Compounding for the skin is a vital area of pharmacy, allowing for the creation of customized therapies for a wide array of dermatological conditions. This practice enables pharmacists to adjust strengths, combine active ingredients, and create unique formulations like creams, gels, and ointments to meet specific patient needs. For PharmD students, mastering the art and science of dermatological compounding is essential for providing effective, patient-centered care.
1. Which characteristic best defines a dermatological paste compared to an ointment?
- It is a completely liquid formulation for easy spreading
- It contains a high percentage of solid material, making it stiffer and more protective
- It is always a clear, transparent preparation
- It contains no active pharmaceutical ingredients
Answer: It contains a high percentage of solid material, making it stiffer and more protective
2. The technique of wetting a powder with a small amount of liquid (a levigating agent) before incorporating it into an ointment base is known as:
- Geometric dilution
- Spatulation
- Levigation
- Fusion
Answer: Levigation
3. What is the primary purpose of using levigation when compounding a cream or ointment?
- To dissolve the powder completely in the base
- To increase the total volume of the preparation
- To reduce the particle size of the powder and prevent a gritty final texture
- To sterilize the active ingredient
Answer: To reduce the particle size of the powder and prevent a gritty final texture
4. A compounded topical preparation that is a semisolid emulsion, is less occlusive than an ointment, and “vanishes” into the skin is likely a(n):
- Paste
- Cream
- Powder
- Solution
Answer: Cream
5. According to USP <795>, what is the maximum beyond-use date (BUD) for a water-containing topical formulation, like a cream?
- 14 days
- 30 days
- 6 months
- 1 year
Answer: 30 days
6. Compounding for dermatological conditions is a key topic in advanced non-sterile compounding. Which of these is a common reason to compound a dermatological product?
- The patient has an allergy to a preservative in a commercial product
- The prescriber wants to combine multiple active ingredients into one formulation
- The patient requires a strength that is not commercially available
- All of the above
Answer: All of the above
7. A gelling agent is the key excipient used to provide the structure for which semisolid dosage form?
- Ointment
- Paste
- Gel
- Anhydrous balm
Answer: Gel
8. When compounding a topical preparation, ensuring the uniform distribution of a small amount of a potent active ingredient is best achieved by:
- Adding the active ingredient all at once to the base
- Using the technique of geometric dilution
- Shaking the container vigorously after preparation
- Storing the preparation in the freezer
Answer: Using the technique of geometric dilution
9. Which type of ointment base is most occlusive and an excellent emollient?
- Water-soluble base (PEG ointment)
- Hydrocarbon base (petrolatum)
- Water-removable base (hydrophilic ointment)
- Absorption base (lanolin)
Answer: Hydrocarbon base (petrolatum)
10. A compounded topical solution would be most suitable for application to:
- A small, localized lesion requiring protection
- The scalp or other hairy areas of the body
- A wound that needs to be kept dry
- An area requiring a very thick, occlusive barrier
Answer: The scalp or other hairy areas of the body
11. The fusion method of compounding would be most appropriate for preparing:
- A powder paper
- An oral suspension
- An ointment or balm containing solid ingredients with high melting points
- A nasal spray
Answer: An ointment or balm containing solid ingredients with high melting points
12. Compounding for aging skin and hair loss is a topic relevant to pharmacy practice. A commonly compounded ingredient for hair loss is:
- Minoxidil in a custom vehicle
- Hydrocortisone
- Aspirin
- Coal tar
Answer: Minoxidil in a custom vehicle
13. What is a primary quality control check a pharmacist performs after compounding a cream?
- Measuring the pH of the preparation
- Checking for uniform consistency and absence of grittiness
- Verifying the weight of the empty container
- Testing the preparation for sterility
Answer: Checking for uniform consistency and absence of grittiness
14. A PLO gel (Pluronic Lecithin Organogel) is a compounded vehicle often used for:
- Oral liquid preparations
- Transdermal delivery of drugs
- Ophthalmic solutions
- Rectal suppositories
Answer: Transdermal delivery of drugs
15. A patient requires a topical anesthetic combined with an anti-inflammatory agent for a skin condition. This would be an example of compounding for which practice area?
