Intranasal drug delivery is a non-invasive route used for rapid systemic absorption or targeted local therapy. It is commonly used in managing allergic rhinitis, hormone therapy, migraine, pain management, and emergency care (e.g., naloxone for opioid overdose). This MCQ quiz covers pharmacokinetics, formulation types, delivery mechanisms, anatomical considerations, and clinical applications—designed for Pharm.D. exam preparation.
1. Intranasal drug delivery refers to administration through the:
- A. Oral mucosa
- B. Eye
- C. Nasal cavity
- D. Rectum
Correct answer: C. Nasal cavity
2. A major advantage of intranasal delivery is:
- A. Avoids mucosal contact
- B. Enhanced hepatic metabolism
- C. Bypasses first-pass metabolism
- D. Decreased vascularity
Correct answer: C. Bypasses first-pass metabolism
3. Which of the following is commonly delivered intranasally for allergic rhinitis?
- A. Insulin
- B. Loratadine
- C. Fluticasone
- D. Amoxicillin
Correct answer: C. Fluticasone
4. Which dosage form is used for intranasal delivery?
- A. Gel
- B. Suppository
- C. Patch
- D. Syrup
Correct answer: A. Gel
5. What is the ideal particle size for intranasal drug deposition in the nasal cavity?
- A. <1 µm
- B. 2–10 µm
- C. >20 µm
- D. 50–100 µm
Correct answer: B. 2–10 µm
6. The nasal mucosa provides:
- A. Poor vascular supply
- B. Rich blood supply for systemic absorption
- C. No drug permeability
- D. Resistance to all drugs
Correct answer: B. Rich blood supply for systemic absorption
7. Which hormone is commonly delivered intranasally?
- A. Cortisol
- B. Estrogen
- C. Oxytocin
- D. TSH
Correct answer: C. Oxytocin
8. What is the main limitation of intranasal delivery?
- A. Long duration
- B. Bitter taste
- C. Limited dose volume and mucociliary clearance
- D. High solubility
Correct answer: C. Limited dose volume and mucociliary clearance
9. The nasal cavity’s primary function in drug delivery is:
- A. Filtering blood
- B. Absorbing nutrients
- C. Providing a large surface area for drug absorption
- D. Digesting medication
Correct answer: C. Providing a large surface area for drug absorption
10. Intranasal naloxone is used to treat:
- A. Hypertension
- B. Asthma
- C. Opioid overdose
- D. Allergic conjunctivitis
Correct answer: C. Opioid overdose
11. The main mechanism for intranasal drug absorption is:
- A. Active transport only
- B. Pinocytosis
- C. Passive diffusion through the nasal mucosa
- D. Exocytosis
Correct answer: C. Passive diffusion through the nasal mucosa
12. Which anatomical structure may limit nasal drug delivery?
- A. Retina
- B. Hard palate
- C. Nasal turbinates
- D. Esophagus
Correct answer: C. Nasal turbinates
13. The nasal route is particularly suitable for:
- A. Emergency medications
- B. Large volume infusions
- C. Slow-release drugs
- D. IV antibiotics
Correct answer: A. Emergency medications
14. Which drug is used intranasally for migraine treatment?
- A. Morphine
- B. Sumatriptan
- C. Hydralazine
- D. Codeine
Correct answer: B. Sumatriptan
15. Intranasal vaccine delivery is being explored for:
- A. Diabetes
- B. Influenza
- C. Tuberculosis
- D. HIV
Correct answer: B. Influenza
16. Which property enhances intranasal drug permeability?
- A. High molecular weight
- B. Low lipophilicity
- C. Small, lipophilic molecules
- D. Ionized, hydrophilic drugs
Correct answer: C. Small, lipophilic molecules
17. Nasal sprays should be administered with the head:
- A. Tilted far back
- B. Facing the ground
- C. Slightly forward or neutral
- D. Facing sideways
Correct answer: C. Slightly forward or neutral
18. Which delivery system improves nasal residence time?
- A. Immediate-release tablet
- B. Mucoadhesive gel
- C. Aerosol spray
- D. Inhaler
Correct answer: B. Mucoadhesive gel
19. The major enzyme present in nasal secretions is:
- A. Pepsin
- B. Protease
- C. Cytochrome P450
- D. Lysozyme
Correct answer: D. Lysozyme
20. Which class of drug is contraindicated in nasal polyps?
- A. NSAIDs
- B. Antihistamines
- C. Corticosteroids
- D. Decongestants
Correct answer: A. NSAIDs
21. How does mucociliary clearance affect nasal drug delivery?
- A. Enhances absorption
- B. Reduces drug residence time and absorption
- C. Increases dosage requirement
- D. Delays metabolism
Correct answer: B. Reduces drug residence time and absorption
22. Which of the following is a common side effect of intranasal corticosteroids?
- A. Cataract
- B. Nasal irritation or dryness
- C. Weight gain
- D. Vomiting
Correct answer: B. Nasal irritation or dryness
23. Which formulation provides both systemic and local nasal action?
- A. Oral tablet
- B. IV injection
- C. Intranasal antihistamine
- D. Subcutaneous implant
Correct answer: C. Intranasal antihistamine
24. Intranasal insulin is under investigation for:
- A. Kidney disease
- B. Cognitive disorders like Alzheimer’s
- C. Asthma
- D. Bone fractures
Correct answer: B. Cognitive disorders like Alzheimer’s
25. The nasal cavity is directly connected to the:
- A. Trachea
