MCQ Quiz: Introduction to the History of Pharmacy

The profession of pharmacy has a rich and storied history, evolving from ancient apothecaries to the modern clinical practitioners of today. Understanding this history provides context for the current roles, responsibilities, and challenges facing the profession. This quiz covers key figures, events,and eras in the history of pharmacy

1. An ancient Egyptian medical text dating to 1550 BC, which contains hundreds of formulas and prescriptions, is known as the:

• a. Code of Hammurabi
• b. Hippocratic Oath
• c. Ebers Papyrus
• d. Magna Carta

Answer: c. Ebers Papyrus

2. The “Father of Medicine” in ancient Greece, who helped move health care away from magic and religion toward a more scientific approach, was:

• a. Galen
• b. Dioscorides
• c. Hippocrates
• d. Aristotle

Answer: c. Hippocrates

3. The Roman physician Galen is known for developing a system of classifying drugs and creating complex preparations by mixing and melting ingredients. These preparations are still sometimes referred to as:

• a. Pharmaceuticals
• b. Galenicals
• c. Nostrums
• d. Elixirs

Answer: b. Galenicals

4. The official separation of the practices of pharmacy and medicine is credited to an edict issued in 1240 AD by which Holy Roman Emperor?

• a. Charlemagne
• b. Frederick II
• c. Augustus Caesar
• d. Henry VIII

Answer: b. Frederick II

5. The first official, city-wide pharmacopoeia was published in which European city in 1498?

• a. London, England
• b. Paris, France
• c. Rome, Italy
• d. Florence, Italy

Answer: d. Florence, Italy

6. Friedrich Sertürner, a German apothecary, is credited with the first isolation of which active alkaloid from opium in the early 1800s?

• a. Codeine
• b. Quinine
• c. Atropine
• d. Morphine

Answer: d. Morphine

7. The first college of pharmacy in the United States was founded in which city in 1821?

• a. Boston
• b. New York
• c. Philadelphia
• d. Baltimore

Answer: c. Philadelphia

8. The Durham-Humphrey Amendment of 1951 is a key piece of U.S. legislation that:

• a. Required all drugs to be proven safe.
• b. Created the distinction between “prescription-only” and “over-the-counter” drugs.
• c. Established the Drug Enforcement Administration (DEA).
• d. Required child-resistant packaging.

Answer: b. Created the distinction between “prescription-only” and “over-the-counter” drugs.

9. The “clinical pharmacy” movement, which began in the 1960s, promoted a shift in the pharmacist’s role from:

• a. A patient-focused provider to a product-focused dispenser.
• b. A product-focused dispenser to a patient-focused provider of clinical services.
• c. A compounder to a manufacturer.
• d. A hospital pharmacist to a community pharmacist.

Answer: b. A product-focused dispenser to a patient-focused provider of clinical services.

10. The concept of “pharmaceutical care,” defined as the responsible provision of drug therapy for the purpose of achieving definite outcomes, was developed by:

• a. Watson and Crick
• b. Hepler and Strand
• c. Banting and Best
• d. Fleming and Florey

Answer: b. Hepler and Strand

11. The Omnibus Budget Reconciliation Act of 1990 (OBRA ’90) established a federal mandate for pharmacists to do what for Medicaid patients?

• a. Provide free medications.
• b. Perform a prospective drug use review (DUR) and offer to counsel.
• c. Compound all prescriptions.
• d. Administer all vaccines.

Answer: b. Perform a prospective drug use review (DUR) and offer to counsel.

12. The symbol of pharmacy, the Bowl of Hygieia, features a serpent and a bowl. The serpent represents:

• a. Poison
• b. Healing and wisdom
• c. Commerce
• d. Sickness

Answer: b. Healing and wisdom

13. In early America, who often served the dual role of physician and apothecary?

• a. Lawyers
• b. Clergy
• c. The town mayor
• d. There was no overlap.

Answer: b. Clergy

14. The development of which of the following in the mid-20th century led to the decline of the pharmacist’s role as a compounder and the rise of the “count and pour” era?

• a. The internet
• b. Large-scale pharmaceutical manufacturing
• c. The creation of chain pharmacies
• d. Stricter pharmacy laws

Answer: b. Large-scale pharmaceutical manufacturing

15. The American Pharmacists Association (APhA) was founded in what century?

• a. 17th Century
• b. 18th Century
• c. 19th Century
• d. 20th Century

Answer: c. 19th Century

16. Which ancient civilization is associated with the “Rx” symbol, thought to be an abbreviation of a Latin verb meaning “to take”?

