Preparing for the Nepal Pharmacy Council licensing examination requires a good understanding of pharmacology, pharmacokinetics, therapeutics, pharmaceutical chemistry, and other core pharmacy subjects.
Practice questions are useful for revision, but understanding the reason behind each answer is more valuable than memorizing answers alone. The following questions are designed as an educational revision resource based on important pharmacy topics commonly studied for pharmacy licensing examinations.
For additional examination preparation, you can also read our article on Nepal Pharmacy Council Website Model Questions with Answers – Part 1.
Pharmacokinetics and General Pharmacology
1. Most drugs are absorbed primarily by which mechanism?
Answer: B. Passive diffusion
Explanation: Most drugs cross biological membranes mainly by passive diffusion, moving from a region of higher concentration to lower concentration.
2. Which route of administration provides 100% bioavailability?
Answer: B. Intravenous
Explanation: Intravenous administration delivers the drug directly into systemic circulation, so bioavailability is considered 100%.
3. Which route commonly undergoes hepatic first-pass metabolism?
Answer: B. Oral
Explanation: Many orally administered drugs enter the portal circulation after absorption and pass through the liver before reaching systemic circulation.
4. What is an important feature of the sublingual route?
Answer: B. Relatively rapid absorption
Explanation: The sublingual mucosa has a good blood supply, allowing rapid absorption of suitable drugs and avoiding the usual hepatic first-pass effect.
5. Weakly acidic drugs may be absorbed from which site?
Answer: B. Stomach
Explanation: Weak acids may have a greater unionized fraction in acidic environments. However, many drugs are still absorbed predominantly from the small intestine because of its large surface area.
6. Hyoscine is commonly absorbed after oral administration mainly from the:
Answer: A. Intestine
Explanation: Like many orally administered drugs, absorption mainly occurs through the small intestine because of its large absorptive surface.
7. Aspirin is a weak acid and can be absorbed from the:
Answer: B. Stomach
Explanation: Aspirin can be absorbed from the stomach because acidic conditions favor a greater unionized fraction. Significant absorption may also occur in the small intestine.
8. Most orally administered drugs are absorbed predominantly from the:
Answer: C. Small intestine
Explanation: The small intestine has a large surface area, extensive blood supply, and favorable conditions for absorption.
9. Alkalinization of urine generally increases the excretion of:
Answer: B. Weakly acidic drugs
Explanation: Alkaline urine increases ionization of weak acids, reducing tubular reabsorption and increasing urinary excretion.
10. The most important organ for drug metabolism is the:
Answer: B. Liver
Explanation: The liver is the major site of metabolism for many medicines because it contains numerous drug-metabolizing enzymes.
11. Which organs play an important role in drug excretion?
Answer: C. Skin and liver
Explanation: Drugs and metabolites may be eliminated through several routes. The kidney is the major excretory organ, while the liver eliminates some substances through bile. Skin and lungs may also contribute to elimination.
12. A major microsomal enzyme system involved in drug metabolism is:
Answer: A. Cytochrome P450
Explanation: Cytochrome P450 enzymes metabolize many medicines and are important in drug interactions.
13. Oxidation and reduction reactions are generally associated with which phase of metabolism?
Answer: A. Phase I
Explanation: Phase I reactions commonly include oxidation, reduction, and hydrolysis.
14. Which phase of metabolism is commonly called the conjugation phase?
Answer: B. Phase II
Explanation: Phase II reactions include conjugation processes such as glucuronidation, sulfation, and acetylation.
15. Which of the following is NOT a recognized basic type of drug action?
Answer: C. Simulation
Explanation: Stimulation, depression, irritation, replacement, and cytotoxic action are traditional classifications of drug action. Simulation is not generally listed as a separate basic type.
16. The rate and extent to which an unchanged drug reaches systemic circulation is called:
Answer: D. Bioavailability
Explanation: Bioavailability describes the extent and rate at which the active drug reaches systemic circulation.
17. Bioavailability is commonly represented by which symbol?
Answer: B. F
Explanation: Absolute bioavailability is commonly represented by the symbol F.
18. The therapeutic index mainly provides information about a drug's:
Answer: B. Safety margin
Explanation: The therapeutic index compares toxic and effective doses and provides an indication of the safety margin.
19. Drugs that bind to receptors but do not produce a pharmacological response are called:
Answer: B. Antagonists
Explanation: Antagonists bind to receptors but do not activate them and may block the effects of agonists.
