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WorksheetsDosage Forms - Rectal Dosage Forms
Total questions: 93
Worksheet time: 47mins
What is one benefit of using rectal dosage forms?
Increased first pass metabolism
Less GI effects
Only for oral use
Not suitable for drugs with bad taste
Which of the following is a local effect of rectal dosage forms?
Anti-inflammatory
Analgesic
Used for pain & itch (e.g., haemorrhoids)
Systemic infection
Fill in the blank: Systemic effects of rectal dosage forms include ________ and analgesics (suppositories, foams, enemas).
anti-inflammatory
antibiotics
antacids
antifungals
Step: Drug release - What happens during this step in rectal absorption?
Drug diffuses through mucus
Drug leaves base and dissolves in rectal fluid
Drug is absorbed by the liver
Drug is excreted
Which of the following is an advantage of the rectal route?
Poor patient acceptability for long term use
Can use when oral route not available (e.g., unconscious, children, elderly, GI issues)
Possible expulsion due to rectal wall movement
Difficult to administer correctly in some cases
Fill in the blank: A disadvantage of the rectal route is ________ for long term use.
Poor patient acceptability
High absorption rate
Enhanced taste masking
Rapid onset of action
Which of the following is NOT an ideal characteristic of suppositories?
Melts at body temperatures
Non-toxic, non-irritant
Difficult to remove from mould
Allows optimal drug release
Which type of suppository base spreads easily and has a faster release than hydrophilic bases?
Hydrophilic
Lipophilic
PEGS
Poloxamers
Fill in the blank: Drug solubility in rectal fluid determines ________ concentration, which is the absorption driving force.
maximum
minimum
average
plasma
Smaller particle size leads to faster dissolution and less irritation.
True
False
Which drug and base combination has a RAPID rate of absorption?
Lipophilic drug + lipophilic base
Hydrophilic drug + lipophilic base
Lipophilic drug + hydrophilic base
Hydrophilic drug + hydrophilic base
Fill in the blank: Enemas come as a solution, emulsion, foams, or ________.
suspensions
tablets
capsules
powders
Which of the following is NOT an ideal property of vaginal dosage forms?
Easy to insert
Odourless
Causes irritation
Limited leakage following administration
Vaginal dosage forms can be used for which of the following local effects?
Bacterial infections (clindamycin)
Fungal infections (clotrimazole)
Hormones for labour (cervidil)
All of the above
Systemic effects of vaginal dosage forms include delivery of which hormones?
Estrogen
Prostaglandin analogues
Progestogens (IVF)
All of the above
Fill in the blank: Vaginal dosage forms are commonly used for ______ uses.
systemic
topical
oral
ophthalmic
One advantage of vaginal dosage forms is localized drug delivery, and one disadvantage is possible irritation.
One advantage is localized drug delivery; one disadvantage is possible irritation.
One advantage is rapid absorption; one disadvantage is high systemic side effects.
One advantage is oral convenience; one disadvantage is taste issues.
One advantage is long shelf life; one disadvantage is poor patient compliance.
Which of the following is a disadvantage of vaginal dosage forms?
Easy access
Avoids 1st pass metabolism
Absorption affected by physiological factors
Avoids hepatoxicity
Endocrine dosage forms are commonly used for which of the following?
Antifungals
Antibacterial
Hormone delivery
All of the above
Which of the following is NOT an example of an endocrine dosage form?
Rings
Cream
Tablets
Injections
Which type of troche base is associated with causing allergic reaction and inflammation of the gum?
Polyethylene glycol (PEG)
Gelatine
Troches must sit in the cheek until dissolved and should not be eaten or drunk at the same time.
True
False
Fill in the blank: Troches are generally marked in ______. Place the indicated amount either under tongue or in the cheek cavity.
quarters
halves
thirds
eighths
A troche should be left in the mouth until it dissolves completely for how long?
About 15-30 minutes
Less than 1 minute
Over 1 hour
5 minutes
Which of the following is NOT a recommended point for using troches?
Swallow or chew the troche before it is dissolved
Wait 5-10 minutes after eating to use troches
Place the indicated amount under tongue or in the cheek cavity
Keep them inside the refrigerator in an airtight container in summer
What is one advantage of the transdermal route for delivering hormones?
Causes skin irritation
Bypasses 1st metabolism
Increases risk of transfer to another person
Difficult to apply
Which of the following is a disadvantage of the transdermal route?
Convenient
Easy to apply
Skin irritation
Bypasses 1st metabolism
Fill in the blank: Transdermal creams deliver hormones directly into ______ through the skin.
circulation
muscles
bones
nerves
Which part of the brain coordinates movement and stores motor memory?
Medulla
Pons
Cerebellum
Thalamus
What is the function of the somatic system in the peripheral nervous system?
Involuntary control of glands
Voluntary control of skeletal muscles
Cluster of nerve cells
Controls emotions
Fill in the blank: The autonomic system controls ______ muscle, glands, and organs involuntarily.
smooth
skeletal
cardiac
striated
The sympathetic nervous system is responsible for the 'fight or flight' response.
