbook topics in your pharmacy?

I studied handbook topics by observing daily pharmacy activities, discussing with the master pharmacist, and relating theory to practical work.

11. What dosage forms are available in your pharmacy??

Tablets, capsules, syrups, suspensions, injections, creams, ointments, drops, inhalers, suppositories, and powders

Cardiovascular & Emergency Medications

1. What is the drug of choice for angina?

Glyceryl trinitrate (GTN) is the drug of choice for the immediate relief of angina.

2. What instructions do you give when dispensing GTN?

Take one tablet sublingually at the onset of chest pain, sit or lie down, repeat after 5 minutes if pain persists (maximum 3 doses can take), and seek medical help if pain continues further.

3. Is GTN given twice a day?

No. GTN is used as needed for acute attacks, not routinely twice daily.

4. What other drugs can be used for the prevention of angina?

Long-acting nitrates (e.g. ISDN), beta-blockers, calcium channel blockers, antiplatelets, and statins.

5. What is the main difference between GTN and ISDN?

GTN has a rapid onset and short duration for acute relief, while ISDN has a slower onset and longer duration for prevention.

6. Can you give examples of anti-infective drugs?

Antibiotics (amoxicillin, ciprofloxacin), antivirals (acyclovir), antifungals (fluconazole), and antiparasitics (metronidazole).

7. What ingredients should be included in an emergency tray?

Adrenaline, atropine, hydrocortisone, GTN, salbutamol inhaler, glucose, normal saline, antihistamine, syringes, needles, IV cannula, and oxygen mask.

8. Can you explain the action of each emergency tray item?

Adrenaline: Treats anaphylaxis and cardiac arrest

Atropine: Treats bradycardia

Hydrocortisone: Reduces severe allergic reactions

GTN: Relieves acute angina

Salbutamol: Relieves bronchospasm

Glucose: Treats hypoglycemia

Normal saline: Maintains circulation and IV access

Antihistamine: Reduces allergic symptoms

Steroids & Inhalation Therapy

1. Do you know the different dosage forms of steroids?

Yes, steroids are available as tablets, injections, creams/ointments, nasal sprays, eye drops, and inhalers.

2. What precautions should be taken when using steroids?

Use the lowest effective dose, monitor for side effects (like hyperglycemia, infections, skin thinning), avoid abrupt stopping of systemic steroids, and follow prescribed duration.

3. What is the most suitable steroid dosage form for preventing asthma?

Inhaled corticosteroids.

4. What instructions do you give when dispensing steroid inhalations?

Shake the inhaler before use, exhale fully, place the mouthpiece in the mouth, inhale deeply while pressing the inhaler, hold breath for 5–10 seconds, rinse mouth after use to prevent oral thrush.

5. Do you know the different types of inhalation preparations?

Metered-dose inhalers (MDI), dry powder inhalers (DPI), nebulizer solutions.

6. What are the advantages of inhalation therapy?

Delivers drug directly to lungs, fast onset, lower systemic side effects, and smaller doses required compared to oral therapy.

Prescription

℞

Warfarin 6 mg vesper (one month)

Aspirin 75 mg nocte (one month)

Clopidogrel 75 mg nocte (one month)

1. Can this be dispensed?

This prescription can be dispensed only with caution. It combines warfarin (anticoagulant) with two antiplatelet drugs (aspirin and clopidogrel), which significantly increases the risk of bleeding. Ensure it is prescribed by a physician, and counsel the patient carefully.

2. What is Warfarin?

Warfarin is an oral anticoagulant that works by inhibiting vitamin K–dependent clotting factors, preventing blood clot formation.

3. What antiplatelet medicines do you know?

Aspirin

Clopidogrel

Ticagrelor

Prasugrel

4. What are the side effects?

Warfarin: Bleeding, bruising, GI upset, skin necrosis (rare), hair loss

Aspirin: GI irritation, bleeding, allergy

Clopidogrel: Bleeding, rash, GI discomfort

Paracetamol

1. Can you dispense this without a prescription?

Yes, paracetamol is an over-the-counter (OTC) medicine and can be dispensed without a prescription.

2. What is the normal daily dose for an adult?

Single dose: 500–1000 mg every 4–6 hours as needed.

Maximum daily dose: 4 g (4000 mg) per day.

3. How is this metabolized?

Paracetamol is mainly metabolized in the liver through glucuronidation and sulfation. A small amount is metabolized via cytochrome P450 to a toxic metabolite (NAPQI), which is detoxified by glutathione.

4. What happens if someone takes more than the normal dose?

Overdose can cause liver toxicity and acute liver failure, which may be life-threatening if untreated.

5. What is the suitable treatment for paracetamol poisoning?

N-acetylcysteine (NAC) is used as an antidote; supportive care and monitoring of liver function are also required.

6. What are the side effects of paracetamol?

Usually well tolerated

Rare: allergic reactions, skin rashes, liver toxicity (especially in overdose)

Depot Preparations & Contraceptives

1. What is the meaning of a depot preparation?

A long-acting formulation that releases the drug slowly over time.

2. Can you give examples of depot parenteral preparations?

Depo-Provera, Benzathine penicillin, Haloperidol decanoate.

3. What are the contents of Depo-Provera?

Medroxyprogesterone acetate 150 mg/mL.

4. Is Depo-Provera contraindicated for lactating mothers?

No, it is safe during lactation.

5. Are combined contraceptive pills contraindicated for lactating mothers?

Yes, especially during the first 6 months of breastfeeding.

6. What instructions should you give for combined oral contraceptives?

Take one tablet daily at the same time; do not miss doses.

7. What are the contraindications of combined contraceptives?

Pregnancy, history of thromboembolism, breast cancer, severe liver disease, uncontrolled hypertension, and smoking in women over 35 years.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

1. What is the meaning of NSAIDs?

NSAIDs are drugs that relieve pain, reduce fever, and decrease inflammation without containing steroids.

2. What is the main difference between Aspirin and Paracetamol?

Aspirin has anti-inflammatory action, while paracetamol has mainly analgesic and antipyretic action with very weak anti-inflammatory effect.

3. Why is paracetamol poisoning more common?

Because it is easily available over the counter and toxic in overdose.

4. What is the antidote for paracetamol overdose?

N-acetylcysteine.

5. Is Aspirin soluble in water?

Aspirin is poorly soluble in water.

6. What are the contents of Disprin?

Aspirin and citric acid (with sodium bicarbonate as effervescent agent).

7. What type of tablet is Disprin?

Effervescent tablet.

Prescription

℞

Aspirin 75 mg capsule nocte

Clopidogrel 75 mg tablet nocte

Warfarin 6 mg BD

1. Can this prescription be dispensed?

Yes, only if prescribed by a physician, but caution is required because warfarin + two antiplatelets (aspirin and clopidogrel) increases the risk of bleeding. Patient counseling is essential.

2. What are the possible drug interactions?

Increased bleeding risk (anticoagulant + antiplatelets)

Interaction with NSAIDs, alcohol, or other anticoagulants

Certain antibiotics or antifungals may increase warfarin effect

3. Is Aspirin available in capsule form at your pharmacy?

Usually, aspirin is available as tablets or chewable tablets. Capsules may be available in some brands.

4. What are the other tablet types available?

Standard tablets

Chewable tablets

Sublingual tablets

Enteric-coated tablets

Sustained-release tablets

5. What is the difference between chewable tablets and sublingual tablets?

Chewable tablets: Chewed and swallowed; absorption occurs in the stomach/intestine

Sublingual tablets: Placed under the tongue, absorbed directly into bloodstream, faster onset

6. Does enteric coating prevent the drug from liver enzyme metabolism?

No. Enteric coating only prevents dissolution in the stomach to protect the drug or stomach; metabolism by liver enzymes (first-pass effect) still occurs.

7. What are the advantages of sustained-release tablets?

Maintains steady drug levels in blood

Reduces frequency of dosing

Improves patient compliance

May reduce side effects compared to multiple immediate-release doses

Hypertension & Cardiovascular Medications

1. What drugs can be given for hypertension?

Diuretics (e.g., hydrochlorothiazide)

ACE inhibitors (e.g., enalapril, lisinopril)

Angiotensin II receptor blockers (ARBs) (e.g., losartan)

Beta-blockers (e.g., propranolol, atenolol)

Calcium channel blockers (e.g., amlodipine, verapamil)

Alfa blockers

2. Can you give examples of beta-blockers?

Propranolol

Atenolol

Carvedilol

Metoprolol

Bisoprolol

3. What are the main differences between Propranolol and Atenolol?

Propranolol: Non-selective beta-blocker, affects beta-1 and beta-2 receptors, lipid soluble, have more CNS side effects

Atenolol: Selective beta-1 blocker, mainly affects heart, fewer respiratory effects, water soluble, have less CNS side effects

4. Can beta-blockers be given to an asthma patient with hypertension?

No, non-selective beta-blockers like propranolol should be avoided.

5. Explain why.

Non-selective beta-blockers block beta-2 receptors in the lungs, causing bronchoconstriction, which may trigger asthma attacks.

6. Can you give examples of ACE inhibitors?

Enalapril

Lisinopril

Ramipril

Captopril

7. What are the main side effects of ACE inhibitors?

Dry cough

Hyperkalemia

Hypotension

Angioedema (rare)

Renal impairment

8. Is Losartan included in the same group as ACE inhibitors?

No, Losartan is an Angiotensin II Receptor Blocker (ARB), works similarly but does not cause cough.

9. Do you know calcium antagonists? What are their uses?

Examples: Amlodipine, Verapamil, Diltiazem

Uses: Treat hypertension, angina, arrhythmias

10. What drugs are contraindicated in pregnancy-induced hypertension?

ACE inhibitors (e.g., enalapril)

ARBs (e.g., losartan)

Direct renin inhibitors

11. Is Propranolol contraindicated in diabetic patients? Are there any precautions?

Not contraindicated, but use with caution:

As it an mask hypoglycemia symptoms (tremor, tachycardia). So should monitor blood glucose carefully

Prescription

℞

Salbutamol 4 mg TDS

Beclomethasone 40 mcg BD, DPI

1. What is the possible condition?

Likely asthma or chronic obstructive pulmonary disease (COPD) requiring both a reliever (Salbutamol) and a preventer (Beclomethasone).

2. What patient instructions should be given for using a DPI (Dry Powder Inhaler)?

Wash hands before use

Load the dose as per device instructions

Exhale completely away from the inhaler

Place mouthpiece in mouth and inhale forcefully and deeply

Hold breath for 5–10 seconds

Do not breathe out into the inhaler

Rinse mouth after inhalation to prevent oral thrush

3. What are the side effects of Salbutamol and Beclomethasone?

Salbutamol: Tremor, palpitations, headache, nervousness

Beclomethasone: Oral thrush, hoarseness, cough, sore throat

4. What clinical condition can occur due to the use of a steroid inhaler?

Oral candidiasis (thrush), which is why mouth rinsing after use is recommended.

Oral Rehydration Solution (ORS)

1. What is the main indication of ORS?

To prevent and treat dehydration caused by diarrhea, vomiting, or excessive sweating.

2. How do you prepare ORS?

Dissolve one sachet in 1 liter(indicated volume) of freshly boiled and cooled water.

3. What instructions should be given with ORS?

Drink frequently in small sips

Do not add extra sugar or salt

Continue feeding (especially in children)

Discard after 24 hours and prepare a new one

4. What is the dosage form of ORS?

Powder for oral solution

5. Can ORS be dispensed without a prescription?

Yes, ORS is an over-the-counter (OTC) product.

6. What are other drugs that cannot be given with ORS?

Drugs causing further dehydration (e.g., strong diuretics without supervision)

Intravenous fluids are reserved for severe dehydration cases

Diabetes & Insulin

1. What are the symptoms of hypoglycemia?

Sweating, trembling, hunger, dizziness, palpitations, confusion.

2. If those symptoms occur, what should the patient do?

Take fast-acting sugar (glucose tablets, juice) and seek medical help if severe.

3. What is the dose of insulin?

Dose varies individually; prescribed by the doctor based on blood glucose levels and type of diabetes.

4. What are the different types of insulin?

Rapid-acting: Lispro, Aspart

Short-acting (soluble): Regular insulin

Intermediate-acting: NPH, Lente

Long-acting: Glargine, Detemir

5. How do you identify soluble insulin from lente insulin?

Soluble insulin: Clear solution

Lente insulin: Cloudy suspension

Pharmaceutical Agents & Preparations

1. Can you give examples of suspending agents?

Bentonite, tragacanth, acacia, methylcellulose.

2. Do you know BP (British Pharmacopoeia) preparations that contain bentonite?

Calamine lotion

3. What instructions should be given with oral iron liquid preparations?

Take with water, avoid tea or milk, may cause dark stools, use a straw to prevent teeth staining.

4. Do you know any drugs that can cause permanent discoloration of teeth?

Tetracyclines (e.g., doxycycline, tetracycline).

5. What do you know about Potassium Citrate mixture?

Used as an alkalinizing agent for kidney stones and urinary acidity.

6. What is the meaning of a buffer solution?

A solution that resists changes in pH when acids or bases are added.

7. What is pH?

Measure of hydrogen ion concentration; indicates acidity or alkalinity.

8. What is the importance of pH in pharmaceuticals?

Ensures drug stability, solubility, absorption, tissue compatibility, and ingredient compatibility.

Antibiotics & Antimicrobials

1. What is the pharmaceutical group of tetracycline?

Tetracyclines (broad-spectrum antibiotics).

2. What are other drugs in that group?

Doxycycline, minocycline, oxytetracycline.

3. Do ciprofloxacin and tetracycline belong to the same group?

No.

4. What is the family of ciprofloxacin?

Fluoroquinolones.

Iodine

1. What iodine-containing preparations do you know?

Povidone-iodine (antiseptic)

Lugol’s iodine

Tincture of iodine

Iodized salt

2. What are the uses of radioactive iodine?

Diagnosis and treatment of thyroid disorders (hyperthyroidism, thyroid cancer)

Imaging studies of thyroid function

Life-Threatening & Essential Drugs

1. What are life-threatening drugs?

Drugs used to treat serious conditions where delay can cause death.

2. What do you mean by life-threatening drugs?

Medicines essential for emergencies like shock, severe infection, or heart failure.

3. Can you name some essential oils?

Clove oil, eucalyptus oil, peppermint oil, castor oil.

4. What are the sources of essential oils?

Plants (leaves, flowers, seeds, bark, roots).

5. What different preparations contain essential oils?

Ointments, liniments, inhalants, lotions, balms.

Storage & Vaccines

1. What drugs should be stored in the fridge?

Vaccines, insulin, oxytocin, biology preparations.

2. What vaccines are included in the EPI schedule?

BCG, OPV, IPV, DPT, Hepatitis B, Hib, Measles.

Anthelmintics & Parasitic Treatments

1. What is the dosage of mebendazole for threadworm infection?

100 mg single dose (repeat after 2 weeks).

2. What instructions should be given with mebendazole?

Maintain hygiene, treat all family members, wash clothes/bedding.

3. What preparations are used for scabies?

Benzyl benzoate, permethrin, sulfur ointment.

