Buccal and sublingual (SL) drug delivery systems are designed for systemic absorption through the mucous membranes in the mouth. These routes allow for rapid onset, improved bioavailability, and avoidance of hepatic first-pass metabolism. This MCQ quiz covers drug properties suitable for buccal/SL delivery, formulation considerations, advantages, limitations, and clinical applications relevant to Pharm.D. students.
1. Which of the following routes bypasses the gastrointestinal tract and first-pass metabolism?
- A. Oral tablet
- B. Buccal
- C. Enteric-coated tablet
- D. Rectal
Correct answer: B. Buccal
2. The sublingual route involves placing the drug:
- A. Inside the cheek
- B. Under the tongue
- C. On the skin
- D. In the stomach
Correct answer: B. Under the tongue
3. Which of the following is an example of a drug administered sublingually?
- A. Amoxicillin
- B. Nitroglycerin
- C. Ciprofloxacin
- D. Omeprazole
Correct answer: B. Nitroglycerin
4. The buccal route is typically used for:
- A. Parenteral administration
- B. Local action in the nasal cavity
- C. Systemic drug delivery through cheek mucosa
- D. Enteric-coated tablets
Correct answer: C. Systemic drug delivery through cheek mucosa
5. Which of the following properties is essential for buccal/sublingual drugs?
- A. Large molecular weight
- B. Poor lipid solubility
- C. Good permeability through mucosal tissue
- D. Low potency
Correct answer: C. Good permeability through mucosal tissue
6. Which of the following is a major advantage of sublingual administration?
- A. Long onset time
- B. Avoids hepatic first-pass metabolism
- C. Requires large volume of fluid
- D. Unstable in saliva
Correct answer: B. Avoids hepatic first-pass metabolism
7. Buccal tablets are designed to:
- A. Dissolve in the stomach
- B. Disintegrate in the colon
- C. Adhere to the inner cheek and release drug slowly
- D. Dissolve rapidly under the tongue
Correct answer: C. Adhere to the inner cheek and release drug slowly
8. Which of the following dosage forms is suitable for buccal administration?
- A. Hard gelatin capsules
- B. Chewable tablets
- C. Mucoadhesive films
- D. Rectal suppositories
Correct answer: C. Mucoadhesive films
9. Drugs absorbed through the buccal mucosa enter:
- A. Hepatic portal vein
- B. Pulmonary circulation
- C. Systemic circulation via the facial vein
- D. Renal excretion pathway
Correct answer: C. Systemic circulation via the facial vein
10. Sublingual administration is preferred when:
- A. Slow release is desired
- B. Rapid onset is needed
- C. Drug has poor mucosal permeability
- D. Drug is highly water-insoluble
Correct answer: B. Rapid onset is needed
11. Which factor negatively affects sublingual absorption?
- A. High vascularity
- B. High salivary flow rate
- C. Thin epithelium
- D. Lipid solubility
Correct answer: B. High salivary flow rate
12. A buccal patch delivers drugs by:
- A. Immediate swallowing
- B. Adhesion to the gingival tissue for prolonged release
- C. Injection into cheek
- D. Mixing with food
Correct answer: B. Adhesion to the gingival tissue for prolonged release
13. What kind of drugs are best suited for buccal/sublingual delivery?
- A. High-dose antibiotics
- B. Poorly potent drugs
- C. Lipophilic, low-dose drugs
- D. Highly ionized compounds
Correct answer: C. Lipophilic, low-dose drugs
14. Buccal dosage forms must avoid:
- A. Prolonged contact
- B. Mucoadhesive agents
- C. Swallowing during drug release
- D. Extended release
Correct answer: C. Swallowing during drug release
15. Which excipient enhances adhesion in buccal formulations?
- A. Magnesium stearate
- B. Sodium lauryl sulfate
- C. Carbopol
- D. Talc
Correct answer: C. Carbopol
