MCQ Quiz: Drug Information Resources

A core competency of any pharmacist is the ability to efficiently locate, critically evaluate, and effectively communicate drug information. Navigating the vast landscape of medical literature requires a systematic approach and a deep understanding of the different types of resources available. From comprehensive tertiary compendia like Lexicomp and Micromedex to secondary indexing services like PubMed and the primary literature of clinical trials, each level of information serves a distinct purpose. This quiz is designed for PharmD students to test their knowledge on the hierarchy of drug information, the strengths and limitations of various resources, and the skills needed to formulate an evidence-based response to any clinical question.

1. A pharmacist needs to quickly find the standard adult dose for lisinopril. Which type of drug information resource would be the most efficient to use first?

• a) Primary Literature
• b) Secondary Literature
• c) Tertiary Literature
• d) A news article

Answer: c) Tertiary Literature

2. Which of the following is an example of primary literature?

• a) A chapter in Goodman & Gilman’s The Pharmacological Basis of Therapeutics.
• b) A review article summarizing multiple studies on a new drug.
• c) An article reporting the results of a randomized controlled clinical trial.
• d) An abstract found in PubMed.

Answer: c) An article reporting the results of a randomized controlled clinical trial.

3. PubMed and Embase are examples of what type of drug information resource?

• a) Primary Literature
• b) Secondary Literature
• c) Tertiary Literature
• d) Consumer Health Information

Answer: b) Secondary Literature

4. What is the primary function of a secondary literature resource?

• a) To provide a comprehensive overview of a disease state.
• b) To report original research for the first time.
• c) To help a user find primary literature via indexing and abstracting services.
• d) To provide drug pricing information.

Answer: c) To help a user find primary literature via indexing and abstracting services.

5. A major limitation of tertiary resources like textbooks is that:

• a) They are too difficult to read.
• b) The information may not be the most current due to publication lag time.
• c) They do not contain any useful information.
• d) They only contain information on brand-name drugs.

Answer: b) The information may not be the most current due to publication lag time.

6. A pharmacist is searching PubMed for articles on the use of metformin for PCOS. To narrow the search to include only articles that discuss both topics, which Boolean operator should be used?

• a) OR
• b) AND
• c) NOT
• d) NEAR

Answer: b) AND

7. MeSH terms in PubMed are a set of controlled vocabulary terms used to:

• a) Hide articles from a search.
• b) Systematically index and categorize articles by subject, making searches more precise.
• c) Translate articles into different languages.
• d) Rank articles by their quality.

Answer: b) Systematically index and categorize articles by subject, making searches more precise.

8. Which section of a drug’s official package insert contains information on its mechanism of action, pharmacodynamics, and pharmacokinetics?

• a) Indications and Usage
• b) Contraindications
• c) Clinical Pharmacology
• d) How Supplied/Storage and Handling

Answer: c) Clinical Pharmacology

9. A physician asks for information on an off-label use of a medication. Which of the following is a reliable tertiary resource to check for evidence-based off-label uses?

• a) The Physician’s Desk Reference (PDR)
• b) The FDA-approved package insert
• c) AHFS Drug Information or Micromedex
• d) A general internet search engine.

Answer: c) AHFS Drug Information or Micromedex

10. A patient asks if it is safe to take a specific medication during pregnancy. Which specialized tertiary resource is considered the gold standard for this type of question?

• a) The Orange Book
• b) Trissel’s Handbook on Injectable Drugs
• c) Briggs’ Drugs in Pregnancy and Lactation
• d) The Pink Book

Answer: c) Briggs’ Drugs in Pregnancy and Lactation

11. A hospital pharmacist needs to determine if two intravenous drugs can be administered together in the same IV line. Which resource is specifically designed to answer questions on IV compatibility and stability?

• a) Lexicomp’s Interactions database
• b) The package insert for one of the drugs
• c) Trissel’s Handbook on Injectable Drugs
• d) The Red Book

Answer: c) Trissel’s Handbook on Injectable Drugs

12. The FDA’s “Orange Book” provides information on:

• a) The prices of medications.
• b) The compatibility of IV drugs.
• c) Therapeutic equivalence evaluations for generic drugs.
• d) Vaccine-preventable diseases.