20. Which type of adverse drug reaction is predictable and dose-dependent?
Answer: A. Type A
Explanation: Type A reactions are usually dose-related and predictable from the known pharmacological action of the drug.
21. Posology is the study of:
Answer: B. Drug dosage
Explanation: Posology is the branch of pharmacology concerned with the study of drug doses.
22. "What the body does to the drug" refers to:
Answer: B. Pharmacokinetics
Explanation: Pharmacokinetics includes absorption, distribution, metabolism, and excretion of drugs.
Gastrointestinal Drugs and NSAIDs
23. Triple therapy is commonly used for the management of:
Answer: A. Helicobacter pylori infection
Explanation: H. pylori treatment commonly uses a combination of acid suppression and appropriate antimicrobial therapy according to current guidelines.
24. Which antibiotic is NOT part of the most common standard H. pylori triple-therapy combinations?
Answer: C. Tetracycline
Explanation: Traditional triple therapy commonly uses a proton pump inhibitor with clarithromycin and amoxicillin or metronidazole. Treatment recommendations can vary according to resistance patterns.
25. Simethicone is mainly used as a:
Answer: D. Antiflatulent
Explanation: Simethicone reduces the surface tension of gas bubbles and helps relieve symptoms associated with flatulence.
26. Antacids can interfere with the action of which medicine because of pH-related effects?
Answer: C. Sucralfate
Explanation: Sucralfate requires an acidic environment for optimal action, so changes in gastric pH can affect its performance.
27. Which H2-receptor antagonist is known for inhibition of cytochrome P450 enzymes?
Answer: C. Cimetidine
Explanation: Cimetidine can inhibit several CYP enzymes and may cause clinically important drug interactions.
28. PPI stands for:
Answer: B. Proton Pump Inhibitor
Explanation: PPIs reduce gastric acid secretion by inhibiting the gastric H+/K+-ATPase proton pump.
29. Which is an example of a systemic antacid?
Answer: B. Sodium bicarbonate
Explanation: Sodium bicarbonate is absorbable and is traditionally classified as a systemic antacid.
30. Which H2-receptor antagonist is known to be moisture sensitive?
Answer: B. Ranitidine
Explanation: Ranitidine formulations historically required appropriate protection from environmental conditions. Note that ranitidine availability has changed in many countries because of NDMA-related concerns.
31. Which combination is commonly used in antacid preparations?
Answer: A. Aluminium hydroxide and magnesium hydroxide
Explanation: Combining aluminium and magnesium salts can help balance gastrointestinal effects because aluminium may cause constipation while magnesium may cause diarrhea.
32. Aspirin primarily acts by inhibiting:
Answer: B. Cyclooxygenase
Explanation: Aspirin irreversibly inhibits cyclooxygenase enzymes, reducing prostaglandin and thromboxane synthesis.
33. Which medicine can produce a hepatotoxic metabolite in overdose?
Answer: C. Paracetamol
Explanation: Excess paracetamol can produce the toxic metabolite NAPQI, especially when normal detoxification pathways are overwhelmed.
34. What is the antidote for significant paracetamol overdose?
Answer: C. N-acetylcysteine
Explanation: N-acetylcysteine helps replenish glutathione and reduces toxicity from NAPQI.
35. A common adverse effect of ibuprofen and other NSAIDs is:
Answer: A. GI irritation
Explanation: NSAIDs can reduce protective prostaglandins in the gastrointestinal tract and may cause irritation, ulcers, or bleeding.
Gout and Rheumatoid Arthritis
36. Excess uric acid can lead to:
Answer: B. Gout
Explanation: Deposition of monosodium urate crystals in joints can cause gout.
37. Which medicine has traditionally been used for acute gout attacks?
Answer: D. NSAIDs such as indomethacin
Explanation: NSAIDs are commonly used for acute gout, while colchicine is also an important option. Choice depends on the patient's clinical condition and contraindications.
38. Which medicine is used to reduce uric acid production in chronic gout?
Answer: A. Allopurinol
Explanation: Allopurinol inhibits xanthine oxidase and reduces uric acid production.
39. A common adverse effect of colchicine is:
Answer: B. Diarrhea
Explanation: Gastrointestinal adverse effects, particularly diarrhea, are common with colchicine.
40. A commonly used low-dose colchicine tablet strength is:
Answer: B. 0.5 mg or 0.6 mg
Explanation: Colchicine tablet strength varies by country and manufacturer. Dosing should always follow current prescribing guidance.
