Introduction: Ginseng is a widely studied herbal medicine with documented medicinal uses and health benefits relevant to B. Pharm students. Panax species contain ginsenosides, polysaccharides and other bioactives that confer adaptogenic, antioxidant, immunomodulatory and metabolic effects. Understanding pharmacology, mechanism of action, clinical evidence, dosage forms, standardization (ginsenoside markers), safety, adverse effects and herb–drug interactions is essential for pharmacists assessing therapeutic use and counseling patients. This topic integrates phytochemistry, pharmacokinetics, quality control and evidence-based indications for conditions such as fatigue, cognitive dysfunction and glucose regulation. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. What is the primary class of active constituents responsible for most pharmacological effects of Panax ginseng?
- Flavonoids
- Ginsenosides (triterpene saponins)
- Alkaloids
- Terpenoids other than saponins
Correct Answer: Ginsenosides (triterpene saponins)
Q2. Which species is commonly referred to as Asian or Korean ginseng?
- Panax quinquefolius
- Eleutherococcus senticosus
- Panax ginseng
- Withania somnifera
Correct Answer: Panax ginseng
Q3. The adaptogenic effects of ginseng are primarily associated with modulation of which physiological system?
- Renin–angiotensin–aldosterone system (RAAS)
- Hypothalamic–pituitary–adrenal (HPA) axis
- Coagulation cascade
- Enteric nervous system
Correct Answer: Hypothalamic–pituitary–adrenal (HPA) axis
Q4. Which metabolite is produced by intestinal microbiota from ginsenosides and is considered pharmacologically active?
- Compound K
- Quercetin
- Resveratrol
- Curcumin glucuronide
Correct Answer: Compound K
Q5. Which of the following is a commonly reported adverse effect of ginseng at higher doses?
- Severe neutropenia
- Insomnia and nervousness
- Renal failure
- Profound bradycardia
Correct Answer: Insomnia and nervousness
Q6. Concomitant use of Panax ginseng with warfarin most likely causes which interaction?
- Increased INR and bleeding risk
- Reduced anticoagulant effect and lower INR
- No interaction; effects are independent
- Conversion of warfarin to inactive metabolites via CYP2D6
Correct Answer: Reduced anticoagulant effect and lower INR
Q7. Which ginsenosides are commonly used as marker compounds for standardization and quality control?
- Rg1 and Rb1
- Catechin and epicatechin
- Alkannin and shikonin
- Glycyrrhizin and glabridin
Correct Answer: Rg1 and Rb1
Q8. Typical standardized adult dose range for Panax ginseng extract in clinical studies is approximately:
- 10–50 mg/day
- 200–400 mg/day
- 2–5 g/day of raw powder
- 1–2 mL/day of essential oil
Correct Answer: 200–400 mg/day
Q9. Which population is generally recommended to avoid ginseng due to insufficient safety data?
- Healthy adults aged 18–65
- Pregnant and lactating women
- Patients with controlled hypertension on ACE inhibitors
- Adults taking multivitamins
Correct Answer: Pregnant and lactating women
Q10. Which analytical technique is most widely employed to quantify ginsenosides in commercial extracts?
- Thin-layer chromatography (TLC) only
- High-performance liquid chromatography (HPLC)
- Gram staining
- Infrared spectroscopy without chromatography
Correct Answer: High-performance liquid chromatography (HPLC)
Q11. Which ginsenoside subtype is generally associated with stimulatory CNS effects?
- Rb1 (dammarane-type)
- Rg1 (protopanaxatriol-type)
- Glabridin
- Glycyrrhizin
Correct Answer: Rg1 (protopanaxatriol-type)
Q12. One major mechanism underlying ginseng’s antioxidant effects is:
- Direct inhibition of CYP enzymes only
- Free radical scavenging and upregulation of antioxidant enzymes
- Chelation of heavy metals exclusively
- Blocking all ROS production at mitochondrial complex I
Correct Answer: Free radical scavenging and upregulation of antioxidant enzymes
Q13. Clinical evidence best supports ginseng use for improvement in which condition?
- Acute bacterial infections
- Chronic fatigue and cognitive performance
- Complete cure of Type 1 diabetes
- Rapid weight loss
Correct Answer: Chronic fatigue and cognitive performance
Q14. Which part of the ginseng plant is primarily used medicinally and standardized in extracts?
- Leaves and flowers only
- Root and rhizome
- Seeds and bark
- Stems exclusively
Correct Answer: Root and rhizome
Q15. Ginsenosides may exhibit weak estrogenic or phytoestrogenic activity; which outcome could this theoretically influence?