• a. Egyptian
• b. Greek
• c. Roman
• d. Babylonian

Answer: c. Roman

17. The first major U.S. law addressing the safety of drugs, passed in response to deaths from a toxic elixir, was the:

• a. Pure Food and Drug Act of 1906
• b. Harrison Narcotic Act of 1914
• c. Food, Drug, and Cosmetic Act of 1938
• d. Kefauver-Harris Amendment of 1962

Answer: c. Food, Drug, and Cosmetic Act of 1938

18. The Kefauver-Harris Amendment of 1962, passed in response to the thalidomide tragedy, required that drugs be proven not only safe but also:

• a. Effective
• b. Inexpensive
• c. Easy to manufacture
• d. Palatable

Answer: a. Effective

19. Medication Therapy Management (MTM) services were formally established as a benefit for eligible beneficiaries under which legislation?

• a. OBRA ’90
• b. HIPAA ’96
• c. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003
• d. The Affordable Care Act of 2010

Answer: c. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003

20. The transition from a 4-year Bachelor of Science in Pharmacy to a 6-year Doctor of Pharmacy (Pharm.D.) as the entry-level degree reflected the profession’s shift toward:

• a. A greater focus on clinical, patient-centered care.
• b. A product-distribution role.
• c. A research-only focus.
• d. A business management focus.

Answer: a. A greater focus on clinical, patient-centered care.

21. The term “apothecary” is an older term for a:

• a. Physician
• b. Nurse
• c. Pharmacist or pharmacy
• d. Surgeon

Answer: c. Pharmacist or pharmacy

22. Early patent medicines in the 19th century were known for:

• a. Their rigorous testing and proven efficacy.
• b. Their clear labeling of all ingredients.
• c. Their secret formulas and often outlandish marketing claims.
• d. Being free of alcohol and narcotics.

Answer: c. Their secret formulas and often outlandish marketing claims.

23. The discovery of penicillin by Alexander Fleming in 1928 ushered in the era of:

• a. Hormonal therapy
• b. Anesthetics
• c. Antibiotics
• d. Antivirals

Answer: c. Antibiotics

24. The historical role of the “drugstore” as a social center and source of general advice reflects the pharmacist’s historical position as:

• a. An isolated professional.
• b. An inaccessible healthcare provider.
• c. One of the most accessible healthcare professionals in the community.
• d. A government employee.

Answer: c. One of the most accessible healthcare professionals in the community.

25. The shift from “pharmaceutical care” to “medication therapy management” represents:

• a. A move away from patient care.
• b. A move toward a more product-focused role.
• c. An evolution and operationalization of the patient-centered philosophy of pharmaceutical care.
• d. A decrease in the pharmacist’s responsibilities.

Answer: c. An evolution and operationalization of the patient-centered philosophy of pharmaceutical care.

26. Which historical figure is known as the “Father of Botany” for his extensive work cataloging medicinal plants, De Materia Medica?

• a. Hippocrates
• b. Galen
• c. Paracelsus
• d. Dioscorides

Answer: d. Dioscorides

27. The concept “the dose makes the poison” is attributed to which Renaissance physician and alchemist?

• a. Galen
• b. Paracelsus
• c. Avicenna
• d. Maimonides

Answer: b. Paracelsus

28. Throughout much of history, the sources of most medicines were:

• a. Synthetic chemicals
• b. Animal products
• c. Minerals
• d. Plants and other natural products

Answer: d. Plants and other natural products

29. The invention of what dosage form in the 19th century helped standardize dosing and mask the unpleasant taste of many drugs?

• a. The liquid elixir
• b. The gelatin capsule
• c. The transdermal patch
• d. The suppository

Answer: b. The gelatin capsule

30. A mortar and pestle is a traditional pharmacy symbol representing:

• a. The act of dispensing.
• b. The act of compounding.
• c. The business of pharmacy.
• d. The science of pharmacology.

Answer: b. The act of compounding.

31. The movement for pharmacists to gain “provider status” is an effort to:

• a. Return to the “count and pour” era.
• b. Gain recognition and payment for providing clinical services, not just for dispensing a product.
• c. Allow all pharmacists to own their own pharmacy.
• d. Limit the number of pharmacists.

Answer: b. Gain recognition and payment for providing clinical services, not just for dispensing a product.

32. The development of long-acting insulin analogs in the 21st century is an example of the evolution of:

• a. Drug delivery systems.
• b. Pharmacogenomics.
• c. Herbal medicine.
• d. Pharmacy law.

Answer: a. Drug delivery systems.

33. The historical separation of pharmacy from medicine helped to:

• a. Create a system of checks and balances to improve patient safety.
• b. Increase the cost of healthcare.
• c. Decrease the quality of care.
• d. Combine the roles into one profession.

Answer: a. Create a system of checks and balances to improve patient safety.