- Dermatological conditions
- Palliative care
- Veterinary health
- Dentistry
Answer: Dermatological conditions
16. The choice between an ointment and a cream vehicle is often based on the:
- Desired level of occlusion and the condition of the skin (e.g., dry vs. weeping)
- Color of the active ingredient
- Patient’s preferred flavor
- Expiration date of the active ingredient
Answer: Desired level of occlusion and the condition of the skin (e.g., dry vs. weeping)
17. What is a key counseling point for a patient using a compounded topical corticosteroid?
- Apply a thick layer all over the body twice a day
- Apply a thin layer only to the affected areas as directed
- The cream can be shared with family members for any skin rash
- Store the preparation in direct sunlight to increase its potency
Answer: Apply a thin layer only to the affected areas as directed
18. Which piece of equipment is essential for the proper preparation of most compounded ointments and creams?
- An autoclave
- A tablet press
- An ointment mill or an ointment slab and spatula
- A sterile laminar flow hood
Answer: An ointment mill or an ointment slab and spatula
19. A preparation containing a high percentage of solids, like zinc oxide, making it very stiff and protective, is a:
- Gel
- Lotion
- Cream
- Paste
Answer: Paste
20. A pharmacist might compound a “hypoallergenic” base for a patient with:
- A systemic infection
- High blood pressure
- Sensitive skin or multiple contact allergies
- A need for a sterile product
Answer: Sensitive skin or multiple contact allergies
21. A “water-in-oil” (W/O) emulsion cream is generally:
- More greasy and occlusive than an oil-in-water (O/W) cream
- Easily washed off with water
- Less moisturizing than an O/W cream
- The same as a hydrophilic ointment
Answer: More greasy and occlusive than an oil-in-water (O/W) cream
22. Mineral oil is a suitable levigating agent for a powder that will be incorporated into which type of base?
- A hydrocarbon (oily) base
- A water-soluble (PEG) base
- An aqueous gel
- An oral syrup
Answer: A hydrocarbon (oily) base
23. Glycerin is a suitable levigating agent for a solid that will be incorporated into a(n):
- Petrolatum-based ointment
- Aqueous cream or gel
- Anhydrous balm
- Mineral oil lotion
Answer: Aqueous cream or gel
24. The term “emollient” refers to an agent that:
- Dries out the skin
- Softens and soothes the skin
- Causes peeling of the skin
- Numbs the skin
Answer: Softens and soothes the skin
25. A key piece of information to record on a Compounding Record for a topical product is the:
- Patient’s favorite TV show
- Lot number and expiration date of each ingredient used
- Weather on the day of compounding
- Pharmacist’s lunch order
Answer: Lot number and expiration date of each ingredient used
26. Why are preservatives often required in water-containing topical formulations like creams?
- To improve the flavor
- To prevent microbial growth
- To make the cream thicker
- To increase the pH of the cream
Answer: To prevent microbial growth
27. An “oil-in-water” (O/W) emulsion cream is considered:
- Anhydrous
- A hydrocarbon base
- Water-washable
- A type of paste
Answer: Water-washable
28. Which factor is LEAST important when assigning a beyond-use date (BUD) to a compounded topical preparation?
- The presence of water
- The stability of the active ingredients
- The storage temperature
- The color of the packaging tube or jar
Answer: The color of the packaging tube or jar
29. Compounding for young aesthetic patients may involve preparing topical agents for conditions like acne. A common compounded ingredient for acne is:
- Tretinoin
- Lidocaine
- Nystatin
- Ketoprofen
Answer: Tretinoin
30. The final check of a compounded dermatological preparation should always be performed by:
- The pharmacy technician
- The patient
- The pharmacist
- The prescriber’s office staff
Answer: The pharmacist
31. Which topical dosage form is generally the most hydrating and occlusive?
- Solution
- Gel
- Cream
- Ointment
Answer: Ointment
32. The primary advantage of a compounded topical gel is its:
- Greasy feel and occlusive properties
- Non-greasy feel and rapid drying time
- Ability to deliver oil-soluble drugs only
- Opaque appearance
Answer: Non-greasy feel and rapid drying time
33. What does it mean if a compounded cream “cracks” or “breaks”?
- The beyond-use date has been reached
- The emulsion has separated into its oil and water phases
- The active ingredient has become more potent
- The cream has frozen and thawed
Answer: The emulsion has separated into its oil and water phases
34. When selecting a container for a topical cream, an ointment jar is suitable, but what is often preferred to reduce product contamination?