4. What advice should be given with benzyl benzoate?

Apply to whole body, avoid eyes, wash off after 24 hours.

5. What do you recommend for a 2-year-old child with scabies?

Permethrin 5% cream (safe for children).

Tuberculosis (TB) Treatment

1. Do you know any drugs that induce liver enzymes?

Rifampicin, carbamazepine, phenytoin.

2. What are the uses of Rifampicin?

TB, leprosy, meningococcal carrier state.

3. What is the meaning of DOT therapy?

Directly Observed Therapy.

4. Why does TB treatment follow DOT?

To ensure compliance and prevent drug resistance.

5. What instructions should be given with Isoniazid?

Take regularly, avoid alcohol, report tingling sensation.

6. What is the other drug dispensed with Isoniazid?

Pyridoxine (Vitamin B6).

Co-trimoxazole Suspension

1. Do you know this?

Yes, it is an antibiotic (trimethoprim + sulfamethoxazole).

2. What are its uses?

UTIs, respiratory infections, diarrhea, ear infections.

3. What are the features of a suspension?

Insoluble particles dispersed in liquid, may settle on standing.

4. What patient instructions should be given when issuing a suspension?

Shake well, measure dose correctly, store properly, complete course.

5. Why do you advise shaking the bottle before use?

To ensure uniform distribution of the drug.

25% Dextrose

1. Is this a life-saving product?

Yes.

2. What does “life-saving products” refer to?

Medicines used in emergencies to prevent death.

3. What does “25%” mean?

25 g dextrose in 100 ml solution.

4. What are the features of sterile water for injection?

Sterile, pyrogen-free, clear, no additives.

Diuretics

1. What are the main uses of diuretics?

Edema, hypertension, heart failure.

2. What is the action of diuretics?

Increase urine output by removing excess water and salts.

3. Can potassium supplements be dispensed with diuretics?

Yes, with potassium-losing diuretics.

4. What are the side effects of furosemide?

Hypokalemia, dehydration, dizziness.

Vitamins & Minerals

1. What is another name for Pyridoxine?

Vitamin B6.

2. What are the sources of Vitamin C?

Citrus fruits, guava, tomatoes, green vegetables.

3. What are some uses of Vitamin C?

Prevent scurvy, improve immunity, wound healing.

4. Do you know sources of potassium?

Bananas, oranges, potatoes, coconut water.

Drug Information Sources & Jeewani

1. What are the main information sources for drugs?

Textbooks, formularies, drug labels, guidelines, internet.

2. Jeewani :

1. What are the indications for Jeewani?

Prevention and treatment of dehydration due to diarrhea.

2. What is its packaging material?

Sachets.

3. What are its ingredients?

Glucose, sodium chloride, potassium chloride, trisodium citrate.

4. Can you explain the uses of these ingredients?

Glucose- bind with sodium and helps to transport and absorption of sodium ions

Pottasium chloride – for pottasium ion replacement

Citrate – to correct acidosis

5. What is the preparation method of Jeewani?

Dissolve one sachet in the recommended amount of boiled and cooled water.

6. What patient advice should be given while dispensing it?

Use boiled and cooled water, do not boil after mixing, use within 24 hours, give frequently in small amounts, do not add any salts or sugar.

Water & Pharmaceutical Uses

1. What are the different types of water?

Purified water, distilled water, sterile water for injection, water for injection.

2. Can distilled water be used to reconstitute parenteral preparations?

No, sterile water for injection should be used.

3. What disinfectants are used for purified water?

Chlorine, ozone.

4. Usually, how much disinfectant should be added?

Small controlled amounts as per standard guidelines.

Prescription

Omeprazole 20 mg bd – 3 days

Diclofenac sodium bd – 3 days

Diclofenac LA

1. Can you dispense this?

Yes

2. What patient advice should be given for Diclofenac and Omeprazole?

Diclofenac – Take after meals, avoid alcohol, do not exceed dose.

Omeprazole – Take about 1 hour before meal.

3. Why is Omeprazole prescribed with Diclofenac?

To prevent gastric irritation and ulcers.

4. What are the side effects of Diclofenac sodium?

Gastric pain, nausea, dizziness.

Calendar Packs & Contraceptives

1. What are the advantages of calendar packs?

Improve compliance and reduce missed doses.

2. What medicines are available in calendar packs?

Oral contraceptive pills, iron tablets.

3. Can combined contraceptive pills be dispensed for lactating mothers?

No.

4. Do you know medicines that cause suppression of lactation?

Bromocriptine.

5. What are the other uses of Bromocriptine?

Parkinson’s disease, hyperprolactinemia.

Antiseptics & Preparation Handling

1. What is the meaning of antisepsis?

Prevention of infection by inhibiting microorganisms on living tissues.

2. Give examples of antiseptics.

Iodine, chlorhexidine, hydrogen peroxide.

3. What precautions should be taken while preparing silver nitrate?

Protect from light, handle carefully, keep in amber container.

Pharmaceutical Packaging & Containers

1. What are the different types of containers used in pharmaceutical preparations?

Glass, plastic, metal containers.

2. What are the parts of a prescription?

Superscription, inscription, subscription, signa.

3. Explain the types of packaging.

Primary packaging (direct contact), secondary packaging (outer cover).

Paracetamol Syrup

1. Explain about Paracetamol syrup.

It is an analgesic and antipyretic used to reduce pain and fever, especially in children.

2. How do you measure the correct dose?

Using a measuring cup, spoon, or oral syringe.

3. What is the closure type?

Child-resistant closure.

4. What advice should be given to the patient with this?

Do not exceed dose, measure accurately, follow dosing interval.

5. What are the safety guidelines?

Keep out of children’s reach, avoid overdose, check strength.

6. What are the main side effects?

Rare liver damage, nausea (usually safe at correct dose).

7. What happens in case of an overdose?

Severe liver toxicity.

Neurology & Cardiovascular Drugs

1. Why can’t Dopamine be used for Parkinson’s disease?

Dopamine cannot cross the blood–brain barrier.

2. What is the meaning of a prodrug?

A drug converted into active form in the body.

3. Do you know the uses of Enalapril?

Hypertension, heart failure.

4. What is the pharmaceutical group of Enalapril?

ACE inhibitor.

5. Does Verapamil belong to the same group?

No, it is a calcium channel blocker.

6. What is the dosage form of Nifedipine?

Tablet/capsule.

7. Is it a sublingual drug?

No.

Tablets & Laxatives

1. Do you know chewable tablets? Give examples.

Tablets chewed before swallowing; antacids, vitamin C.

2. What are the side effects of magnesium-containing laxatives?

Diarrhea, dehydration, electrolyte imbalance.

Diarrhea & ORS

1. What are the causes of diarrhea?

Infection, contaminated food/water, poor hygiene.

2. What is ORS?

Oral Rehydration Salts.

3. What are the uses of ORS?

Prevent and treat dehydration.

4. What instructions should be given with ORS?

Use recently boiled and cooled water, give frequently, use within 24 hours.

5. What is the dosage form of ORS?

Powder sachet.

Asthma & Respiratory Drugs

1. What drugs can be given for asthma?

Salbutamol, inhaled corticosteroids.

2. What are the side effects of Salbutamol?

Tremors, palpitations, headache.

Oral Liquid Preparations & Elixirs

1. What are the internal oral liquid preparations you know?

Syrups, suspensions, elixirs, solutions.

2. What are the differences between liquid elixir and reconstituted elixir?

Liquid elixir is ready to use; reconstituted elixir needs water.

3. Why is reconstituted elixir supplied in dry form?

To improve stability and shelf life.

4. What instructions should be given with elixirs?

Measure dose accurately, store properly, follow directions.

5. Can elixirs be dispensed without a prescription? Why?

Yes, if they contain non-prescription drugs.

6. What drugs can be dispensed without a prescription?

OTC drugs like paracetamol, ORS, antacids.

Sutures

1. What is a suture?

A material used to close wounds or surgical incisions.

2. What other needle types are available in your pharmacy?

Hypodermic needles, insulin needles, IV cannulas.

3. What is the sterilization method of sutures?

Gamma radiation or ethylene oxide.

4. What are the other types of sterilization methods?

Autoclaving, dry heat, chemical sterilization.

Prescription

Calcium gluconate 500 mg bd – 1/12

Folic acid 5 mg mane – 1/12

1. Can you dispense this? Why?

Yes, it is a safe and appropriate combination.

2. What are the side effects of calcium tablets?

Constipation, nausea, bloating.

3. What are the indications of folic acid?

Pregnancy, anemia, folate deficiency.

4. What is the dose of folic acid for pregnancy?

400–800 micrograms daily.

Mithuri Pack

1. What is the Mithuri pack?

A combined oral contraceptive pill pack.

2. What is the pack type?

Calendar pack.

3. Why do the tablets have two colors?

To differentiate active and inactive (placebo) tablets.

4. What are the side effects of this?

Nausea, headache, weight gain.

5. Where do blood clots form from this?

In deep veins, usually legs.

6. What is the term for that condition?

Deep vein thrombosis (DVT).

7. What is the treatment for that condition?

Anticoagulants (e.g., warfarin).

8. At what time should Warfarin be taken?

In the evening.

9. Why should it be taken at that time?

To allow dose adjustment after INR testing.

Anthelmintic

1. What anthelmintic medicines are available in your pharmacy?

Mebendazole, Albendazole, Pyrantel.

2. Can Mebendazole be dispensed without a prescription?

Yes

3. Can Albendazole be recommended for pregnant women? Why?

No, it may cause harm to the fetus.

4. What are the other indications for Albendazole?

Hydatid disease, neurocysticercosis.

5. Is Albendazole the drug of choice for filariasis?

No. But i can use as a part of filariasis mass treatment program.

6. What is the drug of choice for filariasis?

Diethylcarbamazine (DEC).

Narcotics

1. Can narcotics be dispensed with just a signed order? Why?

No, a legal prescription is required due to abuse risk.

2. Give some examples of narcotics.

Morphine, codeine, fentanyl.

3. What are the indications of Morphine?

Severe pain, cancer pain.

4. Can Morphine cause a toothache?

No, it relieves pain.

5. What medicine can be given for a toothache?

Paracetamol or ibuprofen.

External Semisolid Preparations

1. What external semisolid preparations do you know?

Ointments, creams, gels, pastes.

2. What are the main differences between an ointment and a paste?

Paste is thicker and contains more solids.

3. Does aqueous cream contain chlorocresol?

Yes.

4. What other preservatives do you know?

Parabens, benzyl alcohol.

5. What are the characteristics of an ideal preservative?

Effective, non-toxic, stable, non-irritant.

Prescription

Spironolactone 25 mg mane

Bisoprolol 2.5 mg bd

Atorvastatin 10 mg nocte

Aspirin 75 mg nocte

1. Can you dispense this?

Yes, it is a common and appropriate combination.

2. What’s the drug class of Spironolactone?

Potassium-sparing diuretic (aldosterone antagonist).

3. What are the indications of Spironolactone?

Heart failure, hypertension, edema, hyperaldosteronism.

4. What is the likely indication for this patient?

Ischemic heart disease with heart failure or hypertension.

5. What are the side effects of Spironolactone?

Hyperkalemia, gynecomastia, dizziness, impotence.

6. What is the drug class of Bisoprolol?

Beta-1 selective beta blocker.

7. What are the indications of Bisoprolol?

Hypertension, heart failure, angina.

8. Tell some side effects of Bisoprolol.

Bradycardia, fatigue, dizziness.

9. What other medicines belong to this class?

Metoprolol, Atenolol, Propranolol.

10. What other dosage forms of Bisoprolol exist?

Tablets of different strengths.

11. What is the drug class of Atorvastatin?

Statin (HMG-CoA reductase inhibitor).

12. What is its mechanism of action?

Inhibits cholesterol synthesis in the liver.

13. How does it help reduce cholesterol levels?

Lowers LDL and total cholesterol.

14. What are the side effects of Atorvastatin?

Muscle pain, liver enzyme elevation.

15. What tests should this patient undergo before the next clinic visit?

Lipid profile, liver function tests, serum potassium.

Anti-Inflammatory Drugs

1. Do you know the uses of Aspirin?

Pain, inflammation, antiplatelet therapy.

2. What other drugs are used for inflammation?

Ibuprofen, Diclofenac, corticosteroids.

3. Why is Hydrocortisone preferred over Prednisolone as an anti-inflammatory medicine?

Shorter acting and safer for acute use.

4. What are the other uses of steroids?

Allergy, asthma, autoimmune diseases.

Antihistamines & Allergy Medications

1. What drugs can be used for allergic conditions?

Antihistamines, corticosteroids.

2. What is an antihistamine?

A drug that blocks histamine action.

3. Give some examples of antihistamines.

Chlorpheniramine, Loratadine, Cetirizine.

4. What is the main difference between Astemizole and Chlorpheniramine?

Astemizole is non-sedating; Chlorpheniramine is sedating.

5. What are the main differences between Chlorpromazine and Promethazine?

Chlorpromazine is antipsychotic; Promethazine is antihistamine.

6. What are the side effects of Promethazine?

Drowsiness, dry mouth.

7. Is vomiting the main indication for Chlorpromazine?

No, it is mainly used for psychosis.

8. What other drugs are given for psychotic disorders?

Haloperidol, Risperidone.

9. What are the side effects of Chlorpromazine?

Sedation, extrapyramidal symptoms.

10. Can you name other drugs that cause gynecomastia?

Spironolactone, Cimetidine.

Co-Amoxiclav Syrup

1. What is the dosage form?

Dry powder for reconstitution (syrup).

2. Tell about the packaging.

Amber glass or plastic bottle.

3. Why is packaging used for pharmaceuticals?

Protection, stability, identification.

4. Why is this glass colored?

To protect from light.

5. What is the difference between normal syrup and this?

This requires reconstitution.

6. What is the API?

Amoxicillin + Clavulanic acid.

7. What is the strength?

Commonly 125/31.25 mg per 5 ml (varies).

8. Why is Clavulanic acid used in this formulation?

To inhibit beta-lactamase enzymes.

9. What type of water is used to prepare this?

Purified or boiled and cooled water.

10. Tell me the method of preparation.

Read the instructions

Shake the bottle up and down to loosen the powder

Add water to mark, shake well.

11. What are the storage advisories?

Refrigerate after reconstitution, use within 7 days.

Androgens & Hormonal Preparations

1. Name some preparations of androgens.

Testosterone injections, gels.

2. What are the contraindications of androgens?

Prostate cancer, pregnancy.

3. Name some estrogen preparations.

Ethinylestradiol, estradiol.

4. What are the therapeutic uses of estrogen?

Contraception, menopause therapy.

5. What are the adverse effects of estrogen?

Nausea, thromboembolism.

6. List three therapeutic uses of progesterone.

Contraception, menstrual disorders, pregnancy support.

7. What are the contraindications of oral contraceptives?

Thromboembolic disease, breast cancer.

8. Name one ovulation-inducing drug.

Clomiphene citrate.

9. What are the adverse effects of it?

Ovarian enlargement, hot flushes.

10. What are the uses of injectable progesterone?

Luteal support, threatened abortion.

11. What is the main advantage of Norplant?

Long-term reversible contraception.