Answer: c) Therapeutic equivalence evaluations for a generic drugs.

13. A patient brings in a medication from Mexico and asks you to identify it. Which resource would be most helpful for identifying foreign drugs?

• a) The CDC’s Yellow Book
• b) Martindale: The Complete Drug Reference
• c) The Pink Sheet
• d) The package insert

Answer: b) Martindale: The Complete Drug Reference

14. When evaluating a drug information website for reliability, which factor would be a cause for concern?

• a) The website is sponsored by a government agency like the NIH.
• b) The authors’ credentials are not listed.
• c) The information is well-referenced with links to primary literature.
• d) The website was updated last week.

Answer: b) The authors’ credentials are not listed.

15. A review article that summarizes the findings of 20 different clinical trials on a single topic is an example of what type of literature?

• a) Primary
• b) Secondary
• c) Tertiary
• d) Anecdotal

Answer: c) Tertiary

16. The “Clinical Studies” section of a package insert is useful for understanding:

• a) The chemical structure of the drug.
• b) The pivotal clinical trials that led to the drug’s FDA approval.
• c) All possible off-label uses of the drug.
• d) The cost of the drug.

Answer: b) The pivotal clinical trials that led to the drug’s FDA approval.

17. A pharmacist searching for literature on “hypertension OR high blood pressure” will get results containing:

• a) Only articles with the word “hypertension”.
• b) Only articles with the phrase “high blood pressure”.
• c) Articles that contain either “hypertension” or “high blood pressure” or both.
• d) Only articles that contain both terms.

Answer: c) Articles that contain either “hypertension” or “high blood pressure” or both.

18. Which government agency website is a reliable source for information on vaccines and immunizations for both healthcare professionals and the public?

• a) The Drug Enforcement Administration (DEA)
• b) The Centers for Disease Control and Prevention (CDC)
• c) The Food and Drug Administration (FDA)
• d) The National Institutes of Health (NIH)

Answer: b) The Centers for Disease Control and Prevention (CDC)

19. A pharmacist is helping a patient find reliable health information online. Which of the following would be a good recommendation?

• a) A celebrity’s personal health blog.
• b) A social media group dedicated to the condition.
• c) MedlinePlus, a service of the National Library of Medicine.
• d) An online forum where users share personal anecdotes.

Answer: c) MedlinePlus, a service of the National Library of Medicine.

20. The “Contraindications” section of a package insert lists situations in which the drug:

• a) Should be used with caution.
• b) Has a known drug interaction.
• c) Should not be used because the risk outweighs any potential benefit.
• d) Is most effective.

Answer: c) Should not be used because the risk outweighs any potential benefit.

21. A “case report” published in a medical journal is an example of:

• a) Primary literature
• b) Secondary literature
• c) Tertiary literature
• d) A clinical practice guideline

Answer: a) Primary literature

22. Which resource is specifically focused on providing evidence-based information on natural medicines, herbal supplements, and complementary therapies?

• a) Micromedex
• b) Natural Medicines database
• c) The Orange Book
• d) AHFS Drug Information

Answer: b) Natural Medicines database

23. The “Abstract” of a primary literature article provides a:

• a) Detailed description of the study’s statistical methods.
• b) Comprehensive list of all references cited.
• c) Brief summary of the study’s objective, methods, results, and conclusion.
• d) A list of the authors’ credentials and conflicts of interest.

Answer: c) A brief summary of the study’s objective, methods, results, and conclusion.

24. What is the main difference between PubMed and Embase?

• a) PubMed is a tertiary resource, while Embase is secondary.
• b) PubMed is free to access, while Embase is a subscription-based service.
• c) Embase has a stronger focus on international and pharmaceutical literature compared to PubMed.
• d) Both B and C are correct.

Answer: d) Both B and C are correct.

25. A pharmacist is answering a drug information question. The first step in the systematic approach is to:

• a) Immediately search PubMed.
• b) Secure the requestor’s demographics and clearly define the actual question being asked.
• c) Formulate a search strategy.
• d) Provide a response based on personal experience.