- A beaker
- A squeezable tube
- A cardboard box
- A paper bag
Answer: A squeezable tube
35. A “keratolytic” agent is a substance that:
- Hydrates the skin
- Reduces inflammation
- Removes warts or calluses by breaking down keratin
- Acts as a local anesthetic
Answer: Removes warts or calluses by breaking down keratin
36. Compounding allows for the combination of a corticosteroid, an antifungal, and an antibiotic into one cream. This addresses a challenge in treating some:
- Systemic infections
- Cardiovascular diseases
- Dermatological conditions
- Neurological disorders
Answer: Dermatological conditions
37. The choice of vehicle for a topical compound can significantly impact the drug’s:
- Absorption and penetration into the skin
- Chemical name
- Molecular weight
- Oral bioavailability
Answer: Absorption and penetration into the skin
38. A lumpy or gritty final product is a sign of poor compounding technique and may lead to what consequence?
- Increased therapeutic effect
- Patient dissatisfaction and improper dosing
- A longer beyond-use date
- No consequences for the patient
Answer: Patient dissatisfaction and improper dosing
39. A compounded “balm” is typically an anhydrous preparation, similar to a(n):
- Gel
- Aqueous solution
- Ointment
- Cream
Answer: Ointment
40. A pharmacist receives a prescription for “2% hydrocortisone and 1% ketoconazole in a cream base.” This is an example of:
- Manufacturing
- A standard commercial product
- A compounded preparation
- A sterile injectable
Answer: A compounded preparation
41. The primary purpose of an emulsifying agent in a cream is to:
- Thicken the preparation
- Preserve the cream from microbial growth
- Keep the oil and water phases from separating
- Provide a therapeutic effect
Answer: Keep the oil and water phases from separating
42. Which of the following is an important auxiliary label for most compounded topical products?
- “For External Use Only”
- “Take with food”
- “May cause drowsiness”
- “Refrigerate and shake well”
Answer: “For External Use Only”
43. The preparation of dermatological compounds like creams and gels is a key activity in a non-sterile compounding lab session. This hands-on experience helps develop:
- Sterile technique
- Skills in parenteral dose calculation
- Proper manipulation and quality assessment of semisolids
- Knowledge of intravenous compatibility
Answer: Proper manipulation and quality assessment of semisolids
44. What is the primary advantage of a transdermal gel for a patient who experiences GI side effects from an oral medication?
- It bypasses the gastrointestinal tract, reducing systemic side effects
- It ensures 100% of the drug reaches the bloodstream
- It has a faster onset of action than an IV injection
- It is easier to swallow
Answer: It bypasses the gastrointestinal tract, reducing systemic side effects
45. A humectant, such as glycerin or propylene glycol, is added to a topical preparation to:
- Increase water absorption from the air to hydrate the skin
- Make the product feel greasy
- Act as the primary active ingredient
- Preserve the product from bacteria
Answer: Increase water absorption from the air to hydrate the skin
46. The syllabus for advanced non-sterile compounding indicates that a wide variety of dermatological conditions are managed with compounded products. This highlights the need for:
- Only one type of topical base
- Mass manufacturing of these products
- Personalized therapy in dermatology
- Eliminating topical drugs from the market
Answer: Personalized therapy in dermatology
47. When adding a small volume of a liquid active ingredient to an ointment, the best method is to:
- Add it directly to the center of the ointment on a slab and mix via geometric dilution
- Pour it quickly over the top of the entire ointment base in its container
- Heat the ointment until it is fully melted before adding the liquid
- Add the liquid to a different container and ignore the ointment
Answer: Add it directly to the center of the ointment on a slab and mix via geometric dilution
48. Anhydrous lanolin is an example of what type of ointment base?
- Hydrocarbon base
- Absorption base
- Water-removable base
- Water-soluble base
Answer: Absorption base
49. A topical compounded product is deemed pharmaceutically elegant if it is:
- Free of grittiness, uniform in color and texture, and smooth to the touch
- The most expensive possible formulation
- Packaged in a plain, unlabeled container
- Intentionally made with separated layers
Answer: Free of grittiness, uniform in color and texture, and smooth to the touch
50. The scope of compounding for the skin demonstrates the pharmacist’s role as a:
- Prescriber of dermatological drugs
- Manufacturer of commercial skincare lines
- Problem-solver who creates patient-specific therapeutic solutions
- Salesperson for cosmetic products
Answer: Problem-solver who creates patient-specific therapeutic solutions
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