Pyrantel Pamoate Suspension

1. What is the dosage form?

Oral suspension.

2. What are the indications?

Threadworm, roundworm, hookworm infections.

3. Why is this in suspension form?

Suitable for children and for drugs poorly soluble in water.

4. Give other suspension dosage forms available in your pharmacy.

Paracetamol suspension, Amoxicillin suspension, Co-trimoxazole suspension.

5. Do you know any other dosage forms of Pyrantel Pamoate?

Tablets.

IV Cannula

1. Explain the properties of this.

Sterile, flexible, non-toxic, disposable.

2. What does “Luer lock” mean?

A secure screw-type connection preventing leakage.

3. What is the sterilization method?

Ethylene oxide or gamma radiation.

4. What other sterile products are available in your pharmacy?

Syringes, needles, IV fluids, sutures.

5. What is the schedule of the IV cannula?

Prescription-only medical device.

Adrenal Steroids & Cardiac Drugs

1. Name some adrenal steroid preparations.

Hydrocortisone, Prednisolone, Dexamethasone.

2. What are the contraindications of corticosteroids?

Active infections, peptic ulcer, uncontrolled diabetes.

3. What precautions should be taken when a patient is on long-term corticosteroid therapy?

Do not stop abruptly, monitor BP and glucose.

4. Name some important cardiac glycosides.

Digoxin, Digitoxin.

5. What is the source of Digoxin?

Digitalis purpurea plant.

6. Name some antiarrhythmic drugs.

Amiodarone, Lidocaine, Quinidine.

7. What are the therapeutic uses of Lignocaine?

Local anesthesia, ventricular arrhythmias.

8. What drugs are used for hypertension?

ACE inhibitors, beta blockers, diuretics.

9. Give some advantages of Methyldopa.

Safe in pregnancy, effective BP control.

10. What are the uses of Propranolol?

Hypertension, angina, arrhythmias.

11. Do you know about diuretics?

Drugs that increase urine output.

12. What are the side effects of Furosemide?

Hypokalemia, dehydration, dizziness.

13. What are the therapeutic uses of diuretics?

Edema, hypertension, heart failure.

Candid-B Cream

1. Briefly describe it.

Combination of antifungal, steroid, and antibacterial.

2. What is its shelf life?

Usually 2–3 years (check label).

3. What is meant by shelf life?

Time during which drug remains effective and safe.

4. What methods harm the quality of a drug?

Heat, light, moisture, contamination.

5. What is the difference between a cream and an ointment?

Cream is less greasy; ointment is oil-based.

6. What ointment bases are normally used?

Hydrocarbon, absorption, water-soluble bases.

7. Give examples.

Petroleum jelly, lanolin, PEG base.

Lugol’s Iodine

1. Have you ever heard about Lugol’s iodine?

Yes.

2. What is it used for?

Thyroid disorders, iodine supplementation.

3. What are its ingredients?

Iodine, potassium iodide, water.

4. How do you store iodine in the pharmacy?

In a tightly closed amber bottle.

5. Why is iodine stored in an amber-colored bottle?

To protect from light.

Steroid Preparations

1. Name some synthetic steroid preparations.

Prednisolone, Dexamethasone, Betamethasone.

2. Give some examples of different dosage forms of steroid preparations.

Tablets, injections, creams, inhalers.

3. What are the side effects of steroid preparations?

Weight gain, osteoporosis, immunosuppression.

4. How are topical steroid preparations classified?

Mild, moderate, potent, very potent.

Antimuscarinic & Drug Administration

1. What is the meaning of an antimuscarinic drug?

A drug that blocks muscarinic (parasympathetic) receptors.

2. Give examples of muscarinic effects.

Salivation, sweating, bronchoconstriction, miosis.

3. Do you know different routes of drug administration?

Oral, rectal, parenteral, topical, inhalation.

4. What are the advantages of rectal administration?

Useful in vomiting, unconscious patients, partial avoidance of first-pass effect and not cause gastric irritation.

5. What rectal dosage forms are available in your pharmacy?

Suppositories, enemas.

6. What advice must be given when dispensing suppositories?

Store properly, insert rectally, use after bowel movement.

7. What is the storage condition of glycerol suppositories?

Store in a cool place, protect from heat.

Parenteral & Transdermal Dosage Forms

1. What are the different routes of parenteral preparations?

Intravenous, intramuscular, subcutaneous, intradermal.

2. Do you know about transdermal plasters?

Yes, patches that deliver drug through skin.

3. Are they available in your pharmacy?

No.

4. What are the advantages of transdermal plasters?

Sustained release, improved compliance, avoid first-pass metabolism.

Drug Absorption & Metabolism

1. What is the main organ for absorption of orally administered drugs?

Small intestine.

2. What are the advantages and disadvantages of oral administration?

Easy and safe, slow onset, first-pass metabolism.

3. What is the main organ for drug metabolism?

Liver.

4. What is the main organ for drug excretion?

Kidneys.

Povidone Iodine Ointment

1. What are the other dosage forms of this active ingredient?

Solution, gargle.

2. What is the color of iodine?

Dark brown.

3. What is the active ingredient of this ointment?

Povidone iodine.

4. Why is povidone included in this formulation?

To reduce irritation and release iodine slowly.

5. What is the color of Povidone iodine liquid?

Brown.

6. What bottle sizes are available for Povidone iodine liquid?

Small and large bottles (e.g., 30 ml, 100 ml).

7. What is the storage condition of Povidone iodine?

Store in a cool place, protect from light.

Oral Antidiabetic Drugs

1. What oral antidiabetic drugs do you know?

Metformin, Sulfonylureas, DPP-4 inhibitors.

2. What are the differences between Sulfonylureas and Biguanides?

Sulfonylureas increase insulin release; Biguanides reduce glucose production.

3. What is the preferred Sulfonylurea medicine for elderly patients with type II diabetes?

Tolbutamide.

4. Why is it preferred?

Lower risk of hypoglycemia.

5. What instructions should be given with Chlorpropamide?

Avoid alcohol, take regularly, monitor blood sugar.

Asthma Medications & Inhalers

1. What different dosage forms are used for asthma treatment?

Inhalers, tablets, syrups, nebulizers.

2. What medicines are used for asthma?

Salbutamol, inhaled corticosteroids.

3. What are the side effects of Salbutamol?

Tremors, palpitations, headache.

4. What is the pharmaceutical group of Salbutamol?

Beta-2 agonist.

Combined Contraceptive Pills

1. What ingredients are contained in combined contraceptive pills?

Estrogen and progestin.

2. Are they synthetic or natural?

Synthetic.

3. What are the main contraindications for these pills?

Thromboembolic disorders, breast cancer.

4. Are they suitable for lactating mothers? Why?

No, they reduce milk production.

Domperidone

1. What is the indication for Domperidone?

Nausea and vomiting.

2. What other medicines have the same indication?

Metoclopramide, Ondansetron.

3. What are the side effects of Domperidone?

Dry mouth, headache, rare cardiac effects.

Glyceryl Trinitrate (GTN)

1. What does bioavailability mean?

Fraction of drug reaching systemic circulation unchanged.

2. How much bioavailability can GTN achieve when taken orally?

Very low due to extensive first-pass metabolism.

3. What are the advantages of the sublingual route of administration?

Rapid onset, avoids first-pass metabolism.

Atropine Eye Drops

1. What are the indications for Atropine eye drops?

Mydriasis, cycloplegia, uveitis.

2. Is it available in your pharmacy?

Yes (prescription only).

3. What is its storage condition?

Store in a cool place, protect from light.

4. Does Pilocarpine have the same action?

No, it causes miosis (opposite action).

Cloxacillin

1. Give a brief explanation of this drug.

Penicillinase-resistant antibiotic for staphylococcal infections.

2. How frequently should it be taken?

Usually 4 times daily.

3. What patient advice should be given with it?

Take on empty stomach, complete the course.

4. What is its primary packaging material?

Blister pack or bottle.

Tablet Dosage Forms & Coatings

1. What are the different types of tablets?

Conventional, chewable, effervescent, coated, sustained-release.

2. What are the differences between film coating and sugar coating?

Film is thin and quick; sugar is thick and bulky.

3. What are sustained-release tablets?

Tablets releasing drug slowly over time.

4. What are the advantages of sustained-release tablets?

Fewer doses, better compliance.

Metformin Hydrochloride Extended Release 500 mg

1. What is this drug?

Oral antidiabetic (biguanide).

2. What is the packaging type?

Blister pack.

3. What is the label type?

Prescription-only label.

4. What patient advice should be given with this?

Take with food, do not crush or chew.

5. What does “extended release” mean?

Drug is released slowly over time.

6. How should it be used?

Once daily as prescribed.

7. What are its side effects?

GI upset, diarrhea, nausea.

Pharmacy Regulations & Licensing

1. Who are the authorized officers?

Drug inspectors, regulatory officers.…

2. Do you need a license to distribute medical devices?

Yes.

3. What information is needed for the registration of a drug?

Name, composition, manufacturer, safety data.

4. Do you know the prescription book?

Yes.

5. What are its contents?

Prescription records, dates, quantities, prescribers name, pharmacist’s signature.

6. What other records are available in your pharmacy?

Stock registers, temperature records.

7. What certificates need to be exhibited in a retail pharmacy?

Pharmacy license, pharmacist registration certificate.

Losartan

1. What is Losartan used for?

Hypertension, heart failure.

2. What drug class does it belong to?

Angiotensin II receptor blocker (ARB).

3. What are its side effects?

Dizziness, Hyperkalemia.

4. What are other antihypertensive medicines?

ACE inhibitors, beta blockers, diuretics.

5. Give examples of antihypertensive drugs.

Enalapril, Amlodipine, Atenolol.

Diuretics & Capsules

1. What are the types of diuretics?

Loop, thiazide, potassium-sparing, osmotic, carbonic anhydrase inhibitors.

2. What are the differences between Furosemide and Hydrochlorothiazide (HCT)?

Furosemide is loop (strong potent and short acting); HCT is thiazide (mild potent and long acting).

3. What are the types of capsules?

Hard gelatin, soft gelatin.

4. What are the differences between soft gelatin and hard gelatin capsules?

Soft for liquids; hard for powders.

5. What soft gelatin capsule products are available in your pharmacy?

Vitamin E, cod liver oil.

Diclofenac Gel

1. What is this drug?

Topical NSAID (non-steroidal anti-inflammatory drug).

2. What are its indications?

Muscle pain, joint pain, inflammation, arthritis.

3. What is its therapeutic group?

NSAID.

4. What is its dosage form?

Gel.

5. Comment on its packaging.

Usually in aluminum or plastic tube with a screw cap.

Prescription:

Rx:

Metformin 500mg

Atorvastatin 10mg (mane)

Clopidogrel 75mg (nocte)

1. Can you dispense this prescription?

No. Atorvastatin should give as note. Not mane.

2. If not, what should you do?

Clarify with prescriber.

3. What is Metformin?

Oral antidiabetic (biguanide).

4. What are its side effects?

GI upset, nausea, diarrhea, rarely lactic acidosis.

5. What are its available strengths?

500 mg, 850 mg.

6. What is its mode of action?

Reduces hepatic glucose production, increases insulin sensitivity.

7. What are its available formulations?

Tablets, extended-release tablets, oral solution.

Clopidogrel

1. What is its indication?

Prevention of heart attack and stroke.

2. What drug class does it belong to?

Antiplatelet.

3. What is its mechanism of action?

Inhibits platelet aggregation by blocking ADP receptors.

4. How does it prevent heart attacks?

Reduces blood clot formation in arteries.

Atorvastatin 10mg (SPMC)

1. What is it used for?

High cholesterol, prevention of cardiovascular disease.

2. What patient advice should be given with this medication?

Take at night, maintain diet, report muscle pain.

3. Why should Atorvastatin be taken at night?

HMG CoA reductase enzyme activity is highest at night.

HMG-CoA reductase inhibitor, reduces cholesterol synthesis.

5. What are some of its side effects?

Muscle pain, liver enzyme elevation, GI upset.

Prolene Suture

1. What is Prolene suture?

Synthetic non-absorbable monofilament suture.

2. What does “monofilament” mean?

Single-strand thread.

3. Is it absorbable or non-absorbable?

Non-absorbable.

4. Give examples of absorbable sutures.

Vicryl, Chromic gut, Dexon.

5. What does “chromic” mean?

Treated with chromium salt to slow absorption.

6. What sutures are available in your pharmacy?

Prolene, Vicryl, Chromic gut, Silk.

Paracetamol Syrup

1. Is this available in your pharmacy?

Yes.

2. What brands are available?

Crocin, Calpol, Panadol syrup.

3. What is the schedule of Paracetamol syrup?

OTC (Schedule 1)

4. What is the schedule of Paracetamol bulk packs?

Schedule 2A

5. What are drug schedules according to the Act?

Schedule 1,2A,2B,3,4

Hydrocortisone Ointment USP 1% W/W

1. Is this available in your pharmacy?

Yes.

2. What is the strength of this product?

1% w/w.

3. What does “W/W” mean?

Weight/weight.

4. What does “USP” mean?

United States Pharmacopeia (standard).

5. What type of dosage form is this?

Ointment.

6. What are its indications?

Inflammation, eczema, dermatitis.

7. Are there any specific storage conditions for this?

Store in cool, dry place, away from light.

8. What advice should be given when dispensing this?

Apply thin layer, avoid eyes, wash hands after use.

9. What other ointments are available in the pharmacy?

Betamethasone, Mometasone, Candid-B.

10. What other dosage forms contain the same active ingredient?

Creams, lotions.

11. What type of packaging material is used?

Aluminum tube with screw cap.

Carbamazepine

1. What is the indication for this drug?

Epilepsy, trigeminal neuralgia.

2. What does “convulsion” mean?

Sudden uncontrolled muscle activity (seizure).

3. What strengths is this drug available in?

100 mg, 200 mg, 400 mg tablets.

4. What other dosage forms exist?

Suspension, suppository.

5. Are there other indications for this drug?

Bipolar disorder, neuropathic pain.

6. What are its side effects?

Dizziness, drowsiness, nausea, rash.

7. Name other drugs used for convulsions.

Phenytoin, Valproate, Levetiracetam, Phenobarbitone sodium, Ethosuximide, Gabapentin, Vigabatrin, Clonazepam.

8. How long should convulsions be treated? Why?

Long-term(at least 2 years after last episode) to prevent seizure recurrence.

9. What specific instructions should be given to a patient taking Carbamazepine tablets?

Take with food, do not stop suddenly, monitor blood counts.

Ferrous Sulfate

1. What are its indications?

Iron-deficiency anemia.

2. Who should be prescribed this?

Pregnant women, patients with low hemoglobin and iron deficiency anemia.

3. What form of iron does it contain?

Ferrous (Fe²⁺) iron.

4. Why is that form used?

Better absorption than ferric (Fe³⁺) iron.

5. What instructions should be given with this medication?

Take immediately after meals, avoid tea/coffee, may cause dark stools.

6. What other dosage forms contain the same active ingredient?

Syrup, injections.

