Drug distribution systems in hospitals are essential to safe, efficient pharmacy practice, linking procurement, storage, dispensing, and administration. This overview covers major types—centralized, decentralized, unit-dose, ward-stock, satellite, and automated dispensing systems—and key policies on formulary management, controlled substances, cold chain, compounding, and medication returns. B.Pharm students should understand inventory control methods (ABC, VED), labeling, barcoding, MAR documentation, error-reduction strategies, and regulatory compliance to optimize workflows and patient safety. Emphasis on automation, audit trails, and interdisciplinary roles prepares future pharmacists to design, evaluate, and implement robust drug distribution policies. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which drug distribution model centralizes medication storage and dispensing in one main pharmacy for the entire hospital?
- Unit-dose distribution
- Centralized distribution
- Decentralized distribution
- Ward-stock system
Correct Answer: Centralized distribution
Q2. What is the primary advantage of a unit-dose drug distribution system?
- Reduced pharmacy staffing requirements
- Lower inventory turnover
- Decreased medication errors and improved dose accuracy
- Increased ward stock levels
Correct Answer: Decreased medication errors and improved dose accuracy
Q3. Which system places medications in automated dispensing cabinets near patient care areas?
- Central pharmacy cart fill
- Unit-of-use packaging
- Automated dispensing system (ADS)/Automated dispensing cabinet (ADC)
- Satellite compounding unit
Correct Answer: Automated dispensing system (ADS)/Automated dispensing cabinet (ADC)
Q4. Which inventory control method classifies drugs by cost and consumption to prioritize management?
- FIFO (First In, First Out)
- ABC analysis
- FEFO (First Expired, First Out)
- VSM (Value Stream Mapping)
Correct Answer: ABC analysis
Q5. In hospital drug policies, which document records every administration of controlled substances and is required by regulation?
- Medication administration record (MAR)
- Batch manufacturing record
- Narcotics/controlled substances register
- Pharmacy purchase order
Correct Answer: Narcotics/controlled substances register
Q6. What policy element ensures potency and safety of temperature-sensitive drugs during storage and transport?
- Formulary review
- Cold chain management and temperature monitoring
- Barcode verification
- Therapeutic interchange
Correct Answer: Cold chain management and temperature monitoring
Q7. Which practice reduces dispensing and administration errors by scanning barcodes at dispensing and bedside?
- Manual double-checking only
- Barcoded medication administration (BCMA)
- Unit-dose packaging without scanning
- Paper order transcribing
Correct Answer: Barcoded medication administration (BCMA)
Q8. Which distribution model places a pharmacist or pharmacy satellite within clinical units for immediate service?
- Centralized pharmacy
- Decentralized/satellite pharmacy
- Outpatient dispensing
- Home medication delivery
Correct Answer: Decentralized/satellite pharmacy
Q9. What is the main risk associated with a ward-stock system?
- Lower medication accessibility
- Increased medication wastage and higher error potential due to bulk stock
- Reduced nursing workload
- Complete elimination of controlled drug discrepancies
Correct Answer: Increased medication wastage and higher error potential due to bulk stock
Q10. Which policy defines who can prescribe, dispense, and administer medications in the hospital?
- Formulary management policy
- Scope of practice and prescribing/administration policy
- Cold chain policy
- Inventory valuation policy
Correct Answer: Scope of practice and prescribing/administration policy
Q11. What does VED analysis prioritize in inventory control?
- Value, Expiry, Demand
- Vital, Essential, Desirable classification to prioritize supply
- Volume, Efficiency, Distribution
- Verification, Evaluation, Disposal
Correct Answer: Vital, Essential, Desirable classification to prioritize supply
Q12. Which policy is critical when preparing cytotoxic chemotherapy in hospital pharmacies?
- Automated dispensing cabinet stocking guidelines
- Chemo compounding policy including isolator/biological safety cabinet use and PPE
- Ward-stock replenishment schedule
- Generic substitution policy
Correct Answer: Chemo compounding policy including isolator/biological safety cabinet use and PPE
Q13. Which procedure minimizes dose omissions and transcription errors when a medication order is written?
- Handwritten orders with nurse transcription
- Use of computerized physician order entry (CPOE) with clinical decision support
- Faxing prescriptions to pharmacy
- Verbal orders only
Correct Answer: Use of computerized physician order entry (CPOE) with clinical decision support
Q14. What does FIFO inventory rotation prevent?
- Medication counterfeiting
- Use of older stock before newer stock to avoid expired items
- Overuse of controlled drugs
- Excessive returns to supplier
Correct Answer: Use of older stock before newer stock to avoid expired items
Q15. Which documentation is essential for auditing medication distribution processes?
- Personnel lunch schedules
- Medication administration records, dispensing logs, temperature logs, and inventory records
- Supplier marketing brochures
- Patient satisfaction surveys only
Correct Answer: Medication administration records, dispensing logs, temperature logs, and inventory records
Q16. What is therapeutic interchange in hospital formulary policy?