- B. Sinuses and pharynx
- C. Bronchi
- D. Ear canal
Correct answer: B. Sinuses and pharynx
26. Nasal bioavailability can be improved by:
- A. Adding alcohol
- B. Reducing pH to 2
- C. Using absorption enhancers
- D. Diluting drug concentration
Correct answer: C. Using absorption enhancers
27. Which part of the nasal cavity is the main site for drug absorption?
- A. Nasal vestibule
- B. Olfactory region
- C. Respiratory region
- D. Nasal septum
Correct answer: C. Respiratory region
28. A common nasal decongestant is:
- A. Fexofenadine
- B. Oxymetazoline
- C. Metformin
- D. Dextromethorphan
Correct answer: B. Oxymetazoline
29. Which of the following drugs is delivered intranasally for hormone replacement?
- A. Desmopressin
- B. Testosterone
- C. Epinephrine
- D. Melatonin
Correct answer: A. Desmopressin
30. Repeated use of nasal decongestants can lead to:
- A. Sedation
- B. Tachyphylaxis (rebound congestion)
- C. Weight gain
- D. Hyperglycemia
Correct answer: B. Tachyphylaxis (rebound congestion)
31. The intranasal route is ideal for pediatric use because it is:
- A. Invasive
- B. Painful
- C. Needle-free and rapid
- D. Inaccurate
Correct answer: C. Needle-free and rapid
32. Nasal drug delivery avoids which route of metabolism?
- A. Renal
- B. Hepatic first-pass
- C. Pulmonary
- D. Buccal
Correct answer: B. Hepatic first-pass
33. The pH range of nasal formulations should generally be:
- A. 2–3
- B. 4.5–6.5
- C. 7.5–9.0
- D. >10
Correct answer: B. 4.5–6.5
34. Which factor decreases nasal drug absorption?
- A. Hydration
- B. Mucosal injury
- C. Ciliary movement and excessive mucus
- D. Lipophilic drug design
Correct answer: C. Ciliary movement and excessive mucus
35. Intranasal delivery can provide access to the brain via the:
- A. Trigeminal and olfactory nerves
- B. Optic nerve
- C. Spinal cord
- D. Cochlear duct
Correct answer: A. Trigeminal and olfactory nerves
36. Intranasal delivery is not ideal for:
- A. Small peptides
- B. Local infections
- C. Large protein biologics without enhancers
- D. Emergency use
Correct answer: C. Large protein biologics without enhancers
37. The term “nasal spray metered dose” means:
- A. Random quantity delivered
- B. Inhaled deeply
- C. Exact dose released per actuation
- D. Applied with cotton
Correct answer: C. Exact dose released per actuation
38. The major absorption site for systemically acting nasal drugs is:
- A. Olfactory epithelium
- B. Respiratory epithelium
- C. Cilia
- D. Vestibular lining
Correct answer: B. Respiratory epithelium
39. Nasal formulations are commonly administered using:
- A. Oral pipette
- B. Dropper
- C. Spray pump or atomizer
- D. Capsule
Correct answer: C. Spray pump or atomizer
40. A risk with nasal sprays if overused is:
- A. Drug-induced asthma
- B. Nasal septum perforation
- C. Hypertension
- D. Hair loss
Correct answer: B. Nasal septum perforation
41. Intranasal midazolam is used in:
- A. Asthma
- B. Seizure emergencies
- C. Cough
- D. Fungal infections
Correct answer: B. Seizure emergencies
42. Proper intranasal technique includes:
- A. Head upright, slight tilt forward
- B. Breathe in deeply while spraying
- C. Lie flat and spray
- D. Close both nostrils
Correct answer: A. Head upright, slight tilt forward
43. Nasal mucosa allows which type of drug movement?
- A. Active transport only
- B. Passive diffusion and facilitated transport
- C. Oral chelation
- D. Bulk flow
Correct answer: B. Passive diffusion and facilitated transport
44. Intranasal diazepam is used for:
- A. Anxiety
- B. Acute seizures
- C. Cough
- D. Pain
Correct answer: B. Acute seizures
45. Ultimately, intranasal drug delivery provides:
- A. Delayed release only
- B. Local and systemic drug delivery with fast onset and partial hepatic bypass
- C. Replacement for oral surgery
- D. Poor absorption
Correct answer: B. Local and systemic drug delivery with fast onset and partial hepatic bypass
46. Which absorption enhancer is used in intranasal formulations?
- A. Starch
- B. Chitosan
- C. Paraffin
- D. Talc
Correct answer: B. Chitosan
47. What is the role of viscosity enhancers in nasal sprays?
- A. Prevent drug loss
- B. Improve mucoadhesion and residence time
- C. Aid taste masking
- D. Stimulate sneezing
Correct answer: B. Improve mucoadhesion and residence time
48. Nasal absorption is favored in drugs with:
- A. High polarity and large molecular weight
- B. Poor lipid solubility
- C. Moderate molecular weight and lipophilicity
- D. Weak acid structure
Correct answer: C. Moderate molecular weight and lipophilicity
49. The most common preservative in nasal sprays is:
- A. Ethanol
- B. Sodium chloride
- C. Benzalkonium chloride
- D. Citric acid
Correct answer: C. Benzalkonium chloride
50. Intranasal drug delivery is especially useful for:
- A. Intravenous infusion therapy
- B. Targeting upper respiratory tract and rapid CNS access
- C. Increasing gastric pH
- D. Long-term protein infusion
Correct answer: B. Targeting upper respiratory tract and rapid CNS access