Soft vs. Hard Gelatin Capsules

1. What are the differences between soft gelatin and hard gelatin capsules?

Soft: liquid fill, one-piece; Hard: powder fill, two-piece.

2. What soft gelatin capsules are available in your pharmacy?

Vitamin E, cod liver oil, fish oil.

3. What is the shell material, and what are its types?

Gelatin; animal-derived (bovine/pork) or plant-based.

Prescription:

Amoxicillin 500mg TDS,

Paracetamol 2 tablets

Syrup Lactulose 15 mL nocte

Bisacodyl 3 nocte

1. Can you dispense medicine for this prescription?

2. Why or why not?

Dosage and duration is not in the prescription.

3. Give indications for each?

Amoxicillin: Bacterial infection

Paracetamol: Fever, pain

Lactulose: Constipation

Bisacodyl: Constipation

Antihistamines

1. What is an antihistamine?

Drug that blocks histamine receptors.

2. What is the most common side effect of antihistamines?

Drowsiness (for sedative types).

3. Give some examples of antihistamines.

Chlorpheniramine, Loratadine, Diphenhydramine.

4. How are antihistamines classified?

Sedative (first-generation) and non-sedative (second-generation).

5. Give examples of sedative and non-sedative antihistamines.

Sedative: Diphenhydramine; Non-sedative: Loratadine.

6. What advice should be given with sedative antihistamines?

Avoid driving, alcohol; take at night.

Corticosteroids

1. What are the actions of corticosteroids?

Anti-inflammatory, immunosuppressive, metabolic effects.

2. What are the side effects of oral steroid preparations?

Weight gain, hypertension, hyperglycemia, osteoporosis.

Pharmacokinetics & Drug Absorption

1. What is the meaning of pharmacokinetics?

Study of drug absorption, distribution, metabolism, and excretion.

2. What factors influence drug absorption?

Solubility, pH, blood flow, GI motility, first-pass metabolism.

3. What is first-pass metabolism?

Drug metabolism in liver before reaching systemic circulation.

4. Why is GTN not administered orally?

Extensive first-pass metabolism reduces effectiveness.

Medical Devices

1. What medical devices are available in your pharmacy?

Syringes, IV cannula, nebulizers, inhalers, thermometers, glucometers.

2. What instructions should be given with a metered-dose inhaler (MDI)?

Shake before use, inhale slowly, hold breath 10 seconds, rinse mouth.

3. How should capsules for dry powder inhalers be stored?

Keep in cool, dry place; avoid moisture.

Prednisolone

1. What is this?

Oral corticosteroid.

2. What are the other medicines in this class?

Hydrocortisone, Dexamethasone, Methylprednisolone.

3. What are the side effects of this?

Weight gain, hypertension, hyperglycemia, mood changes.

4. What instructions should be given with Prednisolone?

Take with food, do not stop abruptly, follow prescribed dose.

Diuretics

1. What is a diuretic?

Drug that increases urine output.

2. How are diuretics classified?

Loop, thiazide, potassium-sparing, osmotic, carbonic anhydrase inhibitors.

3. What are the indications of Hydrochlorothiazide (HCT) and Furosemide?

HCT: Mild hypertension, edema

Furosemide: Severe edema, heart failure.

4. What are the side effects of Furosemide?

Hypokalemia, dehydration, hypotension.

5. Give examples of potassium-sparing diuretics.

Spironolactone, Amiloride.

6. What are their contraindications?

Hyperkalemia, severe kidney disease.

Insulin

1. What types of insulin are available in your pharmacy?

Rapid-acting, short-acting, intermediate-acting, long-acting, premixed.

2. What are the indications for insulin?

Type 1 diabetes, Type 2 diabetes (when oral agents fail), gestational diabetes.

3. What is the storage condition for unopened insulin?

Store in fridge (2–8°C), do not freeze, protect from light.

4. What instructions should be given with insulin?

Rotate injection sites, check expiry, do not shake vigorously, use as prescribed.

Beta Blockers

1. What beta blockers do you know?

Atenolol, Metoprolol, Propranolol, Bisoprolol, Carvedilol.

2. How are they classified?

Selective (β1) and non-selective (β1+β2).

3. What are the different uses of beta blockers?

Hypertension, angina, heart failure, arrhythmias, post-MI, migraine.

4. What are some contraindications of beta blockers?

Asthma, bradycardia, severe heart block, hypotension.

5. Can beta blockers be used for cardiac failure?

Yes, certain types like Carvedilol, bisoprolol, labetalol.

6. What are the side effects of beta blockers?

Fatigue, bradycardia, hypotension, dizziness, cold extremities.

Diclofenac Sodium Tablets

1. What pharmacological group does it belong to?

NSAID (non-steroidal anti-inflammatory drug).

2. What are the different indications?

Pain, inflammation, arthritis, dysmenorrhea, musculoskeletal disorders.

3. Give examples of other drugs in that group.

Ibuprofen, Naproxen, Indomethacin.

4. What other dosage forms are available?

Gel, injection, suppository, tablets.

5. What are the advantages of diclofenac sodium suppositories?

Bypasses GI irritation, useful in patients unable to take oral meds.

Prescription

Simvastatin 20mg nocte

Isosorbide mononitrate 10mg nocte

1. Can you dispense this prescription?

Yes.

2. What should you consider before dispensing medicines?

Check drug interactions, patient condition, contraindications, proper dosing.

3. What is the action of Simvastatin?

HMG-CoA reductase inhibitor. It helps to lower cholesterol.

4. What other statin drugs do you know?

Atorvastatin, Rosuvastatin, Pravastatin.

5. What pharmacological group does it belong to?

Lipid-lowering agent.

6. What are its side effects?

Muscle pain, liver enzyme elevation, GI upset.

7. What is the mechanism of action of Isosorbide Mononitrate?

Vasodilator; releases NO to reduce cardiac preload and angina.

8. What other drugs belong to the same group?

Glyceryl trinitrate (GTN), Isosorbide dinitrate.

9. What are the different dosage forms of GTN?

Sublingual tablets, sprays, transdermal patches, ointment.

Antiplatelet Drugs & Lipid-Lowering Agents

1. What are some antiplatelet drugs?

Aspirin, Clopidogrel, Ticagrelor.

2. Is Streptokinase an antiplatelet?

No, it is a thrombolytic.

3. What is the source of Streptokinase?

Streptococcal bacteria culture.

4. What lipid-lowering drugs do you know?

Statins, fibrates, bile acid sequestrants.

Implants

1. What are implants?

Solid dosage forms placed subcutaneously for slow drug release.

2. What implants are available in your pharmacy?

Contraceptive implants (e.g., Norplant, Jadelle).

3. What are the main differences between tablets and implants?

Tablets: oral, daily dosing; Implants: subcutaneous, long-term release.

4. What are the advantages of implants?

Long-acting, consistent drug levels, improves compliance.

Thyroxine 50 mcg Tablets

1. What is this medication?

Levothyroxine, synthetic thyroid hormone.

2. What is its strength?

50 mcg.

3. What does “IP” mean?

Indian Pharmacopoeia standard.

4. What are its uses?

Hypothyroidism, myxedema.

5. What is the difference between hyperthyroidism and hypothyroidism?

Hyper: excess thyroid hormone; Hypo: deficient thyroid hormone.

6. Why is this prescribed for hypothyroidism?

Replaces deficient thyroid hormone.

7. What are its side effects?

Overdose can cause palpitations, weight loss, insomnia.

8. What patient advice should be given?

Take on early empty stomach at least half an hour before meal, monitor symptoms, avoid calcium/iron at same time.

9. Why should it be taken on an empty stomach?

Food reduces absorption.

10. How can hyperthyroidism and hypothyroidism be differentiated based on symptoms?

Hyper: weight loss, tachycardia, heat intolerance; Hypo: weight gain, fatigue, cold intolerance.

11. What drugs are used in hyperthyroidism?

Carbimazole, Methimazole, Propylthiouracil (PTU).

12. What are the side effects of thiourea derivatives?

Rash, agranulocytosis, liver toxicity.

13. Is there any specific rare side effect?

Severe neutropenia/agranulocytosis.

Postinor-2

1. What is its use?

Emergency contraception.

2. What schedule does it belong to?

Schedule 2A

3. Who can sell it?

Licensed pharmacists.

4. How should you advise on its usage?

Take as soon as possible after unprotected intercourse, preferably within 72 hours. Take next tablet after 12 hours.

Gliclazide 80mg

1. What is this medication?

Oral antidiabetic.

2. What pharmacological class does it belong to?

Sulfonylurea.

3. What other medicines belong to this class?

Glibenclamide, Glimepiride.

4. What are its side effects?

Hypoglycemia, weight gain, GI upset.

5. Can it be prescribed with Metformin? Why?

Yes, complementary action: Metformin reduces glucose production, Gliclazide increases insulin secretion.

Parenteral Preparations & Surgical Supplies

1. What parenteral preparations are available in your pharmacy?

Injections, infusions, vaccines, IV fluids, antibiotics.

2. What surgical devices are available?

Scalpels, forceps, syringes, needles, cannulas, sutures.

3. What surgical dressings are available?

Gauze, bandages, adhesive plasters, sterile pads.

4. Is there a counseling area in your pharmacy?

Yes, for patient counseling and privacy during medication guidance.

Gentamicin Eye/Ear Drops 0.3% W/V

1. What is this?

Aminoglycoside antibiotic solution for eye and ear infections.

2. What special characteristics does it have?

Sterile, preservative-free or with mild preservatives, water-soluble.

3. Why is it sterile?

Prevents contamination and eye/ear infections.

4. What special patient advice should be given?

Wash hands, avoid touching dropper tip, use as prescribed, complete course.

5. What does “W/V” mean?

Weight/volume percentage (0.3 g per 100 mL solution).

Prescription:

Amoxicillin 500mg TDS

Domperidone 10mg TDS

Paracetamol 2 tablets TDS

Chlorpheniramine 4mg TDS

1. Can you dispense this prescription?

Yes

2. What may be the patient’s condition?

Likely upper respiratory infection or bacterial infection with nausea/allergy.

3. What is Domperidone?

Antiemetic and prokinetic agent.

4. Why is Domperidone prescribed in this case?

To prevent nausea/vomiting associated with infection or medication.

Lithium Carbonate

1. What are its indications?

Bipolar disorder, mania, depression.

2. What is the packaging material?

Blister packs or HDPE bottles, tightly closed.

3. What therapeutic group does it belong to?

Mood stabilizer.

4. What are its main side effects?

Tremor, polyuria, nausea, hypothyroidism, renal effects.

Prescription:

Losartan 50mg BD

Rosuvastatin 5mg nocte

Amlodipine 5mg ½ tab BD

1. Is this prescription correct?

Yes

2. What drug class does Losartan belong to?

ARB (Angiotensin II Receptor Blocker).

3. What are its indications?

Hypertension, heart failure, diabetic nephropathy.

4. What pharmacological group does Amlodipine belong to?

Calcium channel blocker (dihydropyridine).

5. What are its indications?

Hypertension, angina.

Acyclovir (Cyclovir)

1. What is this medication?

Antiviral drug.

2. What drug class does it belong to?

Nucleoside analogue antiviral.

3. What are its indications?

Herpes simplex virus infections, varicella-zoster virus.

4. What diseases is it used to treat?

Cold sores, genital herpes, shingles, chickenpox.

Pyrantel Suspension

1. What is the dosage form?

Oral suspension.

2. What is this?

Anthelmintic (treats intestinal worms).

3. What are the other liquid dosage forms available in your pharmacy?

Syrups, elixirs, suspensions, oral drops.

4. How do you give this to the patient (patient advice)?

Shake well, measure with a calibrated spoon, single dose for roundworm/threadworm.

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

1. What is the meaning of NSAIDs?

Non Steroid Anti Inflammatory Drugs

2. Can you give examples of NSAIDs?

Diclofenac, Ibuprofen, Naproxen, Aspirin.

3. What are the dosage forms of Diclofenac sodium?

Tablets, injections, gel, suppositories.

4. Do you know the indications of Diclofenac sodium?

Pain, arthritis, dysmenorrhea, musculoskeletal disorders.

5. Is Diclofenac sodium recommended for fever?

Yes, mild to moderate fever.

6. What is the main side effect of NSAIDs?

GI irritation, ulcers, renal effects.

7. How does Aspirin differ from Diclofenac sodium?

Aspirin has antiplatelet effect; Diclofenac mainly anti-inflammatory/pain relief.

8. What instructions should you give when dispensing NSAIDs?

Take with food, avoid long-term use without supervision, check for contraindications.

9. What are the indications of Aspirin?

Pain, inflammation, fever, prophylaxis of cardiovascular events.

Tablets & Excipients

1. How do you define tablet excipients?

Inactive ingredients used to form, stabilize, or improve tablets.

2. Examples of disintegrating agents?

Starch, sodium starch glycolate, croscarmellose sodium.

3. How do disintegrating agents work?

Absorb water, swell, break tablet for faster dissolution.

4. Examples of lubricants in tablet formulations?

Magnesium stearate, talc, stearic acid.

5. Ingredients in methyl salicylate ointment?

Methyl salicylate, petroleum jelly, emulsifying wax.

6. Synonym of methyl salicylate?

Oil of wintergreen.

7. Other types of semisolid dosage forms?

Creams, gels, pastes, ointments.

8. Main differences between ointments and pastes?

Ointments: greasy, occlusive; Pastes: thicker, protective barrier, high solid content.

9. Different types of ointment bases?

Hydrocarbon, absorption, water-soluble, emulsifying.

10. Form of PEG in pharmaceutical applications?

Solid or liquid, used as ointment base or solvent.

Amoxicillin & Antibiotics

1. Pharmaceutical group of Amoxicillin?

Penicillin antibiotic.

2. Other groups of antibacterial drugs?

Macrolides, quinolones, cephalosporins, tetracyclines, aminoglycosides.

3. Pharmaceutical group of Erythromycin?

Macrolide antibiotic.

4. Differences between Erythromycin and Clarithromycin?

Clarithromycin: broader spectrum, longer half-life, fewer GI effects.

5. Should Erythromycin be administered before or after meals?

Usually before meals.

6. Examples of quinolone drugs?

Ciprofloxacin, Levofloxacin, Ofloxacin.

7. Which antibiotics are contraindicated in pregnancy?

Tetracyclines, quinolones, streptomycin (some aminoglycosides).

8. Can you dispense penicillin to pregnant women?

Yes, generally considered safe if indicated.

Promethazine & Tablet Coating

1. Do you know the type of tablet that promethazine is in?

Usually available as conventional or film-coated tablets.

2. Do you know other coating methods for tablets?

Sugar coating, film coating, enteric coating, polymer coating.

3. What are the advantages of tablet coating?

Masks taste, protects drug from light/air, improves swallowing, controls release.

4. Do you know the disintegration time of tablets?

Usually 5 minutes for conventional tablets..

5. Do you know the excipients used in tablet formulations?

Fillers, binders, disintegrants, lubricants, glidants, colorants, flavoring agents.

6. Do all types of tablets contain flavoring agents?

No, only chewable, dispersible, or orally dissolving tablets often contain flavoring agents.

