Formulation & Preparation

What is 'extemporaneous dispensing' in pharmacy?

• APreparing medicines from raw materials on request by a pharmacist✓
• BDispensing ready-made licensed medicines straight from the manufacturer's pack
• CManufacturing medicines in bulk under licence for sale on to other pharmacies
• DSupplying a medicine urgently at a time when the prescriber cannot be contacted

Answer: Extemporaneous dispensing involves preparing medicines from ingredients to meet individual patient needs, typically liquids or creams.

What does 'aseptic preparation' mean?

• APreparing medicine without a prescription
• BPreparing at home
• CUsing sterile technique to prepare medicines free from contamination (e.g., IV preparations, eye drops)✓
• DRapid preparation

Answer: Aseptic preparation uses sterile techniques and environments to ensure medicines are free from microbial contamination.

Which piece of equipment is essential for aseptic preparation in a community pharmacy?

• AA mortar and pestle kept for grinding and mixing powders
• BA set of calibrated weighing scales kept on the dispensary bench
• CLaminar flow hood or aseptic workstation✓
• DA set of glass beakers and graduated measuring cylinders

Answer: Laminar flow hoods (or isolators) provide a sterile environment and are essential for aseptic preparations.

What is 'stability' of a medicine?

• AIts ability to maintain its strength and characteristics when stored✓
• BThe taste and the smell of a medicine at the moment it is taken by the patient
• CThe type of outer packaging chosen by the manufacturer for the finished product
• DThe price charged for the medicine as it is listed in the current NHS Drug Tariff

Answer: Stability refers to the physical and chemical integrity of a medicine during storage under specified conditions.

What do 'ICH stability guidelines' define?

• ANHS regulations
• BInternational standards for storage conditions and testing of medicines (temperature, humidity, light)✓
• CInternational pricing
• DPharmacy staff training

Answer: International Council for Harmonisation (ICH) guidelines establish conditions for stability testing of medicines globally.

What is an 'expiry date' on a medicine?

• AThe manufacturing date
• BThe date after which the medicine should no longer be used due to loss of potency or safety✓
• CWhen to reorder stock
• DThe date on which the pharmacy first received that particular stock into the dispensary from its wholesaler

Answer: Expiry dates indicate when a medicine's safety and efficacy can no longer be guaranteed. Medicines must not be used after expiry.

How should insulin be stored once it has been opened and in use?

• AIn the freezer compartment, then thawed before use
• BRefrigerated at 2-8°C and then frozen once the cartridge is half used
• CRoom temperature for up to six months from opening
• DRoom temperature for up to 28 days✓

Answer: Once opened, insulin should be stored at room temperature away from direct heat/light for up to 28 days. Unopened insulin is refrigerated.

What is a 'preservative' in pharmaceutical preparations?

• AThe active ingredient that is responsible for the therapeutic effect of the medicine
• BA flavouring agent that is added to mask an unpleasant taste in a liquid medicine
• CA sweetener
• DA substance that prevents microbial growth and degradation during storage✓

Answer: Preservatives (e.g., benzyl alcohol, phenol) inhibit microbial growth in multi-dose preparations, extending shelf life.

What is a 'suspension' in pharmaceutical formulations?

• AA gas that has been dissolved under pressure in a liquid vehicle
• BA solid dosage form such as a compressed tablet or hard capsule
• CAny liquid medicine which is measured out with a 5 ml medicine spoon
• DA mixture of insoluble particles dispersed in a liquid✓

Answer: A suspension is a liquid formulation where solid particles are distributed but not dissolved (e.g., amoxicillin suspension). Must be shaken before use.

What is a 'solution' in pharmaceutical formulations?

• AA dry powder that is packed into individual sachets before reconstitution
• BA homogeneous liquid where the active ingredient is dissolved✓
• CA mixture in which solid particles remain undissolved and settle out
• DA solid dosage form that is pressed into a tablet or filled into a capsule

Answer: A solution is a clear liquid where an ingredient is completely dissolved at a molecular level (e.g., paracetamol liquid).

What is an 'emulsion' in pharmaceutical preparations?

• AA dry powder blend which is dusted directly onto the skin after washing and drying it
• BA tablet
• CA mixture of two immiscible liquids with an emulsifier to keep them dispersed✓
• DA clear solution in which every one of the ingredients has fully dissolved in a single solvent

Answer: Emulsions contain oil and water mixed with emulsifying agents (e.g., liquid paraffin emulsion). They separate if not mixed well.

What is 'particle size' important for in solid formulations?

• AAffecting absorption, dissolution, and bioavailability✓
• BThe speed at which tablets can be compressed on the production line
• CThe appearance of the finished tablet and nothing more than that
• DReducing the cost of the excipients that are used in the formulation

Answer: Smaller particle size increases surface area, improving dissolution rate and bioavailability of drugs.

What is a 'syrup' in pharmaceutical formulations?