41. Gold salts were historically used in the treatment of:
Answer: B. Rheumatoid arthritis
Explanation: Gold compounds were historically used as disease-modifying treatments for rheumatoid arthritis but are now much less commonly used.
Endocrinology and Diabetes
42. Which is the primary male sex hormone?
Answer: A. Testosterone
Explanation: Testosterone is the principal androgen hormone in males.
43. STD stands for:
Answer: A. Sexually Transmitted Disease
Explanation: STD is a commonly used abbreviation for sexually transmitted disease, although STI is also widely used.
44. Calcitonin is primarily produced by the:
Answer: A. Thyroid gland
Explanation: Calcitonin is produced by parafollicular or C cells of the thyroid gland.
45. Thyroid-stimulating hormone is secreted by the:
Answer: B. Anterior pituitary
Explanation: TSH is secreted by the anterior pituitary and stimulates the thyroid gland.
46. Which hormone primarily stimulates breast milk production?
Answer: B. Prolactin
Explanation: Prolactin stimulates milk production, while oxytocin is involved in milk ejection.
47. Diabetes insipidus may occur because of deficiency of:
Answer: C. ADH
Explanation: Central diabetes insipidus is associated with insufficient production or release of antidiuretic hormone.
48. In which type of diabetes mellitus is there severe deficiency of endogenous insulin due to beta-cell destruction?
Answer: A. Type 1
Explanation: Type 1 diabetes results from autoimmune destruction of pancreatic beta cells in most cases.
49. Insulin is commonly administered for routine treatment by which route?
Answer: C. Subcutaneous
Explanation: Most insulin products are routinely administered subcutaneously.
50. Insulin is produced by which pancreatic cells?
Answer: D. Beta cells
Explanation: Pancreatic beta cells synthesize and secrete insulin.
51. Diabetic ketoacidosis is commonly managed with:
Answer: D. Regular insulin
Explanation: Intravenous regular insulin is commonly used in DKA protocols together with fluid and electrolyte management.
52. In emergency situations such as DKA, regular insulin may be administered by:
Answer: C. Intravenous
Explanation: IV regular insulin is commonly used in DKA management according to approved clinical protocols.
53. Which medicine is commonly considered first-line for many patients with type 2 diabetes?
Answer: B. Metformin
Explanation: Metformin is widely recommended as an important first-line medicine, although treatment should be individualized.
54. Metformin is generally recommended to be taken:
Answer: C. With meals
Explanation: Taking metformin with food can help reduce gastrointestinal adverse effects.
55. Human insulin contains how many amino acids?
Answer: A. 51
Explanation: Human insulin contains 51 amino acids distributed between the A and B chains.
Lipids, Vitamins and Nutrition
56. A desirable total cholesterol level for most adults is generally:
Answer: B. Less than 200 mg/dL
Explanation: A total cholesterol level below 200 mg/dL is generally considered desirable, although cardiovascular risk assessment involves multiple factors.
57. Shorter-acting statins are often taken:
Answer: B. At bedtime
Explanation: Cholesterol synthesis is higher at night, so shorter-acting statins may be more effective when taken in the evening. Some longer-acting statins can be taken at any convenient time.
58. Which lipoprotein is commonly called "good cholesterol"?
Answer: B. HDL
Explanation: HDL participates in reverse cholesterol transport, although cardiovascular risk is more complex than simply increasing HDL levels.
59. Which lipoprotein mainly transports cholesterol from the liver to peripheral tissues?
Answer: A. LDL
Explanation: LDL transports cholesterol to peripheral tissues and elevated LDL is an important cardiovascular risk factor.
60. All of the following are fat-soluble vitamins EXCEPT:
Answer: B. Vitamin C
Explanation: Vitamins A, D, E, and K are fat soluble, whereas vitamin C is water soluble.
61. Scurvy occurs due to deficiency of:
Answer: B. Vitamin C
Explanation: Vitamin C deficiency impairs collagen formation and can lead to scurvy.
62. Which vitamin is known for an important antioxidant role?
Answer: A. Vitamin E
Explanation: Vitamin E, particularly tocopherols, has important antioxidant activity.
63. Which vitamin is used to reverse excessive anticoagulant effects of warfarin in appropriate clinical situations?
Answer: A. Vitamin K
Explanation: Vitamin K can help restore synthesis of vitamin K-dependent clotting factors.
64. Deficiency of which vitamin may cause osteomalacia in adults?
Answer: C. Vitamin D
Explanation: Vitamin D deficiency impairs bone mineralization and can cause osteomalacia.