7. Do you know which tablet types contain flavoring agents?

Chewable, dispersible, effervescent, and orally disintegrating tablets.

8. Can you give examples of lubricating agents used in tablets?

Magnesium stearate, talc, stearic acid.

OTC (Over-The-Counter) Drugs & GTN (Glyceryl Trinitrate)

1. Do you know which drugs can be sold OTC?

Analgesics, antacids, cough/cold remedies, vitamins, topical antiseptics.

2. Under what conditions can you sell GTN tablets?

Only under prescription, as it is a prescription-only medicine due to cardiovascular risks.

3. What instructions should you convey to a patient taking GTN tablets?

Place sublingually, avoid swallowing, store in original container, do not use more than prescribed, monitor for dizziness.

Cimetidine & Drug Interactions

1. Can you dispense NSAIDs with cimetidine?

Yes, cimetidine may reduce NSAID-induced gastric irritation.

2. What are the other drugs that can be dispensed with cimetidine?

Antacids, antibiotics, digoxin (with caution).

Legal Requirements for Opening a Retail Pharmacy

1. What are the legal requirements needed to open a new retail pharmacy?

Qualified pharmacist, premises meeting regulatory standards, license from health authority, registration with local pharmacy council.

2. What are the documents required for that purpose?

Pharmacist qualification certificate, business registration, premises plan, application form, fees, proof of ownership/lease.

Dispensing Medications

1. Can you dispense chloroquine without a prescription?

No. Chloroquine is prescription-only due to risk of toxicity and misuse.

2. Explain why.

Risk of side effects, potential for overdose, and requirement for proper medical supervision.

Tablets & Implants

1. What are the different types of tablets you know?

Conventional, chewable, dispersible, effervescent, film-coated, enteric-coated, sustained-release.

2. How do you define implants?

Sterile, solid devices placed under the skin to deliver drugs over a long period.

3. What are the main differences between tablets and implants?

Tablets: oral, immediate or controlled release. Implants: subcutaneous, long-term release.

4. What are the main advantages of implants?

Long duration of action, better compliance, stable blood levels, bypass first-pass metabolism.

Alkaloids & Glycosides

1. Give examples of some alkaloids.

Morphine, quinine, caffeine, atropine, nicotine.

2. How do you define alkaloids?

Naturally occurring nitrogen-containing compounds with pharmacological activity.

3. What are the pharmaceutically important glycosides?

Digoxin, digitoxin, saponins, cardiac glycosides.

4. Is pethidine an alkaloid or a glycoside?

Alkaloid (synthetic opioid).

Anticholinergic Drugs

1. What are the anticholinergic drugs you know?

Atropine, scopolamine, ipratropium, benztropine, oxybutynin.

2. Do you know the different uses of anticholinergic drugs?

Reduce secretions, treat bradycardia, motion sickness, urinary incontinence, Parkinson’s disease.

3. What are the other drugs that produce anticholinergic side effects?

Antihistamines, tricyclic antidepressants, some antipsychotics.

4. What are the contraindications of anticholinergic drugs?

Glaucoma, urinary retention, BPH, severe cardiac disease, GI obstruction.

Asthma & Related Drugs

1. What are the drugs indicated for asthma?

Salbutamol, terbutaline, budesonide, fluticasone, theophylline, montelukast.

2. Do you know the mode of action of these drugs?

Bronchodilation (β2 agonists), anti-inflammatory (steroids), leukotriene receptor antagonism.

3. Do you know the source of pilocarpine?

Natural alkaloid from Pilocarpus species.

4. What are the main differences between atropine and pilocarpine?

Atropine: antimuscarinic, dilates pupils, reduces secretions. Pilocarpine: muscarinic agonist, constricts pupils, stimulates secretions.

Lipid-Lowering Drugs

1. What are the lipid-lowering drugs you know?

Statins (atorvastatin, simvastatin), fibrates (gemfibrozil), niacin, bile acid sequestrants.

2. What are the side effects of atorvastatin?

Muscle pain, liver enzyme elevation, GI upset, headache.

3. What instructions would you give with atorvastatin?

Take at night, monitor liver function, report muscle pain, maintain diet/exercise.

4. Do you know the mode of action of atorvastatin?

Inhibits HMG-CoA reductase → reduces cholesterol synthesis in liver.

5. Give some examples of drugs included in this group.

Simvastatin, rosuvastatin, pravastatin.

Drug Registration

1. What is the meaning of registered drugs?

Drugs approved by regulatory authority for safety, efficacy, and quality.

2. Are drugs registered before selling?

Yes, registration is mandatory.

3. Why are drugs registered?

To ensure safety, efficacy, quality, and legal compliance.

Ointment Bases

1. What are the ointment bases you know?

Hydrocarbon, absorption, water-soluble, emulsifying.

2. What are the main differences between ointment bases and eye ointment bases?

Eye bases are less irritating, non-toxic, water-miscible, sterile.

3. What are the ingredients in eye ointment base (RP)?

Yellow soft paraffin, liquid paraffin, emulsifying agents.

4. What is the main difference between eye ointments and eye drops?

Ointments: longer contact, slower absorption. Drops: rapid action, easier administration.

5. How do you apply eye ointment?

Thin strip into lower conjunctival sac, avoid touching eyelid.

Antidiabetic Drugs

1. What are the antidiabetic drugs you know?

Metformin, gliclazide, glibenclamide, pioglitazone, insulin.

2. Do you know the indications for oral hypoglycemic drugs?

Type 2 diabetes, sometimes for type 1 adjunct therapy.

3. What are the contraindications of oral hypoglycemic drugs?

Severe renal/hepatic impairment, type 1 diabetes (without insulin), pregnancy (for some).

4. What instructions would you give to a patient taking chlorpropamide?

Take with food, monitor blood sugar, avoid alcohol, watch for hypoglycemia.

5. Give examples of other drugs that interact with alcohol.

Metronidazole, disulfiram, some antihypertensives.

6. What instructions would you give to a patient taking metformin?

Take with meals, avoid alcohol, monitor for GI upset, regular kidney function check.

7. Are there any other drugs taken after meals?

Acarbose, glimepiride, miglitol (to reduce GI upset or hypoglycemia).

Griseofulvin & Antifungal Drugs

1. What are the indications for griseofulvin?

Used to treat dermatophyte infections (ringworm, tinea corporis, tinea capitis).

2. What are the drugs given for candida?

Nystatin, fluconazole, clotrimazole, miconazole.

Nystatin

1. How do you express the strength of nystatin?

In units (e.g., 100,000 units/mL).

2. Do you know other drugs whose strength is expressed in units?

Insulin, heparin, penicillin.

3. Why is the strength of some drugs expressed in units?

Because their activity is biological rather than based on mass, so potency is measured in standardized units.

Diclofenac Sodium

1. What are the indications of Diclofenac sodium?

Pain, inflammation, arthritis, musculoskeletal disorders.

2. Can Diclofenac sodium be given for fever?

Yes, it has antipyretic properties.

3. What are the main side effects of Diclofenac sodium?

GI irritation, nausea, dyspepsia, headache, renal effects.

4. Does Diclofenac sodium suppository cause gastric irritation?

No, as it bypasses the stomach.

5. What are the other drugs included in this group?

Ibuprofen, naproxen, indomethacin, ketorolac (NSAIDs).

Paracetamol

1. What is the drug given for fever?

Paracetamol (acetaminophen).

2. What are the differences between Paracetamol and Ibuprofen?

Paracetamol: analgesic/antipyretic, minimal anti-inflammatory.

Ibuprofen: analgesic, antipyretic, and anti-inflammatory.

3. What are the different dosage forms of Paracetamol?

Tablets, syrup, suspension, drops, suppositories, .

4. Do you know the strength of:

Paracetamol tablet: 500 mg

Emulsion & Oils

1. Define emulsion.

A mixture of two immiscible liquids, one dispersed as droplets in the other (oil in water or water in oil).

2. What are the different types of oils do you know?

Volatile oils (essential oils) and fixed oils (vegetable oils).

3. What is the difference between volatile oil and fixed oil?

Volatile oil: evaporates easily, aromatic (e.g., peppermint oil).

Fixed oil: does not evaporate easily, non-volatile (e.g., olive oil).

4. Do you know the method of extracting volatile oil?

Steam distillation, hydrodistillation.

5. What are the other distillation methods?

Solvent extraction, cold pressing, enfleurage (rare).

Drug Advertising & Regulations

1. What are the conditions for advertising drugs?

Must be factual, not misleading, approved by regulatory authority, and not target prescription-only drugs directly to the public.

2. What is the schedule of Paracetamol 1000’s pack included?

Schedule 2B

Laxatives and Omeprazole

1. Do you know the pharmaceutical group of lactulose?

Osmotic laxative.

2. What is the mode of action of lactulose?

Increases osmotic pressure in the colon, softens stools, and promotes bowel movement.

3. What are the other drugs included in laxatives?

Bisacodyl, senna, magnesium hydroxide, glycerin suppositories.

4. What is the mode of action of Castor oil?

Stimulates intestinal peristalsis (stimulant laxative).

5. Do you know the mode of action of Omeprazole?

Proton pump inhibitor; reduces gastric acid secretion by inhibiting H⁺/K⁺ ATPase in stomach lining.

6. Can Omeprazole be dispensed with NSAIDs?

Yes, often co-prescribed to reduce NSAID-induced gastric irritation.

7. What are the side effects of Omeprazole?

Headache, nausea, diarrhea, vitamin B12 deficiency with long-term use.

Surfactants

1. Do you know what a surfactant is?

Substance that reduces surface tension between two liquids or a liquid and a solid.

2. Can you give examples of surfactants?

Sodium lauryl sulfate, Tween 80, Span 20.

3. What are the uses of surfactants?

For emulsifying agents, detergents, wetting agents, solubilizers in pharmaceuticals.

Drug Strength and Storage

1. Define “strength” of a drug.

The amount of active ingredient in a given dosage form.

2. What is the quantity of sodium chloride in Normal saline 1000 mL?

9 grams per liter (0.9%).

3. What are the factors that influence deterioration of drugs?

Light, heat, moisture, air, pH, microbial contamination.

4. Do you know the EP1 schedule?

Refers to the official pharmacopoeial standards for drug stability and potency.

5. Can drugs be stored in the freezer?

Only if the label/monograph permits; most liquid preparations and injectables are not frozen.

6. Do you know which drugs are photosensitive?

Nitroglycerin, riboflavin, folic acid, some antibiotics.

7. What is the method of storing photosensitive substances?

In amber-colored bottles, away from light and heat.

8. How do you dispose of expired drugs?

Return to manufacturer, incineration, or according to NMRA regulations.

Antiepileptic Drugs

1. What are the antiepileptic drugs you know?

Phenytoin, carbamazepine, valproate, levetiracetam, lamotrigine.

2. What are the indications of Phenytoin sodium?

Generalized and partial seizures.

3. Do you know the side effects of Phenytoin sodium?

Gingival hyperplasia, hirsutism, ataxia, nystagmus, rash.

4. Do you know the drugs that reduce liver enzymes?

Some enzyme inducers like rifampicin may reduce serum drug levels of other drugs metabolized by liver.

Cimetidine

1. What is the pharmaceutical group of Cimetidine?

H2 receptor antagonist.

2. Can you dispense NSAIDs with cimetidine?

Yes, to reduce gastric irritation.

3. What are the other drugs that can be dispensed with cimetidine?

Antacids, antibiotics, PPIs (with caution), digoxin (with monitoring).

Legal Requirements for Opening a Retail Pharmacy

1. What are the legal requirements needed to open a new retail pharmacy?

Qualified pharmacist, licensed premises, regulatory approval, registration with local pharmacy council, business registration.

2. What are the documents required for that purpose?

Pharmacist license, application form, business registration documents, proof of premises, plan/layout of pharmacy, fees, NOC from local authority.

Dispensing Medications

1. Can you dispense chloroquine without a prescription?

No, chloroquine is a prescription-only medicine.

2. What is its drug class?

Antimalarial (4-aminoquinoline).

3. What are the other medicines in that class?

Hydroxychloroquine, amodiaquine, primaquine.

Tablets & Implants

1. What are the different types of tablets you know?

Conventional/compressed, chewable, effervescent, sublingual, buccal, sustained-release.

2. How do you define implants?

Solid dosage forms inserted under the skin to release drugs over a long period.

3. What are the main differences between tablets and implants?

Feature :	Tablets:	Implants:
Route	Oral	Subcutaneous
Release	Immediate or delayed	Sustained/controlled
Duration	Hours to 1 day	Weeks to months

4. What are the main advantages of implants?

Long-term drug delivery, improved compliance, reduced dosing frequency.

Alkaloids & Glycosides

1. Give examples of some alkaloids.

Morphine, quinine, caffeine, atropine.

2. How do you define alkaloids?

Naturally occurring nitrogen-containing compounds with physiological effects.

3. What are the pharmaceutically important glycosides?

Digoxin, digitoxin, sennosides, glycyrrhizin.

4. Is pethidine an alkaloid or a glycoside?

Alkaloid.

Anticholinergic Drugs

1. What are the anticholinergic drugs you know?

Atropine, scopolamine, ipratropium, oxybutynin.

2. Do you know the different uses of anticholinergic drugs?

Reduce secretions, treat bradycardia, treat COPD/asthma, treat overactive bladder.

3. What are the other drugs that produce anticholinergic side effects?

Antihistamines (diphenhydramine), tricyclic antidepressants, phenothiazines.

4. What are the contraindications of anticholinergic drugs?

Glaucoma, urinary retention, myasthenia gravis, severe tachycardia.

Asthma & Related Drugs

1. What are the drugs indicated for asthma?

Salbutamol, salmeterol, theophylline, ipratropium, corticosteroids.

2. Do you know the mode of action of these drugs?

Bronchodilation (β2 agonists), anti-inflammatory (corticosteroids), muscarinic blockade (ipratropium).

3. Do you know the source of pilocarpine?

Derived from Pilocarpus species (natural alkaloid).

4. What are the main differences between atropine and pilocarpine?

Atropine: anticholinergic, dilates pupils.

Pilocarpine: cholinergic agonist, constricts pupils, stimulates secretions.

Lipid-Lowering Drugs

1. What are the lipid-lowering drugs you know?

Atorvastatin, simvastatin, rosuvastatin, gemfibrozil, fenofibrate.

2. What are the side effects of atorvastatin?

Muscle pain (myopathy), elevated liver enzymes, headache, GI discomfort.

3. What instructions would you give with atorvastatin?

Take at night, avoid grapefruit juice, report muscle pain.

4. Do you know the mode of action of atorvastatin?

HMG-CoA reductase inhibitor → reduces cholesterol synthesis in liver.

5. Give some examples of drugs included in this group.

Lovastatin, pravastatin, fluvastatin, pitavastatin.

Drug Registration

1. What is the meaning of registered drugs?

Drugs approved by regulatory authority for safety, efficacy, and quality.

2. Are drugs registered before selling?

Yes, registration is mandatory.

3. Why are drugs registered?

To ensure safety, efficacy, quality, and prevent counterfeit drugs.

Ointment Bases

1. What are the ointment bases you know?

Hydrocarbon, absorption, water-removable, water-soluble.