- Replacing a prescribed drug with an equivalent therapeutic alternative approved by formulary protocol
- Switching from IV to oral route without approval
- Automatic change to brand-name products
- Unrecorded substitution by nursing staff
Correct Answer: Replacing a prescribed drug with an equivalent therapeutic alternative approved by formulary protocol
Q17. Which control measure reduces diversion of narcotics from hospital supply?
- Open shelf storage in wards
- Lockable cabinets, electronic ADC access logs, and strict documentation
- Allowing any staff to access narcotics without sign-out
- Weekly random inventory without documentation
Correct Answer: Lockable cabinets, electronic ADC access logs, and strict documentation
Q18. Which parameter is most important when issuing blood products versus routine medications?
- Batch number only
- Compatibility testing, strict temperature control, and immediate bedside verification
- Long-term storage at room temperature
- Automated dispensing without cross-checks
Correct Answer: Compatibility testing, strict temperature control, and immediate bedside verification
Q19. What is the role of pharmacy-led medication reconciliation on admission and discharge?
- To delay patient discharge
- To ensure accurate medication lists, prevent omissions, duplications, and interactions
- To increase hospital inventory levels
- To replace prescriber responsibility entirely
Correct Answer: To ensure accurate medication lists, prevent omissions, duplications, and interactions
Q20. Which practice is recommended when returning expired or recalled drugs to vendor?
- Mix them with current stock
- Segregate, quarantine, document lot numbers, and follow vendor recall procedures
- Dispose immediately in general waste
- Use for non-patient experimental purposes
Correct Answer: Segregate, quarantine, document lot numbers, and follow vendor recall procedures
Q21. In a hospital pharmacy, what does “beyond-use dating” apply to?
- Shelf life assigned by manufacturer only
- Assigned stability period for compounded or repackaged preparations based on storage and sterility
- Hospital accreditation expiration
- Patient discharge dates
Correct Answer: Assigned stability period for compounded or repackaged preparations based on storage and sterility
Q22. Which system supports timely administration of STAT medications?
- High-frequency batch dispensing
- Emergency drug kit and ADC access for STAT with rapid verification
- Monthly restocking only
- Central purchasing approval process
Correct Answer: Emergency drug kit and ADC access for STAT with rapid verification
Q23. Which practice lowers contamination risk during sterile compounding?
- Compounding in non-classified rooms
- Use of ISO Class 5 laminar flow hood or compounding aseptic isolator and proper garbing
- Open bench compounding during peak hours
- Using expired supplies to reduce cost
Correct Answer: Use of ISO Class 5 laminar flow hood or compounding aseptic isolator and proper garbing
Q24. What is the main purpose of a hospital formulary?
- To list every available OTC product only
- To restrict medication choices to approved, evidence-based therapies and control costs
- To mandate brand-name prescribing exclusively
- To eliminate pharmacist involvement in therapy selection
Correct Answer: To restrict medication choices to approved, evidence-based therapies and control costs
Q25. Which process ensures replacement of dispensed stock in an ADC or ward cabinet?
- Annual inventory audit only
- Par-level setting and automated replenishment based on usage
- Relying on nursing to reorder as needed without oversight
- Random supplier deliveries
Correct Answer: Par-level setting and automated replenishment based on usage
Q26. For controlled temperature storage, which monitoring practice is essential?
- Visual check once a month
- Continuous temperature monitoring with alarms and recorded logs
- Storing temperature-sensitive drugs in any cool area
- Relying solely on supplier labels
Correct Answer: Continuous temperature monitoring with alarms and recorded logs
Q27. Which audit tool helps identify high-risk medications and processes in distribution?
- Patient meal plans
- Failure Mode and Effects Analysis (FMEA) and incident reporting
- Monthly sales reports only
- Unstructured staff interviews without data
Correct Answer: Failure Mode and Effects Analysis (FMEA) and incident reporting
Q28. What is an advantage of barcode scanning at dispensing and administration for inventory?
- Increases manual transcription tasks
- Improves real-time inventory accuracy and traceability
- Removes need for lot number tracking
- Decreases initial capital cost compared to paper
Correct Answer: Improves real-time inventory accuracy and traceability
Q29. Which policy governs handling of returned medications from wards or patients?
- Return and quarantine policy requiring segregation, inspection, documentation, and disposal or reprocessing as allowed
- Immediate restock without inspection
- Automatic disposal without record
- Exchange with another ward without checks
Correct Answer: Return and quarantine policy requiring segregation, inspection, documentation, and disposal or reprocessing as allowed
Q30. Which metric indicates efficiency of a hospital drug distribution system?
- Number of supplier catalogs
- Turnaround time for medication requests, medication error rate, stock-out frequency, and inventory turnover
- Staff break durations only
- Amount of paper used annually
Correct Answer: Turnaround time for medication requests, medication error rate, stock-out frequency, and inventory turnover
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.
Mail- Sachin@pharmacyfreak.com