1.Easy
Which of these is a typical phase II (conjugation) reaction in drug metabolism?
- AOxidation
- BHydrolysis
- CReduction
- DGlucuronidation
2.Easy
Why is methadone used to treat opioid use disorder?
- AIt is a long-acting opioid that prevents withdrawal and craving
- BIt causes vomiting if other opioids are used
- CIt is a pure opioid antagonist that blocks all opioid effects
- DIt cures the liver damage caused by opioids
3.Easy
Disulfiram is used in alcohol use disorder because it:
- ACures liver damage caused by alcohol
- BRemoves alcohol from the blood faster
- CReplaces alcohol at its receptors in the brain
- DCauses an unpleasant reaction if alcohol is drunk
4.Medium
Which teaching about antiepileptic drugs is most important?
- AStop the drug when you have had no seizures for one whole week
- BTake a double dose if you feel a seizure coming
- CAlcohol has no effect on seizure control
- DDo not stop the drug suddenly, as this can trigger severe seizures
5.Medium
A patient with a fentanyl patch is given home-care advice. Which instruction is correct?
- AThrow used patches loose into the household bin with the packaging
- BCut the patch in half if the pain is mild
- CAvoid heating pads, hot baths and saunas over or near the patch
- DApply each new patch over the same skin area
6.Medium
A patient with difficulty swallowing is prescribed several tablets. Which one should not be crushed?
- AA plain paracetamol tablet
- BA modified-release (extended-release) tablet
- CA plain aspirin dispersible tablet
- DA tablet that the pharmacist says may be crushed
7.Hard
A woman with epilepsy who takes an antiepileptic drug plans to become pregnant. Which advice is standard?
- AAvoid folic acid because it lowers drug levels
- BNo change is needed, as antiepileptics carry no risk in pregnancy
- CTake folic acid before conception and seek specialist review of her medication
- DStop all antiepileptic drugs straight away as soon as she stops contraception
8.Hard
Why is vincristine labelled "for intravenous use only – fatal if given by other routes"?
- AAccidental intrathecal injection causes fatal ascending neurotoxicity
- BOral vincristine causes immediate anaphylaxis
- CSubcutaneous injection makes the drug inactive
- DIntramuscular injection causes severe and prolonged hypoglycaemia
Answer key
- 1. D · Glucuronidation
- 2. A · It is a long-acting opioid that prevents withdrawal and craving
- 3. D · Causes an unpleasant reaction if alcohol is drunk
- 4. D · Do not stop the drug suddenly, as this can trigger severe seizures
- 5. C · Avoid heating pads, hot baths and saunas over or near the patch
- 6. B · A modified-release (extended-release) tablet
- 7. C · Take folic acid before conception and seek specialist review of her medication
- 8. A · Accidental intrathecal injection causes fatal ascending neurotoxicity
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