2. What are the main differences between ointment bases and eye ointment bases?

Eye ointments are sterile, non-irritant, isotonic; general ointments may not be sterile.

3. What are the ingredients in eye ointment base (RP)?

White petrolatum, mineral oil, lanolin derivatives.

4. What is the main difference between eye ointments and eye drops?

Ointments are semi-solid, longer-acting; drops are liquid, immediate-acting.

5. How do you apply eye ointment?

Pull lower eyelid, place thin strip inside conjunctival sac, avoid touching eye.

Antidiabetic Drugs

1. What are the antidiabetic drugs you know?

Metformin, glibenclamide, gliclazide, glimepiride, pioglitazone, insulin.

2. Do you know the indications for oral hypoglycemic drugs?

Type 2 diabetes mellitus.

3. What are the contraindications of oral hypoglycemic drugs?

Type 1 diabetes, severe renal/hepatic disease, pregnancy, ketoacidosis.

4. What instructions would you give to a patient taking chlorpropamide?

Take with food, monitor blood glucose, avoid alcohol.

5. Give examples of other drugs that interact with alcohol.

Metronidazole, disulfiram, some cephalosporins.

6. What instructions would you give to a patient taking metformin?

Take with meals to reduce GI upset; monitor renal function; do not crush extended-release tablets.

7. Are there any other drugs taken after meals?

Glibenclamide, acarbose, voglibose.

Griseofulvin & Antifungal Drugs

1. What are the indications for griseofulvin?

Dermatophyte infections (tinea capitis, tinea corporis).

2. What are the drugs given for candida?

Nystatin, fluconazole, clotrimazole, ketoconazole.

Nystatin & Drug Strength

1. How do you express the strength of nystatin?

Units (e.g., 100,000 units/mL).

2. Do you know other drugs whose strength is expressed in units?

Insulin, heparin, penicillin.

3. Why is the strength of some drugs expressed in units?

Activity is biological, not mass-based.

TAC (Technical Advisory Committee)

1. What is the meaning of TAC?

Technical Advisory Committee.

2. Who set it up?

Ministry of Health or National Drug Regulatory Authority.

3. Why was it set up?

To advise on drug policy, registration, safety, and technical standards.

4. What are the functions of TAC?

Evaluate drug safety and efficacy, recommend guidelines, advise on essential drug lists.

5. Do you know the members of TAC?

Pharmacologists, clinicians, regulatory experts, pharmacists.

Pharmaceutical Excipients

1. What is the meaning of pharmaceutical excipients?

Inactive substances that aid drug processing, stability, and delivery.

2. Can you give examples of some pharmaceutical excipients?

Fillers, binders, disintegrants, lubricants, coloring agents.

3. What is the importance of using coloring agents?

Identification, aesthetics, stability.

4. What is the meaning of permitted colors?

Approved colors safe for pharmaceutical use.

Beta-lactam Antibiotics

1. What is the meaning of Beta-lactam antibiotics?

Antibiotics with β-lactam ring that inhibit bacterial cell wall synthesis.

2. Can you give examples of Beta-lactam antibiotics?

Penicillin, ampicillin, amoxicillin, cephalosporins.

3. Do you know the difference between ampicillin and other Beta-lactam antibiotics?

Ampicillin has broader spectrum and oral bioavailability.

4. Can you give examples of cephalosporins?

Cefalexin, cefuroxime, ceftriaxone.

5. What are the other groups of antibacterial drugs?

Aminoglycosides, macrolides, tetracyclines, quinolones.

Streptomycin & TB Treatment

1. What are the side effects of aminoglycosides?

Nephrotoxicity, ototoxicity, neuromuscular blockade.

2. What are the uses of streptomycin?

Tuberculosis (MDR-TB), plague, tularemia.

3. Is streptomycin given to all TB patients?

No, only selected or resistant cases.

4. Are there any other drugs given for TB patients?

Isoniazid, rifampicin, ethambutol, pyrazinamide.

5. What is the meaning of DOT therapy?

Directly Observed Therapy – supervised drug intake to ensure compliance.

6. What are the instructions given with anti-TB drugs?

Take full course, avoid alcohol, monitor liver function, report side effects.

Deliquescent Substances

1. What is the meaning of deliquescent substances?

Substances that absorb moisture from the air until they dissolve and form a solution.

2. Can you give examples of deliquescent substances?

Calcium chloride, sodium hydroxide, potassium hydroxide.

3. What do you know about the solubility of deliquescent substances?

They readily dissolve in the absorbed water.

4. How do you store deliquescent substances?

In airtight containers, in a cool and dry place.

5. What is the difference between an airtight container and a well-closed container?

Airtight: completely prevents air and moisture entry.

Well-closed: prevents spilling but may allow slight air exchange.

Devices in Pharmacy

1. What are the different types of devices in your pharmacy?

Clinical thermometers, syringes, inhalers, condoms, nebulizers, glucometers.

2. How do you think a clinical thermometer is a device?

It is an instrument used for measuring body temperature.

3. How do you think a condom is a device?

It is a physical barrier for contraception and disease prevention.

4. What are the legal requirements for selling devices?

Must comply with medical device regulations; may require registration or license.

Drug Half-life & Bioavailability

1. Define “Half-life” of drugs.

Time taken for the plasma concentration of a drug to reduce by 50%.

2. What are the pharmacological importance of knowing the half-life of drugs?

Determines dosing interval, duration of action, and accumulation risk.

3. Do you know the meaning of “Bioavailability of a drug”?

The proportion of a drug that reaches systemic circulation intact.

4. What are the factors that influence the bioavailability of drugs?

First-pass metabolism, formulation, solubility, food interaction, drug interactions.

5. What are the factors that influence the absorption of drugs?

pH, gastric emptying, blood flow, surface area, presence of food.

6. Do you know which drugs increase liver enzymes?

Rifampicin, phenytoin, carbamazepine, some statins.

Prodrugs & Drug Excretion

1. Do you know the meaning of “selective tissue concentration”?

Drug accumulation preferentially in certain tissues for targeted action.

2. Do you know what prodrugs are?

Inactive compounds metabolized into active drugs in the body.

3. What are the advantages of prodrugs?

Improved absorption, reduced side effects, enhanced solubility, prolonged action.

4. What are the routes of excretion of drugs?

Urine, bile, feces, sweat, exhaled air, breast milk.

Dosage Forms & Characteristics

1. What are soft capsules, and do you know any?

Gelatin-based capsules containing liquid or semi-solid drugs; e.g., fish oil, vitamin E softgels.

2. What are the advantages of soft capsules?

Easy to swallow, better bioavailability, masks unpleasant taste, stable for liquids.

3. Do you know the advantages of oral liquid dosage forms?

Easy dosing, faster absorption, suitable for children and elderly, flexible dose adjustment.

4. Do you know the typical characteristics of a glycerin trinitrate container?

Amber colour glass container, airtight, light-resistant, moisture-proof.

5. What are the special characteristics of sublingual tablets?

Rapid dissolution under the tongue, fast onset, bypass first-pass metabolism.

Disintegration Time of Tablets

1. Do you know the meaning of disintegration time?

Time taken for a tablet to break into particles in a specified fluid under standard conditions.

2. What is the disintegration time for normal tablets and sugar-coated tablets?

Normal: 5–15 minutes; sugar-coated: 15–30 minutes.

Tablet Coating & Forms

1. What are uncoated tablets?

Tablets without any coating and may have direct release of drug.

2. What are sugar-coated tablets?

Tablets coated with sugar for taste masking and protection.

3. What are film-coated tablets?

Tablets coated with a thin polymer layer to protect, mask taste, or control release.

Injections & Devices

1. What are the different types of injection containers?

Ampoules, vials, prefilled syringes, infusion bottles.

2. Is a prefilled syringe with medicine considered a device?

Yes, it is a combination product: device + drug.

3. What are the basic legal requirements for medical devices?

Registration, labeling, safety testing, and compliance with regulatory authority.

Adrenaline & Beta Agonists

1. What is the meaning of “non-selective beta receptor agonist”?

Stimulates both β1 (heart) and β2 (lungs) receptors.

2. Give an example.

Adrenaline (epinephrine).

3. What are the different uses of adrenaline?

Anaphylaxis, cardiac arrest, asthma attacks, hypotension.

4. What is the usual strength of adrenaline?

1:1000 (1 mg/mL) .

5. What factors influence the deterioration of adrenaline?

Light, heat, oxidation, prolonged storage.

6. What precautions can prevent adrenaline deterioration?

Store in dark, cool, airtight containers; avoid repeated opening.

7. What is a light-resistant container?

A container that blocks light to protect light-sensitive drugs.

8. What substances can prevent oxidation?

Antioxidants like sodium metabisulfite or ascorbic acid.

Drug Stability & Water for Injection

1. What is the meaning of hygroscopicity?

Ability of a substance to absorb moisture from the air.

2. What is the meaning of deliquescent?

Absorbs moisture until it dissolves.

3. Give examples of deliquescent substances.

Calcium chloride, sodium hydroxide, potassium hydroxide.

4. What is the standard for water for injection?

Sterile, pyrogen-free, free from particulate matter, distilled or purified water.

5. Can distilled water be used to reconstitute drugs before injection? Why or why not?

Only if sterile and pyrogen-free; otherwise, risk of infection or pyrogenic reaction.

6. What is the meaning of pyrogen?

Substance that causes fever when introduced into the body.

7. What methods are used to remove pyrogens?

Distillation, dry heat sterilization, ultrafiltration.

8. Do you know the tests for pyrogen-free products?

Rabbit pyrogen test, Limulus Amebocyte Lysate (LAL) test.

Drug Quality & Disposal

1. How do you identify quality-failed drugs?

Changes in color, odor, consistency, precipitation, expiration date.

2. What are the methods of disposing of quality-failed drugs?

Incineration, chemical inactivation, approved landfill disposal.

3. Who can be an authorized officer?

Regulatory inspectors or pharmacists appointed by the authority.

4. What are the powers of an authorized officer?

Inspect, seize, enforce compliance, close non-compliant pharmacies.

Drugs from Plant Sources & Morphine

1. Do you know drugs obtained from plant sources?

Morphine, quinine, digoxin, atropine, pilocarpine.

2. How are these drugs chemically classified?

Alkaloids, glycosides, terpenes, flavonoids.

3. Why is morphine classified as an alkaloid?

It contains nitrogen and has pharmacological activity derived from plants.

4. What is the main indication of morphine?

Severe pain relief.

5. What are other indications of morphine?

Pulmonary edema, preoperative sedation, palliative care.

6. What is the main disadvantage of morphine?

Risk of addiction, respiratory depression.

7. What are the contraindications of morphine?

Respiratory depression, CNS depression, head injury, GI obstruction.

8. What synthetic drugs are available in the same pharmacological group?

Fentanyl, oxycodone, hydromorphone.

9. Do you know other drugs commonly given with morphine? Why?

Anti-emetics (ondansetron), laxatives (senna) to manage side effects.

Antiemetic Drugs & Promethazine

1. What are the other antiemetic drugs?

Ondansetron, metoclopramide, domperidone, prochlorperazine.

2. What are the different indications for these drugs?

Nausea, vomiting, motion sickness, chemotherapy-induced vomiting.

3. What are the different dosage forms of promethazine?

Tablets, syrup, injection, suppositories.

4. What are the types of promethazine?

HCl salt form, injectable, oral, and rectal forms.

Tablet Coating & Sampling

1. What are the features of sugar-coated tablets?

Taste masking, protection from moisture, attractive appearance, delayed disintegration.

2. How do sugar-coated tablets differ from film-coated tablets?

Thicker coating, longer disintegration, aesthetic vs thin polymer layer for film-coating.

3. Do you know the additives used in sugar coating?

Sugar, colorants, flavoring agents, polishers.

4. Do you know the method for taking drug samples by an authorized officer?

Random sampling, proper documentation, sealing, labeling, reporting to authority.

5. What are the special label requirements for medical sample drugs?

“For Medical Sample Only – Not for Sale.”

Drug Registration & Pharmacy Licensing

1. What are the sample requirements for drug registration?

Sufficient quantity for laboratory testing, stability studies, bioavailability studies.

2. What are the drug schedules in the CD&D Act?

Schedule 1,2A,2B,3,4.

3. Give examples for each drug schedule.

Schedule 1: ORS

Schedule 2A: Paracetamol box

Schedule 2B: amoxicillin .

4. What are the conditions for selling drugs in different schedules?

Prescription drugs: sold with valid prescription

OTC: sold freely; controlled: with license.

Schedule 1: Can sold freely in and out of the pharmacy

5. What are the basic requirements for a retail pharmacy?

Licensed pharmacist, secure storage, proper labeling, sale record maintenance.

6. How many pharmacies can be run under one pharmacy license?

One license per retail pharmacy.

Pharmaceutical Containers & Packaging

1. What are the different types of containers used for pharmaceutical preparations?

Glass bottles, plastic bottles, ampoules, vials, blister packs, tubes, jars, sachets.

2. What is the difference between a primary and secondary container?

Primary container: Direct contact with the drug (e.g., vial, blister).

Secondary container: Outer packaging for protection, labeling, and marketing (e.g., carton box).

3. What are the different types of packaging materials?

Glass, plastics (HDPE, LDPE, PVC), aluminum foil, paper, laminates.

4. What are the different types of glass used in pharmaceutical packaging?

Type I (borosilicate), Type II (treated soda-lime), Type III (soda-lime), colored glass.

5. What are the advantages of unit-dose packaging compared to bulk packaging?

Reduces contamination, accurate dosing, improves patient compliance, reduces waste.

6. What are the advantages of blister packaging over strip packaging?

Protection from moisture and light, tamper-evident, convenient individual doses.

7. What are the advantages of calendar packs over blister packs?

Helps track daily dosing, improves compliance, prevents missed doses.

8. Give examples of drugs available in calendar packs.

Oral contraceptives (ethinylestradiol + levonorgestrel), antihypertensives, antibiotics like amoxicillin.

Antimicrobial Agents & Special Considerations

1. What are some combination antimicrobial treatments?

Amoxicillin + clavulanic acid, Trimethoprim + sulfamethoxazole.

2. What are the differences between clarithromycin and erythromycin?

Clarithromycin has better bioavailability, longer half-life, fewer GI side effects.

3. What are the differences between clarithromycin and azithromycin?

Azithromycin has a longer half-life, better tissue penetration, shorter treatment duration.

4. What fluoroquinolones do you know?

Ciprofloxacin, levofloxacin, moxifloxacin, ofloxacin.

5. What are the special side effects of ciprofloxacin?

Tendonitis, photosensitivity, QT prolongation, CNS effects.

6. What are the special side effects of vancomycin?

Red man syndrome, nephrotoxicity, ototoxicity.

Mechanism of Action & Drug Interactions

1. What are the different modes of drug action?

Agonist, antagonist, enzyme inhibition, receptor modulation, ion channel blockade.

2. Give examples of drug antagonists.

Naloxone (opioid antagonist), propranolol (beta-blocker), atropine (muscarinic antagonist).