• AA dry powder that must be reconstituted with purified water before use
• BA sterile preparation which is given to the patient by intramuscular injection
• CA thin, sugar-free liquid that is used to dilute a concentrated medicine
• DA concentrated sugar solution used as a vehicle for medicines✓

Answer: Syrups are concentrated sugar solutions used to mask bitter tastes and provide a pleasant vehicle for liquid medicines.

What is the purpose of a 'bulking agent' in powder formulations?

• ATo improve the taste of the powder so that a patient is willing to take it
• BTo add weight and ensure proper filling of capsules or tablets✓
• CTo increase the amount of active drug that each individual capsule delivers
• DTo speed up the manufacturing process when tablets are made on a press

Answer: Bulking agents (e.g., lactose) fill out the volume when the active ingredient amount is small, ensuring proper capsule/tablet size.

What does 'bioequivalence' mean?

• ASame brand name
• BSame price
• CSimilar absorption profiles and blood levels achieved by different formulations of the same drug✓
• DSame appearance

Answer: Bioequivalent medicines have similar bioavailability and therapeutic effects despite being from different manufacturers or formulations.

What is a 'cream' in pharmaceutical formulations?

• AA clear liquid preparation which is measured out for the patient in millilitres
• BA semi-solid emulsion containing water and oil for topical application✓
• CA powder
• DA sterile preparation that is drawn up into a syringe and given by injection

Answer: Creams are semi-solid emulsions for topical use, easier to apply and absorb than ointments.

What is an 'ointment' in pharmaceutical formulations?

• AA semi-solid preparation containing oil/grease without water for topical application✓
• BA clear liquid preparation in which the active ingredient has been completely dissolved in a solvent
• CA pourable liquid preparation that is taken by mouth using a medicine spoon or an oral syringe
• DA powder

Answer: Ointments are greasy, water-free semi-solids providing occlusive effects for skin conditions.

What is a 'gel' in pharmaceutical formulations?

• AA free-flowing liquid that is poured from a bottle and then swallowed by the patient
• BA compressed solid tablet which the patient swallows whole with a full glass of water
• CA semi-solid colloid that may be water or oil-based for topical application✓
• DA powder

Answer: Gels are semi-solid formulations where a liquid is thickened by gelling agents, often water-based and non-greasy.

What is the role of a 'surfactant' in pharmaceutical formulations?

• ATo lower the temperature at which the finished preparation has to be stored and used
• BTo increase the weight of each finished pack so that it feels more substantial to hold
• CTo reduce surface tension and improve solubility and mixing of ingredients✓
• DTo add flavour

Answer: Surfactants (e.g., polysorbate) reduce surface tension, helping mix immiscible liquids and improve drug solubility.

What is 'osmolarity' important for in sterile preparations?

• AThe speed at which the preparation is absorbed into the bloodstream after injection
• BThe pH of the preparation, which must always be adjusted to exactly 7.0 before use
• CPreventing cell damage by maintaining osmotic balance with body fluids✓
• DPrice

Answer: Osmolarity matches body fluid osmolarity to prevent osmotic damage to cells (e.g., hypertonic solutions cause crenation).

What is a 'controlled-release' or 'modified-release' formulation?

• AA liquid version of the medicine that is supplied in a multi-dose bottle
• BA standard immediate-release tablet that dissolves quickly in the stomach
• CA powder that is sprinkled onto the patient's food at each of their mealtimes
• DA formulation that releases drug slowly over an extended period✓

Answer: Modified-release formulations (e.g., extended-release, delayed-release) control drug release to maintain therapeutic levels and reduce dosing frequency.

What is a 'dissolution test' used for?

• AChecking the quality of the purified water that is used for preparations in the dispensary
• BTesting whether or not a patient has been taking their tablets exactly as prescribed
• CAssessing how quickly a solid dosage form releases its active ingredient✓
• DMeasuring drug stability

Answer: Dissolution testing confirms that solid dosage forms (tablets/capsules) release their active ingredient at appropriate rates for absorption.

What is the purpose of 'coating' on tablets?

• ADecoration alone, so that each manufacturer's brand can be told apart on the pharmacy shelf
• BTo protect the medicine, improve taste, modify release, or protect the stomach✓
• CTo speed up manufacturing by allowing the tablet press to be run at a much faster rate
• DReduce cost

Answer: Tablet coatings (sugar, film, enteric) improve taste, protect from moisture, target release site, and improve patient acceptability.

What is 'reconstitution' of a powder medicine?

• AStoring dry powders
• BAdding a liquid (usually water) to a powder to create a liquid formulation✓
• CRe-dispensing a medicine which has been returned to the pharmacy by another patient
• DChecking the quality of a powder against the specification set by its manufacturer

Answer: Reconstitution involves dissolving a powder in a specified liquid (usually water) to create the actual usable medication (e.g., antibiotics).

What should be checked after reconstituting a powder medicine?

• ANothing at all, because a reconstituted medicine can always be used straight away without checks
• BJust the colour
• CThe package only
• DThe expiry date, instructions, concentration, and any visible particles or discolouration✓

Answer: After reconstitution, verify the resulting concentration, expiry/use-by date, appearance, and that no particles/cloudiness are present.