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Sterile Dosage Forms Dr. Miroshnyk

Total questions: 60

Worksheet time: 6hrs 41mins

Name
Class
Date
1.

All parenteral routes of administration are sterility demanding.

a)

True

b)

False

2.

All parenteral injections or ophthalmic are sterility-demanding.

a)

True

b)

False

3.

Which of the following provides the minimum practice and quality standards for compounded sterile preparations (CSPs)?

a)

USP (707)

b)

USP (797)

c)

USP (420)

d)

USP (690)

4.

Small-volume parenteral (SVP): an injection packaged in containers up to 100 mL.

a)

True

b)

False

5.

Large-volume parenteral (LVP): a single dose injection intended for IV use and is packaged in container larger than 100 mL.

a)

True

b)

False

6.

Which of the following is the destruction of ALL living organisms and their spores or their complete removal from the preparation?

a)

Ionization

b)

Sterilization

c)

Catabolism

d)

Epigenesis

7.

Which of the following are considered Methods of Sterilization? Select all that apply

a)

Dry Heat

b)

Ionizing Radiation

c)

Moist-heat (steam)

d)

Filtration

e)

Gas

8.

A pharmacist intern is asked to compound a sterile preparation using nonsterile excipients. How would you assess the microbial contamination level of this preparation?

a)

Low risk level

b)

Medium risk level

c)

High risk level

d)

Impossible to determine

9.

A pharmacist intern is asked to compound a sterile preparation using all ingredients and equipment sterile; minimal manipulation in a ISO Class 5 environment. How would you assess the microbial contamination level of this preparation?

a)

High risk level

b)

Medium risk level

c)

Low risk level

d)

Impossible to determine

10.

 

A pharmacist intern is asked to compound multiple products, complex and time-consuming manipulations. How would you assess the microbial contamination level of this preparation?

a)

High risk level

b)

Medium risk level

c)

Low risk level

d)

Impossible to determine

11.

Which of the following methods of sterilization is the method of choice in which temperature is responsible for sterilization and pressure increases temperature?

a)

Steam sterilization

b)

Dry heat sterilization

c)

No sterilization is required in this case

d)

Sterilization by filtration

12.

Which of the following is the methods of sterilization is used for sterilizing glassware, surgical instruments, oils, glycerin, mineral oil and heat stable powders heated by gas or electricity?

a)

Steam sterilization

b)

Dry heat sterilization

c)

No sterilization is required in this case

d)

Sterilization by filtration

e)

Gas sterilization

13.

Which of the following methods of sterilization is the most appropriate for a heat sensitive API?

a)

Steam sterilization

b)

Dry heat sterilization

c)

No sterilization is required in this case

d)

Sterilization by filtration

e)

Gas sterilization

14.

Which of the following are advantages of doing sterilization by filtration? Select all that apply

a)

Faulty assembly

b)

Relatively inexpensive

c)

Speed

d)

Inspection needed

15.

Which of the following are disadvantages of doing sterilization by filtration? Select all that apply

a)

Inspection needed

b)

Speed

c)

Relatively inexpensive

d)

Faulty assembly

16.

Which of the following methods of sterilization removes of bacteria and spores by filtration, using a 0.22µm filter?

a)

Steam sterilization

b)

Dry heat sterilization

c)

No sterilization is required in this case

d)

Sterilization by filtration

e)

Gas sterilization

17.

Which of the following are possible complications that can arise from IV administration? Select all that apply

a)

Air emboli

b)

Dehydration

c)

Thrombosis

d)

Phlebitis

e)

Infection

18.

A pharmacist will be compounding a sterile preparation. Which of the following documents is considered as a standard of practice for this activity?

a)

USP monograph 767

b)

USP monograph 795

c)

USP monograph 797

d)

USP monograph 1097

19.

Which of the following statements is TRUE about Gas Sterilization?

a)

The mixtures with air does not have any effect

b)

The mixtures with air is necessary for better sterilization

c)

The mixtures with air very flammable

d)

The mixtures needs to be with water and air for better sterilization process

20.

Which of the following is TRUE about the mechanism of Gas Sterilization?

a)

Removal of bacteria and spores by filtration, using a 0.22µm filter

b)

Ethylene oxide is thought to sterilize by interfering with the metabolism of the bacterial cell

c)

Used for sterilizing glassware, surgical instruments, oils, glycerin, mineral oil and heat stable powders

d)

Temperature is responsible for sterilization, pressure increases temperature

e)

Often the method of choice

21.