3. Name some agonist drugs.

Morphine (opioid agonist), salbutamol (beta-2 agonist), adrenaline (non-selective beta agonist).

4. Explain the use of enzyme inhibitors.

Block enzyme activity to reduce production of harmful metabolites or prolong drug action (e.g., ACE inhibitors, MAO inhibitors).

5. What is the mechanism of action of tricyclic antidepressants?

Inhibit reuptake of norepinephrine and serotonin, increasing their levels in the synaptic cleft.

6. How does aluminum hydroxide act in the treatment of gastric ulcers?

Neutralizes gastric acid, forming a protective gel over the ulcer.

Drug Information & Reference Sources

1. What are the sources of drug information?

Pharmacopoeias, drug formularies, textbooks, journals, online databases.

2. What are considered reliable drug information sources?

British Pharmacopoeia (BP), United States Pharmacopeia (USP), WHO publications, FDA/EMA resources,BNF, SLSF

3. What are the contents of the British Pharmacopoeia (BP)?

Drug monographs, standards of purity, strength, quality, analytical methods.

4. Does the BP contain clinical information?

No, it focuses on pharmaceutical quality and standards.

5. Where do you usually refer to find information about drug side effects?

Product inserts, WHO database, FDA/EMA reports, pharmacovigilance data,BNF.

6. What are the contents of the United States National Formulary (USNF)?

Monographs of excipients, drug standards, preparation methods, quality requirements.

Pharmaceutical Additives & Labeling

1. What is the meaning of pharmaceutical additives?

Substances added to formulations to aid manufacturing, stability, taste, or appearance.

2. Give examples of pharmaceutical additives used in tablets.

Binders (starch), disintegrants (croscarmellose), lubricants (magnesium stearate), coloring agents.

3. What is the meaning of placebo tablets?

Inactive tablets with no pharmacological effect.

4. What are the uses of placebo tablets?

Clinical trials, psychological benefit, dose form standardization.

5. What are the labeling requirements for poisons under the Poisons Act?

Must include “Poison,” active ingredient, concentration, hazard warnings, storage instructions.

Controlled Substances & Narcotics

1. Who can handle narcotics?

Licensed pharmacists, authorized medical practitioners, registered institutions.

2. What is the role of the Chief Opium Officer?

Oversees narcotic import, distribution, regulation, and record-keeping compliance.

Pain Management & Antiplatelet Therapy

1. What are the main differences between paracetamol and aspirin?

Paracetamol: analgesic and antipyretic, minimal anti-inflammatory effect.

Aspirin: analgesic, antipyretic, anti-inflammatory, antiplatelet.

2. What are the main indications of paracetamol?

Fever, mild to moderate pain, headache, musculoskeletal pain.

3. What is the usual antiplatelet dose of aspirin?

75–100 mg daily for cardiovascular protection.

Drug Effects & Patient Education

1. What are the drugs that cause dark urine?

Rifampicin, metronidazole, nitrofurantoin, chloroquine.

2. What conditions are harmful?

Hepatic disease, renal impairment, chronic alcohol use.

3. What instructions should you give to patients to prevent resistance to antibacterial drugs?

Complete full course, do not skip doses, do not self-medicate.

4. What are the drugs indicated to be taken after meals?

Metformin, some NSAIDs (like naproxen), potassium supplements, corticosteroids.

Drug Storage Guidelines

1. Which drugs should be stored at:

a. -20°C: Insulin, some vaccines, biologicals.

b. 2–8°C: Vaccines, some antibiotics, biologics, eye drops requiring refrigeration.

c. 15–20°C: Most tablets, capsules, syrups, ointments.

Cardiovascular Drugs & Heart Failure Management

1. Do you know the drug groups used for cardiac failure?

ACE inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, diuretics, aldosterone antagonists, digoxin, vasodilators.

2. Give examples of ACE inhibitors.

Enalapril, captopril, lisinopril, ramipril.

3. What are the special characteristics of ACE inhibitors?

Reduce afterload and preload, decrease aldosterone secretion, improve survival in heart failure, lower blood pressure, protect kidneys in diabetes.

4. What diuretics do you know?

Furosemide, hydrochlorothiazide, spironolactone, bumetanide, indapamide.

5. How do you classify diuretics?

Loop diuretics, thiazide diuretics, potassium-sparing diuretics, osmotic diuretics, carbonic anhydrase inhibitors.

6. Name some beta-blockers indicated for cardiac failure.

Carvedilol, bisoprolol, metoprolol succinate.

7. Do you know a common drug that has the opposite action of beta-blockers?

Salbutamol (beta-2 agonist).

Salbutamol

1. How can you tell that salbutamol has the opposite action of beta-blockers?

Beta-blockers block beta receptors, while salbutamol stimulates beta-2 receptors causing bronchodilation.

2. What are the side effects of salbutamol?

Tremors, palpitations, tachycardia, headache, nervousness.

3. What are the indications of salbutamol?

Asthma, chronic obstructive pulmonary disease (COPD), bronchospasm.

4. Do you know the different dosage forms of salbutamol?

Inhaler (MDI), nebulizer solution, oral tablets, syrup.

Key Cardiovascular Drugs

1. What are the main differences between furosemide and spironolactone?

Furosemide: loop diuretic, potent, causes potassium loss.

Spironolactone: potassium-sparing, aldosterone antagonist, mild diuretic.

2. What are the special features of glyceryl trinitrate (GTN)?

Vasodilator, rapid onset, treats angina, sublingual form bypasses first-pass metabolism.

3. How should it store?

Store in a cool, dry place, protected from light, in original container.

4. What are the advices should give to the patient while dispensing this?

Use under the tongue, avoid touching tablet, keep in original container, replace every 3–6 months after opening.

Lipid-Lowering Drugs & Statins

1. What lipid-lowering drugs do you know?

Statins (atorvastatin, simvastatin), fibrates (gemfibrozil), bile acid sequestrants (cholestyramine), niacin, ezetimibe.

2. What are the “statins” you know?

Atorvastatin, simvastatin, rosuvastatin, pravastatin, lovastatin.

3. Do you know the mode of action of statins?

Inhibit HMG-CoA reductase, reducing cholesterol synthesis in the liver.

4. What are the main side effects of atorvastatin?

Muscle pain (myalgia), liver enzyme elevation, headache, gastrointestinal upset, rare rhabdomyolysis.

Gastrointestinal Drugs

1. What are the drugs used for gastric ulcers?

Proton pump inhibitors (omeprazole, pantoprazole), H2 blockers (ranitidine, cimetidine), antacids, sucralfate.

2. What are the drugs used to decrease acid secretion?

Proton pump inhibitors (PPIs), H2 receptor antagonists.

3. Do you know the drugs used for eradication of Helicobacter pylori?

Triple therapy: PPI + clarithromycin + amoxicillin/metronidazole.

4. Name some antiemetic drugs.

Metoclopramide, ondansetron, domperidone, promethazine.

5. What is the mode of action of metoclopramide?

Dopamine D2 receptor antagonist, increases GI motility, antiemetic effect.

6. What are the other indications of metoclopramide besides its antiemetic action?

Gastroparesis, reflux esophagitis, facilitation of small bowel intubation.

7. What are the side effects of metoclopramide?

Extrapyramidal symptoms, drowsiness, restlessness, diarrhea, galactorrhea.

Diabetes Management

1. What are the main drug groups used for diabetes mellitus?

Insulin, sulfonylureas, biguanides, meglitinides, thiazolidinediones, DPP-4 inhibitors, GLP-1 analogs.

2. Give examples for each drug group.

Insulin: Regular, NPH, glargine, lispro

Sulfonylureas: Glibenclamide, tolbutamide

Biguanides: Metformin

Meglitinides: Repaglinide, nateglinide

Thiazolidinediones: Pioglitazone

DPP-4 inhibitors: Sitagliptin

GLP-1 analogs: Exenatide

3. What is the mode of action of sulfonylureas?

Stimulate insulin release from pancreatic beta cells.

4. Can you name some sulfonylureas?

Glibenclamide, gliclazide, glipizide, tolbutamide.

5. What are the side effects of sulfonylureas?

Hypoglycemia, weight gain, nausea, skin rash.

6. What are the differences between glybenclamide and tolbutamide?

Glybenclamide: longer duration, more potent.

Tolbutamide: shorter duration, less potent.

7. What is the mode of action of metformin?

Decreases hepatic glucose production, increases insulin sensitivity, reduce glucose absorption.

8. What are the adverse effects of metformin?

GI upset, lactic acidosis (rare), metallic taste, vitamin B12 deficiency.

9. What are the differences between glybenclamide and metformin?

Glybenclamide: stimulates insulin secretion.

Metformin: decreases glucose production, does not cause hypoglycemia alone.

Insulin Therapy

1. What are the different types of insulin preparations in your pharmacy?

Rapid-acting (lispro, aspart), short-acting (regular), intermediate-acting (NPH), long-acting (glargine, detemir), premixed.

2. Classify insulin preparations according to their duration of action.

Rapid-acting: 15–30 min onset, 3–5 hr duration

Short-acting: 30–60 min onset, 6–8 hr duration

Intermediate-acting: 1–2 hr onset, 12–16 hr duration

Long-acting: 1–2 hr onset, 24 hr duration

3. What are the main differences between short-acting and long-acting insulin?

Onset, peak time, duration of action, use for basal vs mealtime coverage.

4. How do you store insulin?

Refrigerated 2–8°C before opening. in-use vials can be kept at 15–25°C for 28 days, protected from light and heat.

Antidiabetic Drug Combinations

1. What are the antidiabetic drugs you know?

Metformin, sulfonylureas, thiazolidinediones, meglitinides, DPP-4 inhibitors, insulin.

2. What are the side effects of glybenclamide?

Hypoglycemia, weight gain, nausea, rash.

3. Can you dispense metformin with glybenclamide?

Yes, for additive glucose-lowering effect and different mechanisms of action.

4. What is the main advantage of that combination?

Better glycemic control with lower doses of each drug and reducing side effects.

5. Do you know other drugs that cause weight gain?

Insulin, thiazolidinediones, sulfonylureas, corticosteroids.

Antiepileptic Drugs

1. What are the indications of sodium valproate?

Epilepsy (generalized seizures, absence seizures, myoclonic seizures).

2. Do you know any other indications of sodium valproate?

Bipolar disorder, migraine prophylaxis, neuropathic pain.

3. What are the special side effects of it?

Hepatotoxicity, weight gain, tremor, hair loss, thrombocytopenia, teratogenicity.

4. Can this prescribe to the pregnant women?

Sustained Release & Tablet Formulations

1. Do you know different types of sustained-release dosage forms?

Matrix tablets, coated beads, osmotic pump tablets, multiparticulate systems.

2. What are the main advantages of sustained-release tablets?

Maintain steady plasma levels, reduce dosing frequency, improve compliance, reduce side effects.

3. What are the main differences between tablets and implants?

Tablets: oral, short-term release, systemic absorption.

Implants: subcutaneous, long-term, controlled drug release.

4. What are the lubricants used for tablet formulations?

Magnesium stearate, talc, stearic acid, polyethylene glycol (PEG).

5. Do you know the source of talc?

Natural mineral (hydrated magnesium silicate).

6. Do you know the synonym of talc?

Magnesium silicate.

7. What are the other uses of talc?

Dusting powder, lubricant in tablet formulation, cosmetic powder, pharmaceutical excipient.

8. Do you know the difference between surgical dusting powder and medicinal dusting powder?

Surgical: sterile, used in operations.

Medicinal: non-sterile, topical use on skin to prevent irritation.

Sterilization & Aseptic Techniques

1. What is the meaning of sterilization?

Process of killing or removing all forms of microbial life.

2. What conditions should be fulfilled for proper sterilization?

Correct temperature, pressure, exposure time, and method depending on the material.

3. What is the meaning of aseptic technique?

Procedures to prevent contamination by pathogens.

4. What is the meaning of a HEPA filter?

High-Efficiency Particulate Air filter that removes 99.97% of particles ≥0.3 µm.

5. Do you know the different uses of HEPA filters?

Clean rooms, laminar airflow cabinets, hospital operating theaters, pharmacies.

6. How does sterilization differ from disinfection?

Sterilization kills all microorganisms; disinfection kills most pathogenic microorganisms.

7. Do you know the differences between antiseptics and disinfectants?

Antiseptics: safe for living tissue.

Disinfectants: used on inanimate objects.

8. Give examples of antiseptics. Do you know any other actions of cetrimide?

Examples: iodine, chlorhexidine, alcohol, cetrimide.

Cetrimide: also acts as a surfactant and cleansing agent.

Surfactants & Antimicrobial Agents

1. What is the meaning of surfactants?

Compounds that reduce surface tension between two substances (liquid-liquid, liquid-solid).

2. Do you know the difference between soap and cetrimide?

Soap: anionic surfactant, cleanses skin.

Cetrimide: cationic, antimicrobial, antiseptic.

3. Can you name a preparation containing cetrimide?

Cetrimide 0.5% solution, cetrimide ointment.

Oral Hypoglycemic Agents & Narcotics

1. What oral hypoglycemic drugs do you know?

Sulfonylureas (glibenclamide, gliclazide), biguanides (metformin), meglitinides, thiazolidinediones, DPP-4 inhibitors.

2. What is the main difference between tolbutamide and glibenclamide?

Tolbutamide: shorter acting, less potent.

Glibenclamide: longer acting, more potent.

3. Does glipizide have any advantages over glibenclamide?

Less risk of prolonged hypoglycemia, especially in elderly patients as it has an intermediate action.

4. What are the special laws that apply to narcotics?

Controlled under PODDO regulations. require prescription and strict record-keeping.

5. Why are these laws in place?

Prevent abuse, addiction, and diversion of controlled substances.

6. What is the main indication for narcotics?

Severe pain relief.

7. How can you obtain narcotics for sale?

Through licensed suppliers with proper documentation and permits.

Oral Contraceptives & Reproductive Health

1. What are the different types of oral contraceptives available?

Combined oral contraceptives (COCs), progestogen-only pills (POPs), emergency contraceptives.

2. What are the contents of combined oral contraceptives?

Estrogen + progestogen.

3. What are the indications for progestogen-only contraceptives?

Contraindications to estrogen, breastfeeding women, contraception in women with cardiovascular risk.

4. What is the most reliable contraceptive preparation?

Long-acting reversible contraception (e.g., implants, IUDs).

5. What instructions should be given with a packet of combined contraceptive pills?

Take daily at the same time, use backup if missed, store in a cool dry place, avoid antibiotics interfering with absorption.

6. What is the content of the “Depo-Provera” injection?

Medroxyprogesterone acetate.

7. What are the advantages of “Depo-Provera”?

Long-acting (3 months), high efficacy, no daily adherence needed.

8. Do you know the available post-coital contraception preparations?

Levonorgestrel, ulipristal acetate.

9. What advice should you give when dispensing post-coital contraception?

Take as soon as possible, ideally within 72 hours, not a replacement for regular contraception.

10. What is the meaning of “Depo” preparations?

Injectable, long-acting depot formulations.

Diarrhea Management & ORS

1. What are the antidiarrheal drugs you know?

Loperamide, diphenoxylate, kaolin-pectin.