Answer: b) Secure the requestor’s demographics and clearly define the actual question being asked.

26. The “Red Book” is a pharmacy resource primarily used for finding:

• a) Information on toxicology.
• b) Pediatric dosing information.
• c) Drug pricing information, including Average Wholesale Price (AWP).
• d) IV compatibility data.

Answer: c) Drug pricing information, including Average Wholesale Price (AWP).

27. A new drug has just been approved by the FDA. The most up-to-date and detailed information about this drug would likely be found first in:

• a) A medical textbook published last year.
• b) The FDA-approved package insert and the pivotal clinical trial articles.
• c) A summary in a drug information handbook.
• d) A consumer health website.

Answer: b) The FDA-approved package insert and the pivotal clinical trial articles.

28. A key limitation of using primary literature to answer a clinical question is that:

• a) It is always free of bias.
• b) It requires careful appraisal and interpretation to understand its context and limitations.
• c) It provides a broad overview of a topic.
• d) The information is always outdated.

Answer: b) It requires careful appraisal and interpretation to understand its context and limitations.

29. Clinical practice guidelines, such as those from the American Diabetes Association (ADA), are considered what type of resource?

• a) Primary Literature
• b) Secondary Literature
• c) Tertiary Literature
• d) Social Media

Answer: c) Tertiary Literature

30. Which database, often included in resources like Micromedex, is used to identify unknown tablets and capsules based on their physical appearance (imprint, color, shape)?

• a) TRISSEL’S
• b) RED BOOK
• c) IDENTIDEX
• d) BRIGGS’

Answer: c) IDENTIDEX

31. The “Adverse Reactions” section of a package insert contains:

• a) A list of every side effect ever reported for the drug.
• b) Only life-threatening side effects.
• c) Adverse events observed during the pre-marketing clinical trials.
• d) Information on how to manage side effects.

Answer: c) Adverse events observed during the pre-marketing clinical trials.

32. Using the Boolean operator “NOT” in a PubMed search for “stroke NOT hemorrhagic” will:

• a) Retrieve articles that contain both terms.
• b) Retrieve articles that contain the term “stroke” but exclude any articles that also contain the term “hemorrhagic”.
• c) Retrieve only articles about hemorrhagic stroke.
• d) Cause a search error.

Answer: b) Retrieve articles that contain the term “stroke” but exclude any articles that also contain the term “hemorrhagic”.

33. Which resource provides information on vaccine and immunization recommendations from the Advisory Committee on Immunization Practices (ACIP)?

• a) The FDA Orange Book
• b) The CDC Pink Book
• c) The USP-NF
• d) The Harriet Lane Handbook

Answer: b) The CDC Pink Book

34. The methods section of a clinical trial article should provide detailed information about:

• a) The study’s conclusions.
• b) The study design, patient population, and statistical analysis plan.
• c) The funding sources for the study.
• d) The baseline characteristics of the study participants.

Answer: b) The study design, patient population, and statistical analysis plan.

35. A pharmacist is looking for information on compounding a specific oral liquid that is not commercially available. A good resource to check would be:

• a) The package insert for the tablet form.
• b) A resource like the International Journal of Pharmaceutical Compounding or a compounding-specific database.
• c) MedlinePlus.
• d) The Red Book.

Answer: b) A resource like the International Journal of Pharmaceutical Compounding or a compounding-specific database.

36. The Physician’s Desk Reference (PDR) is essentially a compilation of:

• a) Peer-reviewed clinical trials.
• b) Off-label use information.
• c) Manufacturer-provided package inserts.
• d) Clinical practice guidelines.

Answer: c) Manufacturer-provided package inserts.

37. When using a tertiary resource like UpToDate or Lexicomp, it is important for the pharmacist to:

• a) Accept the information without question.
• b) Understand that it is a summary and synthesis of literature, and check primary sources for complex or controversial topics.
• c) Only use it for pricing information.
• d) Assume it contains information on all drugs ever made.

Answer: b) Understand that it is a summary and synthesis of literature, and check primary sources for complex or controversial topics.