Which of the following uses gamma and cathode rays in some applications like bulk pharmaceuticals & medical devices?

a)

Beta radiation

b)

Ionizing radiation

c)

Alpha radiation

d)

pH radiation

22.

Which of the following parenteral route of administrations has the longer onset of action?

a)

Subcutaneous (SQ/SC)

b)

Intramuscular

c)

Intravenous (IV) injections

23.

 

Which of the following parenteral route of administrations has the shorter onset of action?

a)

Intravenous (IV) injections

b)

Intramuscular

c)

Subcutaneous (SQ/SC)

24.

Which of the following injections is introduced into the loose interstitial tissue "slowly"?

a)

Subcutaneous

b)

Intramuscular

c)

Intravenous

d)

Intradermal

25.

Which of the following are TRUE about Intradermal (intracutaneous)? Select all that apply

a)

0.1 mL or less of medication

b)

10 – 15 needle degree angle

c)

Used for Diagnosis, desensitization, and immunization

d)

Injection into the more vascular layers of the skin just under epidermis

e)

Introduced into the loose interstitial tissues – ‘give slowly’

26.

Which of the following injections or parenteral route of administrations takes 10 – 30 min to “work”?

a)

Intradermal (intracutaneous)

b)

Intravenous

c)

Subcutaneous

d)

Intramuscular

27.

Which of the following statements are TRUE about the use of Parenteral Routes? Select all that apply

a)

Drug itself is ineffective by other routes

b)

Rapid action is required

c)

Patient is uncooperative or unconscious

d)

Patient is unable to tolerate or accept oral medication

e)

Long onset of action more than 2 hours is required

28.

Which of the following are TRUE about the weaknesses/drawbacks for Parenteral Routes of administration? Select all that apply

a)

Invasive ROA

More expensive

b)

Must be administered by trained personnel

c)

The effect of overdose or hypersensitive reaction to the drug is difficult to reverse

d)

Aseptic procedures are required

e)

Contamination of dosage form prior to injection is possible

29.

Which of the following solvents for injections are NOT suitable for use in neonates?

a)

Water for injections

b)

Sterile water for injections

c)

Bacteriostatic water for injections

30.

Which of the following solvents for injections has an USP labeling requirement: “NOT FOR USE IN NEONATES”?

a)

Ethanol

b)

Diphenhydramine

c)

Benzyl alcohol

d)

Zinc oxide

31.

A pharmacist needs to compound a large volume parenteral solution for IV infusions. Which of the following solvents would be appropriate to use? Select all that apply

a)

Purified Water USP

b)

Water for Injections USP

c)

Sterile Water for Injections

d)

Bacteriostatic Water for Injections

e)

Tap water

32.

Which of the following excipients is linked to poisoning causing Gasping Syndrome?

a)

Benzyl Benzoate

b)

Benzyl Salicylate

c)

Benzoic Acid

d)

Benzyl Alcohol

33.

Which of the following are the symptoms caused by Benzoyl alcohol poisoning? Select all that apply

a)

metabolic acidosis

b)

central nervous system depression

c)

gasping respirations

d)

high levels of benzyl alcohol and its metabolites in the blood and urine

e)

lupus like syndrome

34.

Which of the following is TRUE about Gasping syndrome (benzyl alcohol poisoning) association dosages?

a)

>19 mg/kg/day, but less than 90 mg/kg/day

b)

>99 mg/kg/day

c)

>19 mg/kg/day, but less than 75 mg/kg/day

d)

>19 mg/kg/day, but less than 50 mg/kg/day

35.

Which of the following is often used to prepare bacteriostatic WFI?

a)

0.9% w/v sodium chloride

b)

0.9% v/w benzyl alcohol

c)

0.9% w/v benzyl alcohol

d)

0.9% v/w sodium chloride

36.

Sesame oil is a Non-Aqueous vehicle used in IM and IV routes of administration.

a)

True

b)

False

37.

Sesame oil is a Non-Aqueous vehicle used in IM route of administration only.

a)

True

b)

False

38.

Which of the following are TRUE of when do we use Non-Aqueous Vehicles? Select all that apply

a)

susceptibility of APIs to hydrolysis

b)

to create the internal phase of parenteral emulsions

c)

water-insoluble APIs

d)

water-soluble APIs

39.