True
False
Which neurotransmitter is involved in the parasympathetic nervous system?
NA
ACH
ATP
5HT
Which system is responsible for voluntary control and skeletal muscles?
Autonomic nervous system
Somatic nervous system
Parasympathetic nervous system
Sympathetic nervous system
Which neurotransmitter is associated with the Locus Coeruleus and is responsible for arousal, mood, and blood pressure regulation?
NA & some adrenaline
Dopamine
Serotonin
Acetylcholine
Which brain region is associated with dopamine and is involved in movement, motivation, and reward?
Substantia nigra (SN)
Cerebellum
Amygdala
Hippocampus
Which neurotransmitter is the target of SSRIs and is associated with mood regulation in the Raphe nuclei?
5HT
Dopamine
GABA
Acetylcholine
Which neurotransmitter is associated with learning, memory, and Alzheimer's disease in the Nucleus Basalis?
ACH
Dopamine
Serotonin
GABA
Dopamine acts on which receptors to control motor function, reward, and hormone control?
D1-D5
Alpha-1 and Alpha-2
Beta-1 and Beta-2
Nicotinic
Which neurotransmitter acts on 5HT1-5HT7 receptors and is involved in mood, arousal, feeding, and sensory functions?
Serotonin
Dopamine
Acetylcholine
GABA
Which neurotransmitter is associated with wakefulness, appetite, sedation, and nausea, and acts on H1 receptors?
Histamine
Dopamine
Serotonin
Acetylcholine
Which neurotransmitter acts on A1-A3 receptors and is involved in sedation and neuroprotection?
Purines
Dopamine
Glutamate
Acetylcholine
Which neurotransmitter is involved in sleep and circadian rhythm and does not have a specific receptor listed?
Melatonin
Dopamine
Serotonin
Acetylcholine
Which neurotransmitter is a signaling molecule, and excess causes neurotoxicity?
NO (Nitric Oxide)
Dopamine
Serotonin
Acetylcholine
Which neurotransmitter acts on CB1 receptors and is involved in mood, appetite, sleep, and analgesia?
Cannabinoids
Dopamine
Serotonin
Acetylcholine
Which neurotransmitter is involved in pain control and mood?
Opioids (endorphins)
Dopamine
Acetylcholine
Glutamate
Which neurotransmitter acts on GABA A & GABA B receptors and inhibits CNS control?
GABA
Dopamine
Serotonin
Acetylcholine
Which neurotransmitter acts on NMDA, AMPA, and kainite receptors and is involved in learning, memory, and excitation?
Glutamate
Dopamine
Serotonin
GABA
Which neurotransmitter acts on nicotinic and muscarinic receptors and is involved in muscle movement, memory, and ANS function?
ACH
Dopamine
Serotonin
GABA
Which CNS drug action mechanism activates or blocks receptors?
Agonist/antagonist
Enzyme inhibitor
Reuptake enhancer
Ion channel opener
Which CNS drug action mechanism increases neurotransmitter at synapse?
Reuptake inhibitor
Enzyme inducer
Receptor blocker
Ion channel opener
Which CNS drug action mechanism prevents breakdown of neurotransmitters?
Enzyme inhibitor
Receptor agonist
Ion channel blocker
Neurotransmitter reuptake enhancer
Which CNS drug action mechanism delays therapeutic response, such as with SSRIs?
Neuroadaptation
Immediate receptor blockade
Direct neurotransmitter release
Enzyme inhibition
Which of the following is NOT a type of depression listed in the worksheet?
Major depression
Melancholia
Bipolar disorder
Atypical depression
Depression can be secondary to an underlying condition or primary with an unknown cause.
True
False
Which of the following is NOT a type of depression listed in the notes?
Postnatal depression
Seasonal affective disorder
Bipolar depression
Schizophrenia
According to the notes, what is a risk factor for depression under the 'Genetics' category?
A) Family history of depression or psychosis
B) Trauma
C) Abuse
D) Stroke
Fill in the blank: A stressful life event that can contribute to depression includes _________
Trauma, loss, chronic pain, social isolation, life changes
Eating a balanced diet, regular exercise, and enough sleep
Winning a lottery, going on vacation, and making new friends
Learning a new skill, reading books, and playing sports
Which hormone is decreased in neuroendocrine abnormalities associated with depression?
Serotonin (5HT)
Dopamine (DA)
Noradrenaline (NA)
Cortisol
According to the monoamine hypothesis, depression is due to a deficiency of which neurotransmitters?
Dopamine (DA), Serotonin (5HT), Noradrenaline (NA)
Glutamate, GABA, Acetylcholine
Histamine, Glycine, Glutamate
Endorphins, Substance P, Enkephalins
The neurotransmitter hypothesis suggests that depression is due to higher levels of neurotransmitters and how neurons respond to them.