38. Which of the following is NOT a characteristic of a high-quality clinical practice guideline?

• a) It is based on a systematic review of the evidence.
• b) It is authored by a panel of anonymous experts.
• c) It provides graded recommendations based on the strength of the evidence.
• d) It is regularly updated.

Answer: b) It is authored by a panel of anonymous experts.

39. A pharmacist looking for a summary of new drug approvals and pharmacy-related news would find this in:

• a) A medical textbook.
• b) A trade journal or newsletter like Pharmacist’s Letter.
• c) The FDA’s Orange Book.
• d) A primary research article.

Answer: b) A trade journal or newsletter like Pharmacist’s Letter.

40. The final step in the systematic approach to answering a drug information question is to:

• a) Classify the question.
• b) Conduct a search.
• c) Evaluate the literature.
• d) Formulate and provide a response, then follow up.

Answer: d) Formulate and provide a response, then follow up.

41. A major advantage of primary literature is that it:

• a) Is easy to read and understand for all audiences.
• b) Is the most current source of information and provides details on study methodology.
• c) Is free from any bias or limitations.
• d) Provides a broad overview of a topic.

Answer: b) Is the most current source of information and provides details on study methodology.

42. The “Drug Interactions” section of a drug’s package insert is based on:

• a) All theoretically possible interactions.
• b) Known clinical studies and pharmacokinetic data available at the time of approval.
• c) Anecdotal reports from patients.
• d) Information from other countries.

Answer: b) Known clinical studies and pharmacokinetic data available at the time of approval.

43. A pharmacist uses quotation marks around the phrase “atrial fibrillation” in a search engine. This will tell the search engine to:

• a) Search for the words “atrial” and “fibrillation” separately.
• b) Search for the exact phrase “atrial fibrillation”.
• c) Exclude that phrase from the search results.
• d) Prioritize articles about atrial fibrillation.

Answer: b) Search for the exact phrase “atrial fibrillation”.

44. The DailyMed website, maintained by the National Library of Medicine, is a reliable source for finding:

• a) Patient reviews of medications.
• b) Up-to-date, FDA-approved drug package inserts (labels).
• c) The cost of medications.
• d) Off-label dosing information.

Answer: b) Up-to-date, FDA-approved drug package inserts (labels).

45. Which of the following is the best resource to determine if a specific generic manufacturer’s product is therapeutically equivalent to the brand name product?

• a) The package insert.
• b) The CDC Pink Book.
• c) The FDA Orange Book.
• d) Micromedex.

Answer: c) The FDA Orange Book.

46. When a pharmacist receives a question, why is it important to obtain background information from the requestor?

• a) To determine if they can pay for the information.
• b) To understand the context and formulate the true question that needs to be answered.
• c) To make the process take longer.
• d) To test the requestor’s knowledge.

Answer: b) To understand the context and formulate the true question that needs to be answered.

47. A “meta-analysis” is a type of:

• a) Primary literature that reports on a single patient.
• b) Secondary literature database.
• c) Primary literature that uses statistical methods to combine the results of multiple studies.
• d) Consumer health blog.

Answer: c) Primary literature that uses statistical methods to combine the results of multiple studies.

48. The “Use in Specific Populations” section of a package insert would contain information regarding a drug’s use in:

• a) Pediatric patients.
• b) Geriatric patients.
• c) Patients with renal or hepatic impairment.
• d) All of the above.

Answer: d) All of the above.

49. A pharmacist wants to find information on managing a patient who has overdosed on a medication. A good tertiary resource to consult would be:

• a) A drug interactions database.
• b) A toxicology-specific database like POISINDEX® (in Micromedex).
• c) The Orange Book.
• d) A medical dictionary.

Answer: b) A toxicology-specific database like POISINDEX® (in Micromedex).

50. The ultimate goal of being proficient with drug information resources is to:

• a) Pass pharmacology exams.
• b) Answer questions faster than other pharmacists.
• c) Practice evidence-based medicine to provide optimal patient care.
• d) Memorize every fact about every drug.

Answer: c) Practice evidence-based medicine to provide optimal patient care.