Visual inspection of parenteral solutions can reveal the presence of which of the following?

a)

particle contamination and precipitation

b)

pH and precipitation

c)

chemical degradation of a drug and osmolarity

d)

pyrogens and precipitation

40.

ALL parenteral injections are required to have the final pH of around 7.4.

a)

True

b)

False

41.

Final pH of ALL parenteral injections depend on the administration route.

a)

True

b)

False

42.

Which of the following are TRUE about pH depending on the administration route? Select all that apply

a)

IV: pH 2-12

b)

IM: 3-11

c)

SC: 3-6

d)

IM: 2-12

43.

Which of the following buffers can be used to control pH when change during manufacturing process, sterilization or storage? Select all that apply

a)

citrate

b)

acetate

c)

phosphate

d)

mononitrate

44.

Which of the following is TRUE about Isotonicity in parenteral preparation? Select all that apply

a)

it will make the preparation more irritable

b)

it will make the preparation less irritable

c)

Decreases risk of hemolysis

d)

Increases risk of hemolysis

45.

All of the following are the most commonly used agents to control isotonicity, EXCEPT:

a)

NaCl

b)

Benzoyl alcohol

c)

Glycerol

d)

Mannitol

e)

Glucose

46.

Parenteral nutrition solution are extremely hypertonic and they should be administered only into large veins so that the preparation is diluted quickly to the blood circulation.

a)

True

b)

False

47.

Parenteral nutrition solution are extremely hypotonic and they should be administered only into large veins so that the preparation is diluted quickly to the blood circulation.

a)

True

b)

False

48.

Which of the following is a drawback of Non-Aqueous Vehicles?

a)

Hydration

b)

Sensitivity/Pain/irritation on injection

49.

Which of the following is one of the main attributes of Sterile Parenteral Dosage forms?

a)

Not isotonic

b)

Pyrogen free

c)

Free soluble material

d)

Longer onset of action exceeding 6 hours

50.

Large Volume Parenterals must not contain bacteriostatic agents or other additives.

a)

True

b)

False

51.

Which of the following are examples of Large Volume Parenterals? Select all that apply

a)

Piggy

b)

Ringer’s injection, USP

c)

Lactated Ringer’s Injection, USP

52.

Which of the following are TRUE about Bacteriostatic Water for Injections? Select all that apply

a)

Sterile WFI + one or more antimicrobial agents

b)

Container label must state the names and proportions of the antimicrobial agents 

c)

Packaged in pre-filled syringes or multiple-dose vials NMT30 ml

d)

Due to the presence of antimicrobial agents used only for SVP

e)

Compatibility of the antimicrobial agents and APIs has to be considered

53.

Which of the following are TRUE about Water for Injections(WFI), USP? Select all that apply

a)

Freely soluble APIs (injections)

b)

The external phase for injectable emulsions

c)

Poorly water soluble APIs (suspensions)

d)

It is non-sterile and is used in preparation of terminally sterilized preparations

e)

Must be pyrogen-free

54.

Which of the following uses healthy rabbits  (n=3) to inject a product to be tested?

a)

Pyrogen Test (USP)

b)

Bacterial Endotoxine Test (USP)

55.

Which of the following is the most commonly used test and utilizes LAL (Limulus amebocyte lysate) ?

a)

Bacterial Endotoxine Test (USP)

b)

Pyrogen Test (USP)

56.

Which of the following are additional formulation requirements for parenteral? Select all that apply

a)

hygroscopicity

b)

Isotonicity

c)

pH in physiological range

d)

Sufficient chemical and microbiological stability

57.

Which of the following statements is TRUE regarding Preservatives?

a)

Single-dose containers must contain one or more preservatives regardless of the method of sterilization

b)

Multiple-dose containers must NOT contain one or more preservatives regardless of the method of sterilization

c)

Multiple-dose containers must contain one or more preservatives regardless of the method of sterilization

58.

Typically, NO preservatives added to injections of volume more than 15 ml.

a)

True

b)

False

59.

Which of the following are TRUE regarding Packaging? Select all that apply

a)

Should protect the product from contamination during the entire shelf-life

b)

Containers, including the closures, must be inert

c)

Should NOT allow visual inspection of the solution

d)

Should allow visual inspection of the solution

60.

Which of the following are packaged in single-dose containers up to 1 L

Pyrogen-free, with an allowable endotoxin level?

a)

Water for Injections(WFI), USP

b)

Bacteriostatic Water for Injections

c)

Sterile Water for Injection, USP