True
False
Which of the following is NOT a symptom under the 'Emotional' category in the clinical presentation of depression?
Depressed mood
Hallucinations
Sadness
Anhedonia
Fill in the blank: Impaired concentration, indecisiveness, and poor memory are symptoms under the ________ category in depression.
Cognitive
Physical
Emotional
Behavioral
Which symptom is classified as a psychotic symptom in depression?
Hallucinations
Sleepiness
Increased appetite
Fatigue
According to the notes, what is required for the diagnosis of depression?
Full history and symptom recognition
1 week of symptoms
Only physical symptoms
No need to exclude differential diagnosis
40% of patients have a recurrent attack of depression in 1 year.
True
False
Fill in the blank: One third of patients with depression achieve ________.
remission
relapse
mania
psychosis
What is one of the physical risks associated with depression?
Suicide
CVD
Gambling
Poor hygiene
Which of the following is a goal of depression treatment?
Ignore underlying cause
Provide education
Increase drug dosage
Avoid psychotherapy
General rules of treatment for depression include:
Psychotherapy (monotherapy for mild) + pharmacotherapy (severe cases)
SSRI & SNRI are most effective treatment options
Adherence is critical
Effects can take 2-3 weeks, but full effect seen at 8 weeks
Fill in the blank: If no response in 6-12 weeks, trial other agent with different _____
MOA
dose
frequency
route
The recommended approach when switching between medications for depression is:
Taper the first medication before starting the new one
Stop the first medication abruptly and start the new one immediately
Take both medications at full dose simultaneously
Switch only if the first medication causes weight gain
Which drug category requires gradual withdrawal and may need hospitalisation during washout/changeover if severely depressed?
Category A
Category B
Category C
Category D
Combination therapy for depression is:
Always recommended
Not recommended due to increased risk of AE, toxicity, and drug interactions
The first line of treatment
Only for mild depression
Which of the following is a non-pharmacological treatment for depression?
Electroconvulsive therapy (ECT)
Dietary modifications
Both A and B
None of the above
Electroconvulsive therapy (ECT) is highly effective for which of the following conditions?
Major depressive disorder
Generalized anxiety disorder
Obsessive-compulsive disorder
Schizoid personality disorder
A consideration when using Electroconvulsive therapy (ECT) is:
The risk of memory loss
The need for daily exercise
The importance of dietary supplements
The use of antibiotics
What is Bright Light Therapy (BLT) used for?
Seasonal affective disorder (SAD) or morning depression
Moderate-severe depression
All depression
Postnatal depression
Which therapy is underused for moderate-severe depression when medications have not worked?
Bright light therapy (BLT)
Transcranial magnetic stimulation (TMS)
Selective serotonin reuptake inhibitors (SSRI)
Monoamine oxidase inhibitors (MAOI)
Fill in the blank: Tricyclic antidepressants (TCA) inhibit reuptake of ____ & 5HT + other receptors.
NA
DA
GABA
ACh
Which of the following is NOT a counselling point for Tricyclic antidepressants (TCA)?
Not 1st line due to adverse effects
Used for sleep and pain
Risk of hyperkalaemia
Caution in elderly
Which drug class selectively inhibits 5HT reuptake?
Tricyclic antidepressants (TCA)
Selective serotonin reuptake inhibitors (SSRI)
Monoamine oxidase inhibitors (MAOI)
Tetracyclic antidepressants
Selective noradrenaline reuptake inhibitor (Reboxetine) is less commonly used and has a risk of hyperkalaemia.
True
False
What is a major counselling point for Monoamine oxidase inhibitors (MAOI)?
Many drug/food interactions causing hypertensive crisis
Used for sleep and pain
Risk of serotonin syndrome
Good for insomnia
Which antidepressant is associated with blocking alpha2 adrenoreceptors and enhancing NA/5HT release?
Mirtazapine
Agomelatine
Bupropion
Reboxetine
Fill in the blank: Agomelatine is a melatonin receptor agonist and a ____ antagonist.
5HT2c
D2
NMDA
GABA-A
Which antidepressant can cause insomnia, anxiety, seizures, and has weak efficacy for depression?
Bupropion
Mirtazapine
Agomelatine
Amitriptyline
Antipsychotics are used in treatment resistant depression as adjunct therapy.
True
False
What is the peak period for 'baby blue' depression during the postpartum period?
Between 4-5 days postpartum
Immediately after delivery
After 2 weeks postpartum
At 6 weeks postpartum
Which of the following is NOT a risk factor for postnatal depression?
A) History of depression
B) Stressful life event
C) Regular exercise
D) Unintended pregnancy or complications during pregnancy
Postnatal depression usually occurs after the ____ month postpartum.
1st
2nd
3rd
6th
Which medication is considered safe in breastfeeding for treating postnatal depression?
TCA
Fluoxetine
Sertraline
All of the above
In depression during pregnancy, treatment outweighs the risk of not treating.
True
False