65. Beriberi is caused by deficiency of:
Answer: B. Vitamin B1
Explanation: Beriberi results from thiamine deficiency.
66. Pellagra is caused by deficiency of:
Answer: C. Niacin
Explanation: Niacin deficiency causes pellagra, classically associated with dermatitis, diarrhea, and dementia.
67. The approximate energy value of fat is:
Answer: A. 9 kcal/g
Explanation: Fat provides approximately 9 kilocalories per gram.
68. Which is a rich plant-based source of protein?
Answer: A. Soybean
Explanation: Soybeans are rich in protein and are an important plant protein source.
69. The building blocks of proteins are:
Answer: C. Amino acids
Explanation: Proteins are polymers made from amino acids joined by peptide bonds.
Cardiovascular Drugs and Diuretics
70. Renin is primarily secreted by the:
Answer: B. Kidney
Explanation: Renin is released by juxtaglomerular cells in the kidneys.
71. A common adverse effect of ACE inhibitors is:
Answer: A. Dry cough
Explanation: ACE inhibition can increase bradykinin levels, contributing to a persistent dry cough.
72. Ankle swelling is a common adverse effect of:
Answer: B. Amlodipine
Explanation: Peripheral edema is a common adverse effect of dihydropyridine calcium-channel blockers.
73. Which strengths of amlodipine are commonly available?
Answer: B. 2.5 mg, 5 mg, 10 mg
Explanation: These strengths are commonly marketed, although availability can vary by country.
74. The usual route of administration of nifedipine is:
Answer: A. Oral
Explanation: Nifedipine is generally administered orally. Immediate-release sublingual use is not recommended because of safety concerns.
75. Which calcium-channel blocker has a benzothiazepine structure?
Answer: A. Diltiazem
Explanation: Diltiazem is classified as a benzothiazepine calcium-channel blocker.
76. A common effect of furosemide may include:
Answer: B. Muscle cramps
Explanation: Furosemide can cause electrolyte loss, which may contribute to muscle cramps and weakness.
77. Acetazolamide acts by inhibiting:
Answer: B. Carbonic anhydrase
Explanation: Acetazolamide is a carbonic anhydrase inhibitor and is also used for certain indications including prevention of acute mountain sickness.
78. Propranolol should generally be avoided or used with great caution in:
Answer: C. Bronchial asthma
Explanation: Propranolol blocks beta-2 receptors and may cause bronchoconstriction.
79. Which beta-blocker is relatively short acting?
Answer: C. Esmolol
Explanation: Esmolol has a very short duration of action and is commonly used intravenously in acute clinical settings.
80. Which medicine has historically been used for hypertension during pregnancy?
Answer: C. Methyldopa
Explanation: Methyldopa has a long history of use in pregnancy. Current treatment choices depend on guidelines and individual clinical circumstances.
81. Which diuretic may cause gynecomastia?
Answer: D. Spironolactone
Explanation: Spironolactone has antiandrogenic effects and can cause gynecomastia.
82. Which is a potent loop diuretic?
Answer: B. Furosemide
Explanation: Furosemide is a loop diuretic and produces powerful diuresis.
83. Which is an osmotic diuretic?
Answer: A. Mannitol
Explanation: Mannitol increases osmotic pressure within renal tubules and promotes water excretion.
84. The active metabolite of enalapril is:
Answer: A. Enalaprilat
Explanation: Enalapril is a prodrug that is converted to enalaprilat.
85. Which drug class is commonly used as an alternative when an ACE inhibitor causes cough?
Answer: A. Losartan
Explanation: Losartan is an angiotensin II receptor blocker and does not usually cause bradykinin-related cough.
86. Which drug has an extremely short plasma half-life?
Answer: A. Sodium nitroprusside
Explanation: Sodium nitroprusside has a very rapid onset and short duration, making continuous IV administration necessary.
87. Which is a plant-derived antihypertensive alkaloid?
Answer: A. Reserpine
Explanation: Reserpine is an alkaloid obtained from Rauwolfia species and depletes catecholamine stores.
Antimicrobial Drugs
88. Sulfonamide therapy originated historically from the discovery of:
Answer: B. Prontosil
Explanation: Prontosil was an early sulfonamide antibacterial prodrug and an important development in antimicrobial therapy.
89. Silver sulfadiazine is commonly used for:
Answer: C. Burn wound management
Explanation: Silver sulfadiazine has historically been used topically for prevention and treatment of infection in burn wounds.