16. The primary barrier for buccal drug absorption is the:
- A. Stomach lining
- B. Intestinal villi
- C. Stratified squamous epithelium
- D. Blood-brain barrier
Correct answer: C. Stratified squamous epithelium
17. Sublingual tablets dissolve in:
- A. Intestinal fluid
- B. Gastric acid
- C. Saliva
- D. Plasma
Correct answer: C. Saliva
18. The role of a mucoadhesive polymer is to:
- A. Improve taste
- B. Enhance drug solubility
- C. Maintain contact between dosage form and mucosa
- D. Increase saliva flow
Correct answer: C. Maintain contact between dosage form and mucosa
19. Buccal drug delivery systems should have which feature?
- A. High dosage
- B. Rapid gastric transit
- C. Controlled release with bioadhesion
- D. Need for fluid intake
Correct answer: C. Controlled release with bioadhesion
20. One clinical advantage of buccal tablets is:
- A. Irregular dosing
- B. Better taste than coated tablets
- C. Reduced hepatic metabolism and patient-friendly application
- D. Lower solubility
Correct answer: C. Reduced hepatic metabolism and patient-friendly application
21. What is a drawback of sublingual delivery?
- A. Delayed onset
- B. Patient non-compliance due to holding dosage in mouth
- C. Requires high-fat meals
- D. No dosage control
Correct answer: B. Patient non-compliance due to holding dosage in mouth
22. What feature improves permeability in buccal delivery?
- A. Lower temperature
- B. Surfactants or penetration enhancers
- C. Enteric coating
- D. Increased saliva
Correct answer: B. Surfactants or penetration enhancers
23. Which drug is commonly used in buccal film form for pain management?
- A. Metformin
- B. Ondansetron
- C. Fentanyl
- D. Ciprofloxacin
Correct answer: C. Fentanyl
24. Buccal absorption depends heavily on:
- A. GI motility
- B. Lipid solubility and pKa of the drug
- C. Food intake
- D. First-pass metabolism
Correct answer: B. Lipid solubility and pKa of the drug
25. A mucoadhesive buccal patch may include which of the following?
- A. Hydrophobic wax
- B. Sugar syrup
- C. Polyvinyl alcohol or Carbopol
- D. Alcohol
Correct answer: C. Polyvinyl alcohol or Carbopol
26. The ideal pH for sublingual absorption is:
- A. <3
- B. 5.5–7
- C. >9
- D. 2–3
Correct answer: B. 5.5–7
27. Which layer of the oral mucosa offers least resistance to drug diffusion?
- A. Buccal epithelium
- B. Gingival epithelium
- C. Sublingual mucosa
- D. Palatal epithelium
Correct answer: C. Sublingual mucosa
28. Bioavailability of SL/BU drugs is generally:
- A. Lower than oral
- B. Variable and erratic
- C. Higher than oral due to bypassing liver metabolism
- D. Same as IV
Correct answer: C. Higher than oral due to bypassing liver metabolism
29. Buccal films are manufactured using:
- A. Fluid-bed granulation
- B. Solvent casting
- C. Compression molding
- D. Microwave drying
Correct answer: B. Solvent casting
30. One limitation of buccal delivery is:
- A. High cost of sugar
- B. Low drug permeability for large molecules
- C. Increased GI transit
- D. Rapid metabolism
Correct answer: B. Low drug permeability for large molecules
31. Sublingual administration offers which benefit over oral tablets?
- A. Cost effectiveness
- B. Slower absorption
- C. Avoidance of degradation in GI tract
- D. Longer duration
Correct answer: C. Avoidance of degradation in GI tract
32. Buccal tablets should ideally have which shape?
- A. Round and chewable
- B. Oval and enteric-coated
- C. Flat, mucoadhesive discs
- D. Capsules
Correct answer: C. Flat, mucoadhesive discs
33. Excessive salivation can:
- A. Aid absorption
- B. Wash drug away and reduce effectiveness
- C. Increase mucoadhesion
- D. Improve solubility
Correct answer: B. Wash drug away and reduce effectiveness