- Thyroid hormone production directly
- Estrogen receptor–mediated pathways
- Vitamin D synthesis in skin
- Direct inhibition of pepsin
Correct Answer: Estrogen receptor–mediated pathways
Q16. “Siberian ginseng” (not a true Panax species) is Eleutherococcus senticosus; its characteristic marker compounds are called:
- Ginsenosides
- Eleutherosides
- Withanolides
- Curcuminoids
Correct Answer: Eleutherosides
Q17. Which non-saponin fraction of ginseng contributes prominently to immunomodulatory effects?
- Proteolytic enzymes
- Polysaccharides
- Essential oils
- Simple monoterpenes
Correct Answer: Polysaccharides
Q18. Which statement about ginseng and platelet function is most accurate?
- Ginseng markedly increases platelet aggregation
- Ginseng inhibits platelet aggregation and may increase bleeding risk with antiplatelet drugs
- Ginseng has no effect on platelets
- Ginseng causes irreversible platelet depletion
Correct Answer: Ginseng inhibits platelet aggregation and may increase bleeding risk with antiplatelet drugs
Q19. What term best describes ginseng’s general pharmacological classification based on stress resistance and homeostasis support?
- Analgesic
- Adaptogen
- Antibiotic
- Anthelmintic
Correct Answer: Adaptogen
Q20. Which extraction method is commonly used to prepare standardized ginseng extracts for clinical use?
- Pure water infusion only
- Hydroalcoholic (ethanol-water) extraction
- Supercritical CO2 extraction exclusively for saponins
- Maceration in hexane
Correct Answer: Hydroalcoholic (ethanol-water) extraction
Q21. Standardization of ginseng extracts is usually expressed as percentage of:
- Total flavonoids
- Total ginsenosides
- Inorganic ash
Correct Answer: Total ginsenosides
Q22. Which in vitro assay is commonly used to assess antioxidant activity of ginseng extracts?
- DPPH radical scavenging assay
- ELISA for interleukin-6 only
- Gram staining
- Kirby–Bauer disk diffusion
Correct Answer: DPPH radical scavenging assay
Q23. Ginseng can exert hypoglycemic effects; a proposed mechanism is:
- Complete destruction of pancreatic beta cells
- Enhancement of insulin sensitivity and peripheral glucose uptake
- Direct binding and inactivation of circulating glucose
- Stimulation of glucagon secretion only
Correct Answer: Enhancement of insulin sensitivity and peripheral glucose uptake
Q24. “Ginseng abuse syndrome” typically includes which constellation of symptoms?
- Hypertension, nervousness, insomnia and skin eruptions
- Profound immunosuppression and fever
- Severe hypoglycemia and coma
- Pancytopenia and mucositis
Correct Answer: Hypertension, nervousness, insomnia and skin eruptions
Q25. Which laboratory parameter should be monitored when a patient on long-term ginseng and anticoagulant therapy presents to clinic?
- Serum creatinine only
- INR (international normalized ratio)
- Fasting triglycerides only
- Serum vitamin B12
Correct Answer: INR (international normalized ratio)
Q26. Which factor most significantly limits the oral bioavailability of many ginsenosides?
- Extensive first-pass hepatic glucuronidation only
- Poor intestinal absorption and extensive metabolism by gut microbiota
- Rapid renal excretion of intact saponins
- Complete degradation by salivary enzymes
Correct Answer: Poor intestinal absorption and extensive metabolism by gut microbiota
Q27. For authenticity and fingerprinting of ginseng products, which analytical approach is commonly used?
- HPLC fingerprinting of ginsenoside profile
- Simple odor assessment by sniff test
- Visual inspection of powder color only
- pH paper testing
Correct Answer: HPLC fingerprinting of ginsenoside profile
Q28. Which clinical endpoint is frequently used in randomized trials assessing ginseng effects on cognition?
- Reduction in tumor size
- Improvement in standardized psychomotor and memory tests
- Changes in bone mineral density
- Urine output volume
Correct Answer: Improvement in standardized psychomotor and memory tests
Q29. Which storage conditions help preserve ginsenoside content in dried ginseng preparations?
- High humidity and direct sunlight
- Cool, dry, and protected from light
- Open container at room temperature near heat source
- Immersion in saline solution
Correct Answer: Cool, dry, and protected from light
Q30. Which herb–drug interaction concern is most relevant when advising patients taking antidiabetic medications?
- Ginseng may potentiate hypoglycemic effects and require monitoring of blood glucose
- Ginseng universally prevents absorption of oral hypoglycemics
- Ginseng converts metformin to inactive metabolites
- Ginseng has no effect on glucose homeostasis
Correct Answer: Ginseng may potentiate hypoglycemic effects and require monitoring of blood glucose
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
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