90. The standard ratio of sulfamethoxazole to trimethoprim in co-trimoxazole is:
Answer: A. 5:1
Explanation: Co-trimoxazole contains sulfamethoxazole and trimethoprim in a 5:1 ratio by weight.
91. Which drug is historically associated with the term "magic bullet" in early antimicrobial chemotherapy?
Answer: C. Sulfonamides
Explanation: The concept of a "magic bullet" originated with Paul Ehrlich and selective antimicrobial chemotherapy. Early sulfonamide discoveries were major milestones in this field.
92. Patients receiving co-trimoxazole may be advised to maintain adequate fluid intake to reduce the risk of:
Answer: A. Crystal-related urinary problems
Explanation: Adequate hydration can help reduce the risk of crystalluria with sulfonamide-containing medicines.
93. A possible adverse effect of sulfonamide therapy is:
Answer: A. Crystalluria
Explanation: Some sulfonamides can precipitate in urine, particularly when hydration is inadequate.
94. Stevens-Johnson syndrome is a serious adverse reaction that can be associated with:
Answer: B. Sulfonamides
Explanation: Sulfonamides are among the medicines associated with severe cutaneous adverse reactions, including Stevens-Johnson syndrome.
95. A delayed skin reaction developing after prolonged drug exposure may involve which type of hypersensitivity?
Answer: D. Type IV
Explanation: Type IV hypersensitivity is delayed and mediated primarily by T cells.
96. Which antibiotic has historically been called the "queen of antibiotics" in some pharmacy examination materials?
Answer: B. Chloramphenicol
Explanation: This is a traditional examination term. Chloramphenicol has broad antibacterial activity but its use is limited because of serious potential toxicity.
97. Penicillin was discovered by Alexander Fleming in:
Answer: A. 1928
Explanation: Alexander Fleming observed the antibacterial effect of Penicillium mold in 1928.
98. Who is widely known as the discoverer of penicillin?
Answer: A. Alexander Fleming
Explanation: Alexander Fleming discovered penicillin, while later scientists including Howard Florey and Ernst Chain contributed significantly to its clinical development.
99. Penicillin was first widely developed for clinical use around:
Answer: B. 1941
Explanation: Penicillin began to be used clinically in the early 1940s after successful purification and development work.
100. Which of the following is a natural penicillin?
Answer: B. Benzylpenicillin (Penicillin G)
Explanation: Benzylpenicillin is a natural penicillin. Ampicillin and amoxicillin are semisynthetic penicillins.
Quick Revision Tips
When preparing for the Nepal Pharmacy Council licensing examination, do not memorize only the correct option. Try to understand the mechanism, indication, adverse effect, or scientific principle behind each answer.
Important areas for revision include:
- Drug absorption and bioavailability
- Drug metabolism and excretion
- Pharmacodynamics and adverse drug reactions
- Gastrointestinal pharmacology
- NSAIDs and analgesics
- Gout and rheumatoid arthritis
- Diabetes and endocrine pharmacology
- Vitamins and nutrition
- Cardiovascular drugs and diuretics
- Antimicrobial pharmacology
For more pharmacy examination practice, you can also read Nepal Pharmacy Council Past Questions – Part 2.
Students preparing for pharmaceutical analysis can also read Pharmaceutical Analysis MCQ-1 for Nepal Pharmacy Council Exam and Pharmaceutical Analysis MCQ-2 with Answers.
For students interested in pharmaceutical industry work and Quality Control, our article on Quality Control Test of Tablet in Pharmaceutical Industry provides useful information about pharmaceutical product testing.
Conclusion
Past and practice questions are useful tools for pharmacy examination preparation, but conceptual understanding is essential for long-term success.
This collection of 100 important questions covers several fundamental areas of pharmacology and therapeutics. Students should revise the scientific principles behind the answers, consult standard pharmacy textbooks, and follow current clinical and examination guidance where applicable.
References
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Katzung BG. Basic and Clinical Pharmacology.
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Rang HP, Ritter JM, Flower RJ, Henderson G. Rang and Dale's Pharmacology.
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Brunton LL, Hilal-Dandan R, Knollmann BC. Goodman & Gilman's The Pharmacological Basis of Therapeutics.
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Tripathi KD. Essentials of Medical Pharmacology.
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Standard pharmacy textbooks and current academic resources relevant to pharmacy licensing examinations.
Disclaimer
This article is intended for educational and examination-preparation purposes only. It is not an official Nepal Pharmacy Council question paper. Drug recommendations and clinical guidelines may change over time, and students should verify important information using current textbooks, official guidance, and reliable academic resources.
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