2. Are they suitable for treating diarrhea in children?

No. Not recommended.

3. What is the most suitable therapy for watery diarrhea in children?

Oral rehydration solution (ORS).

4. Do you know the WHO formula for Oral Rehydration Solution (ORS)?

Sodium chloride 3.5 g, potassium chloride 1.5 g, trisodium citrate 2.9 g, glucose 20 g per liter of water.

5. Why does ORS contain dextrose?

To facilitate sodium and water absorption via the sodium-glucose co-transport mechanism.

6. What is the difference between dextrose anhydrous and dextrose monohydrate?

Monohydrate contains 1 molecule of water, slightly heavier; anhydrous is water-free.

7. What are the advantages of ORS over IV fluids in moderate diarrhea cases?

Easier administration, less invasive, cost-effective, can be used at home.

8. What instructions should be given to patients when dispensing an ORS packet?

Dissolve in required amount of recently boiled and cooled water, consume within 24 hours, do not add extra sugar or salt.

9. Can you dispense an ORS packet without a prescription?

Yes, it is over-the-counter (OTC).

Prescription & Drug Regulations

1. What is the meaning of POM?

Prescription Only Medicine.

2. Give some examples of POM drugs.

Antibiotics (amoxicillin, ciprofloxacin), insulin, narcotics, cardiovascular drugs.

3. What are the columns of a prescription?

Superscription (Rx), Inscription (drug name and strength), Subscription (directions to pharmacist), Signature (directions to patient), Refill information.

4. Do you know the registration requirements for pharmacists?

Must have a recognized pharmacy degree/certificate/ Diploma and register with the SLMC, obtain license to practice.

Tranquilizers & CNS Drugs

1. What is the meaning of tranquilizers?

Drugs that reduce anxiety, tension, or agitation without causing significant sedation.

2. Do you know the different types of tranquilizers?

Major tranquilizers (antipsychotics, e.g., chlorpromazine)

Minor tranquilizers (anxiolytics, e.g., benzodiazepines)

3. What are their different uses?

Major: schizophrenia, psychosis

Minor: anxiety, insomnia, agitation

4. What are the side effects of chlorpromazine?

Extrapyramidal symptoms, sedation, hypotension, anticholinergic effects, weight gain, photosensitivity.

5. What other drugs can cause extrapyramidal symptoms?

Haloperidol, fluphenazine, metoclopramide, risperidone.

6. What can be done to manage extrapyramidal symptoms?

Anticholinergic drugs (e.g., benztropine), dose adjustment, switching to atypical antipsychotics.

7. What are other terms used for extrapyramidal symptoms?

Drug-induced movement disorders, Parkinsonian symptoms.

8. What are the pharmaceutical uses of metoclopramide?

Antiemetic, prokinetic agent, gastroesophageal reflux treatment.

9. What drugs are used to treat Parkinsonism?

Levodopa, carbidopa, dopamine agonists (pramipexole, ropinirole), MAO-B inhibitors (selegiline).

Drug Stability & Chemical Reactions

1. What factors influence drug deterioration?

Light, heat, moisture, pH, oxidation, microbial contamination, packaging.

2. Give examples of drugs that can undergo oxidation.

Ascorbic acid, epinephrine, penicillins, unsaturated fatty acids.

3. What can be done to prevent oxidation?

Store in airtight, light-resistant containers, use antioxidants, control temperature and pH.

4. What is the meaning of pH?

Measure of hydrogen ion concentration.

5. Do you know the pharmaceutical applications of pH?

For stability of formulations, drug solubility, drug absorption, eye and parenteral preparations.

6. What is the meaning of a buffer solution?

A solution that resists changes in pH when acids or bases are added.

7. How do you prepare a buffer solution?

Mix a weak acid with its conjugate base or a weak base with its conjugate acid in appropriate ratio.

8. Give an example of an oral buffer solution.

Sodium citrate + citric acid solution.

Suspensions & Dosage Forms

1. What are the advantages of suspensions over solutions?

Better stability for insoluble drugs, mask taste, easier to administer large doses.

2. What are the characteristics of an ideal suspension?

Uniform particle distribution, resuspendable, stable, palatable, appropriate viscosity.

3. What are the different types of suspensions?

Oral, topical, parenteral(flocculated, non-flocculated).

4. Do you know the difference between flocculated and non-flocculated suspensions?

Flocculated– particles form loose aggregates (settle quickly, easily redispersed).

Non-flocculated– particles settle slowly and form hard cake (difficult to redisperse).

Insulin & Antidiabetic Drugs

1. What is the dosage of insulin?

Units per milliliter

2. Name oral antidiabetic drugs.

Sulfonylureas (glibenclamide, tolbutamide), biguanides(metformin), DPP-4 inhibitors(sitagliptin), SGLT 4 inhibitors (empaglifozin)

3. What is the mechanism of hypoglycemic action of sulfonylurea drugs?

Stimulate pancreatic β-cells to release insulin.

4. What are the adverse effects of biguanides?

Gastrointestinal upset, lactic acidosis (rare), vitamin B12 deficiency.

5. What instructions should be given when dispensing biguanides?

Take with meals, maintain hydration, avoid alcohol, monitor kidney function.

6. What drugs are used in the treatment of hypoglycemic attacks?

Oral glucose, dextrose IV, glucagon injection.

Thyroid & Adrenal Hormones

1. Name the thyroid hormones.

Thyroxine (T4), Triiodothyronine (T3).

2. What are the therapeutic uses of thyroid hormones?

Hypothyroidism, myxedema, goiter, thyroid hormone replacement.

3. What are the iodine preparations you know?

Potassium iodide, Lugol’s solution.

4. What are the oral iodine preparations?

Potassium iodide tablets, Lugol’s solution (oral).

5. What instructions should be given when dispensing Lugol’s solution?

Take as prescribed, avoid overdose, not for long-term use without monitoring.

6. Name some antithyroid drugs.

Propylthiouracil, methimazole, carbimazole.

7. Name some adrenal steroid preparations.

Hydrocortisone, prednisone, dexamethasone, methylprednisolone.

8. What are the common uses of corticosteroids?

Anti-inflammatory, immunosuppressive, asthma, autoimmune disorders, adrenal insufficiency.

9. What are the contraindications of corticosteroids?

Systemic fungal infections, uncontrolled infections, peptic ulcer, osteoporosis (long-term).

10. What precautions are necessary when a patient is on corticosteroid therapy?

Gradual tapering, monitor for infection, blood sugar, bone health, vaccination status.

11. What are the actions of corticosteroids on body calcium?

Reduce calcium absorption, increase calcium excretion → risk of osteoporosis.

12. What is the therapeutic use of spironolactone?

Potassium-sparing diuretic; used in heart failure, hypertension, edema, hyperaldosteronism.

Pharmacokinetics & Drug Absorption

1. What is the meaning of pharmacokinetics?

Study of absorption, distribution, metabolism, and excretion of drugs.

2. What factors influence the absorption of drugs?

Solubility, pH, gastric emptying, blood flow, formulation, surface area.

3. What is the meaning of first-pass metabolism?

Drug metabolism in the liver before it reaches systemic circulation.

4. Why can’t certain drugs be administered orally?

Destroyed by gastric acid, poorly absorbed, extensive first-pass metabolism.

5. Do you know the routes of drug elimination from the body?

Renal, biliary, pulmonary, sweat, saliva, milk.

6. What is the meaning of prodrugs?

Inactive compounds converted into active drug in the body.

7. Give examples of prodrugs.

Enalapril, codeine, fosphenytoin, aspirin (some esters).

8. What are the advantages of prodrugs?

Improved solubility, bioavailability, reduced side effects, targeted delivery.

Sustained Release & Tablet Coating

1. What is the meaning of sustained-release drugs?

Drugs designed to release active ingredient gradually over time.

2. Give examples of different dosage forms for sustained-release preparations.

Matrix tablets, coated beads, osmotic tablets, capsules with coated pellets.

3. What are the advantages of sustained-release (SR) preparations?

Less frequent dosing, stable plasma levels, improved compliance, reduced side effects.

4. Do you know some mechanisms used to prepare SR preparations?

Diffusion-controlled, dissolution-controlled, osmotic pump, matrix systems.

5. What are the advantages of coating tablets?

Protect from moisture/light, mask taste, improve appearance, modify release.

6. What are the advantages of film coating over sugar coating?

Thinner, faster, durable, less bulky, more elegant appearance.

7. Do you know the disintegration test for enteric-coated tablets?

Tested in acidic medium (stomach) to ensure resistance, then in alkaline medium (intestine) for release.

8. What instructions should be given with enteric-coated tablets?

Do not crush or chew, take with water, follow dosing schedule.

Drug Licensing & Regulations

1. According to the CD&D Act, define a retail licensed dealer of drugs.

A person licensed to sell drugs directly to the public from a retail pharmacy.

2. Do you have such a license?

[Personal answer dependent]

3. If you have such a license, what conditions must be observed?

Proper storage, record-keeping, dispensing only authorized drugs, following schedules and labeling rules.

4. What documents are needed to apply for a retail drug license?

Application form, pharmacist qualification certificate, premises layout, proof of ownership, fee.

Expanded Program on Immunization (EPI) & Vaccines

1. Do you know the meaning of the EPI schedule?

National immunization schedule covering essential childhood vaccines.

2. What diseases are covered under the EPI schedule?

Diphtheria, tetanus, pertussis, polio, measles, BCG (tuberculosis), hepatitis B, Haemophilus influenzae type B.

3. What are the aims of the EPI schedule?

Reduce morbidity and mortality from vaccine-preventable diseases, achieve high immunization coverage.

4. What vaccines are included in the EPI schedule?

BCG, DTP, Polio, Measles, Hepatitis B, Hib, rotavirus (depending on country).

5. What is the meaning of DTP?

Vaccine against Diphtheria, Tetanus, Pertussis.

6. What are the indications of the DT vaccine?

Diphtheria and tetanus protection for children who cannot receive pertussis component.

7. What disease is covered by the BCG vaccine?

Tuberculosis.

8. What is the route of administration of the BCG vaccine?

Intradermal.

9. What are the common contraindications of vaccines?

Severe allergic reaction to vaccine component, immunodeficiency, acute severe illness.

10. Are steroid inhalations contraindicated in certain conditions?

Yes, in acute infections and untreated systemic infections; otherwise generally safe for asthma/COPD under supervision.

Regulatory & Dispensing Questions

1. Can a transport agent issue drugs to the patient?

No. Only licensed pharmacists or authorized personnel can dispense drugs to patients.

2. Can medical representatives issue drugs according to the prescription?

No. Medical representatives can promote drugs but cannot dispense them.

3. What are the labeling requirements for “medical samples”?

Must include “Medical Sample – Not for Sale,” drug name, strength, manufacturer, batch number, and expiry date.

Sulfonamides & Antimicrobials

1. What are Sulfonamides?

Synthetic antimicrobial agents that inhibit bacterial folic acid synthesis.

2. What is the composition of Co-trimoxazole tablet?

Sulfamethoxazole + Trimethoprim in a 5:1 ratio.

3. What is the adult dose of Co-trimoxazole?

Usually 1 double-strength tablet (800 mg sulfamethoxazole + 160 mg trimethoprim) twice daily.

4. What are the important adverse effects of Sulfonamides?

Allergic reactions, crystalluria, hemolytic anemia, photosensitivity, nausea.

5. Can you prevent crystalluria caused by Sulfonamides?

Yes, by maintaining adequate hydration and alkalinizing urine if needed.

6. What are the therapeutic uses of Nitrofurantoin?

Urinary tract infections (especially cystitis).

Beta-lactams & Antibiotics

1. What are Cephalosporins?

Beta-lactam antibiotics structurally related to penicillins.

2. Are Cephalosporins bactericidal or bacteriostatic?

Bactericidal.

3. What common properties are shared by Penicillins and Cephalosporins?

Beta-lactam ring, bactericidal action, inhibit bacterial cell wall synthesis.

4. What is Clavulanic acid?

A beta-lactamase inhibitor used to enhance activity of penicillins.

5. What are the therapeutic uses of Streptomycin?

Tuberculosis, certain Gram-negative infections, plague, tularemia.

6. What are the adverse effects of Gentamicin?

Nephrotoxicity, ototoxicity, neuromuscular blockade, allergic reactions.

7. What are the adverse effects of Tetracycline?

Photosensitivity, tooth discoloration in children, GI upset, hepatotoxicity.

8. What is the spectrum of Chloramphenicol?

Broad-spectrum: Gram-positive, Gram-negative, rickettsiae, some anaerobes.

Antifungal & Antiprotozoal Drugs

1. Name some antifungal drugs.

Griseofulvin, Nystatin, Ketoconazole, Fluconazole, Amphotericin B.

2. What are the therapeutic uses of Griseofulvin?

Dermatophytosis (ringworm, scalp infections, nail infections).

3. Name hepatic amebicides.

Chloroquine, Diloxanide furoate, Metronidazole, Tinidazole.

4. What are the adverse effects of Emetine?

Cardiotoxicity, vomiting, muscle pain.

5. What is the toxicity of Primaquine?

Hemolytic anemia in G6PD-deficient patients, GI upset.

6. What are the adverse effects of Chloroquine?

GI upset, pruritus, headache, retinopathy (long-term), cardiotoxicity.

7. What are the therapeutic uses of Chloroquine?

Malaria prophylaxis and treatment, extraintestinal amebiasis.

Antidiabetic Drugs & Insulin

1. What are the antidiabetic drugs you know?

Sulfonylureas (glibenclamide, tolbutamide), biguanides (metformin), meglitinides, thiazolidinediones, DPP-4 inhibitors, insulin.

2. What are the side effects of Glibenclamide?

Hypoglycemia, weight gain, GI upset, skin reactions.

3. What is the main advantage of Glibenclamide-Metformin combination?

Combines insulin secretion stimulation with improved insulin sensitivity, better glycemic control.

4. Can you dispense Metformin with Glibenclamide?

Yes, it is a common combination therapy.

5. Do you know other drugs that cause weight gain?

Insulin, thiazolidinediones, sulfonylureas, corticosteroids.

6. What are the insulin preparations you know?

Regular (short-acting), NPH (intermediate), Lispro/Aspart (rapid-acting), Glargine/Detemir (long-acting), premixed formulations.

7. What are the sources of insulin?

Recombinant human insulin (E. coli or yeast).

8. How is the insulin dosage expressed?

In units (U) per mL (e.g., 100 U/mL).

Probeta

1. What is this?

A 1% w/v hydrocortisone topical cream.

2. Is this available in your pharmacy?

Yes

3. Where does it store?

Store in a cool, dry place, away from direct sunlight.

4. Should it keep in refrigerator?

5. What is the main ingredient of this?

Hydrocortisone.

6. What does it mean by 1% w/v?

1 g of hydrocortisone in 100 mL of cream base.

7. What are the indications for this?

Inflammatory skin conditions: eczema, dermatitis, rashes, insect bites.

Stay dedicated, keep practicing, and trust in your abilities. Wishing you great success on your path to becoming a registered pharmacist!

H. A. N. N. Hettiarachchi

Registered Pharmacist, SLMC