34. A patient on buccal fentanyl should be advised to:
- A. Swallow immediately
- B. Remove after 5 minutes
- C. Keep it in place until fully dissolved
- D. Chew for faster effect
Correct answer: C. Keep it in place until fully dissolved
35. Buccal administration is inappropriate when:
- A. Rapid onset is needed
- B. Drug causes mucosal irritation
- C. Drug is low dose
- D. Patient is unconscious
Correct answer: B. Drug causes mucosal irritation
36. Saliva acts as a:
- A. Flavor agent
- B. Mucosal buffer and drug solvent
- C. Drug transporter to stomach
- D. Barrier to all drug absorption
Correct answer: B. Mucosal buffer and drug solvent
37. One major factor influencing drug absorption from buccal tablets is:
- A. Tablet color
- B. Coating material
- C. Contact time with mucosa
- D. Patient height
Correct answer: C. Contact time with mucosa
38. Buccal films provide drug release via:
- A. Gastrointestinal route
- B. Pulmonary route
- C. Mucosal diffusion
- D. Intravenous access
Correct answer: C. Mucosal diffusion
39. What excipient helps increase residence time in buccal systems?
- A. Water
- B. Talc
- C. HPMC or chitosan
- D. Alcohol
Correct answer: C. HPMC or chitosan
40. What is the typical onset of action for SL nitroglycerin?
- A. 5–10 minutes
- B. 30 minutes
- C. 1–3 minutes
- D. 1 hour
Correct answer: C. 1–3 minutes
41. Buccal tablets should be stored:
- A. In freezer
- B. In open air
- C. In dry, room-temperature containers
- D. Under sunlight
Correct answer: C. In dry, room-temperature containers
42. One reason for failure in buccal drug absorption is:
- A. High lipid solubility
- B. Small dose
- C. High enzymatic activity in oral cavity
- D. Low blood flow
Correct answer: C. High enzymatic activity in oral cavity
43. Which form of nitroglycerin is ideal for SL use?
- A. Patch
- B. Tablet
- C. Suspension
- D. Injection
Correct answer: B. Tablet
44. Buccal drug delivery is classified under:
- A. Parenteral
- B. Enteral
- C. Mucosal systemic delivery
- D. Inhalation
Correct answer: C. Mucosal systemic delivery
45. Ultimately, buccal and SL systems are designed to:
- A. Delay absorption
- B. Improve patient discomfort
- C. Provide rapid or controlled systemic absorption while avoiding GI and liver metabolism
- D. Replace all injectables
Correct answer: C. Provide rapid or controlled systemic absorption while avoiding GI and liver metabolism
46. Which of the following is an important counseling point for patients using SL tablets?
- A. Swallow the tablet immediately
- B. Store tablets in the refrigerator only
- C. Do not eat or drink until the tablet is fully dissolved
- D. Chew for faster onset
Correct answer: C. Do not eat or drink until the tablet is fully dissolved
47. Buccal drug delivery is especially beneficial for:
- A. Poorly potent antibiotics
- B. Emergency medications requiring rapid action
- C. Drugs that require gastric acid for activation
- D. Hydrophilic peptides
Correct answer: B. Emergency medications requiring rapid action
48. SL absorption primarily occurs through:
- A. Active transport in the liver
- B. Passive diffusion across oral mucosa
- C. Filtration in the kidneys
- D. Enzymatic digestion
Correct answer: B. Passive diffusion across oral mucosa
49. Buccal tablets must be formulated to:
- A. Completely resist saliva
- B. Dissolve rapidly in the stomach
- C. Stay in place and release drug slowly
- D. Mask the tablet’s shape
Correct answer: C. Stay in place and release drug slowly
50. The key formulation goal of SL tablets is to:
- A. Increase pH
- B. Increase hardness
- C. Maximize rapid disintegration and absorption under the tongue
- D. Reduce adhesion
Correct answer: C. Maximize rapid disintegration and absorption under the tongue