34. The United States Pharmacopeia (USP) was created to:

• a. Set prices for medications.
• b. Regulate pharmacy practice.
• c. Set standards for the identity, strength, quality, and purity of medicines.
• d. Represent pharmacists in political advocacy.

Answer: c. Set standards for the identity, strength, quality, and purity of medicines.

35. A “show globe” in an apothecary window historically signified:

• a. The pharmacy was open for business.
• b. The pharmacist was a professional who could be trusted.
• c. Different colors were thought to represent different health conditions or remedies.
• d. Both b and c.

Answer: d. Both b and c.

36. The historical development of pharmacy education has trended toward:

• a. Shorter, less scientific programs.
• b. More clinically-oriented, science-based programs.
• c. Apprenticeship-only models.
• d. Business-only programs.

Answer: b. More clinically-oriented, science-based programs.

37. The “drug lag” refers to the time it takes for:

• a. A drug to be absorbed in the body.
• b. A new drug to be approved by the FDA compared to other countries.
• c. A pharmacist to fill a prescription.
• d. A generic drug to come to market.

Answer: b. A new drug to be approved by the FDA compared to other countries.

38. The Harrison Narcotic Act of 1914 was the first major US law to:

• a. Regulate the sale of cosmetics.
• b. Control the distribution and use of narcotics.
• c. Require prescriptions for all medications.
• d. Ensure all drugs were effective.

Answer: b. Control the distribution and use of narcotics.

39. The increasing complexity of medications in the 20th and 21st centuries has driven the need for pharmacists to be:

• a. Less involved in patient care.
• b. The primary medication experts on the healthcare team.
• c. Focused only on dispensing.
• d. General business managers.

Answer: b. The primary medication experts on the healthcare team.

40. The evolution of the pharmacist’s role has consistently been shaped by:

• a. Public need and safety concerns.
• b. Changes in technology and drug manufacturing.
• c. Legislation and regulation.
• d. All of the above.

Answer: d. All of the above.

41. The role of the pharmacist in immunization delivery became widespread in the US starting in the:

• a. 1950s
• b. 1970s
• c. Late 1990s and 2000s
• d. It is not a widespread practice.

Answer: c. Late 1990s and 2000s

42. The term “pharmacist” is derived from the Greek word “pharmakon,” which meant:

• a. Health and wellness.
• b. To dispense.
• c. Drug, which could be a remedy or a poison.
• d. The study of plants.

Answer: c. Drug, which could be a remedy or a poison.

43. The development of chain drug stores in the 20th century:

• a. Led to the end of the pharmacy profession.
• b. Changed the business model of community pharmacy.
• c. Eliminated the need for independent pharmacies.
• d. Had no impact on the profession.

Answer: b. Changed the business model of community pharmacy.

44. The focus on interprofessional education (IPE) in modern PharmD curricula reflects:

• a. A move back to physicians and pharmacists having the same role.
• b. The understanding that patient care is best delivered by a collaborative team.
• c. A requirement to make pharmacy school more difficult.
• d. A desire to have pharmacists perform nursing functions.

Answer: b. The understanding that patient care is best delivered by a collaborative team.

45. A key driver of the “clinical pharmacy” movement was:

• a. The realization that potent new drugs were causing significant adverse events.
• b. A desire for pharmacists to have a more direct role in patient outcomes.
• c. The work of pioneering pharmacists in hospital settings.
• d. All of the above.

Answer: d. All of the above.

46. A “nostrum” was a historical term for a:

• a. Well-regulated prescription drug.
• b. A patent medicine or secret remedy with questionable effectiveness.
• c. A compounded sterile product.
• d. A type of herbal tea.

Answer: b. A patent medicine or secret remedy with questionable effectiveness.

47. The Pure Food and Drug Act of 1906 was the first federal law to address:

• a. Drug efficacy.
• b. Drug prices.
• c. Misbranding and adulteration of food and drugs.
• d. The creation of the DEA.

Answer: c. Misbranding and adulteration of food and drugs.

48. Historically, the pharmacist’s knowledge of what was paramount in the compounding era?

• a. Botany and chemistry
• b. Business and marketing
• c. Law and ethics
• d. Pharmacology only

Answer: a. Botany and chemistry

49. The ongoing evolution of pharmacy practice continues to emphasize:

• a. Less patient interaction.
• b. A greater role in public health and direct patient care.
• c. A focus on dispensing over clinical services.
• d. The elimination of pharmacy technicians.

Answer: b. A greater role in public health and direct patient care.

50. The ultimate reason to study the history of pharmacy is to:

• a. Understand the context of the modern profession and its future trajectory.
• b. Memorize dates and names for an exam.
• c. Learn old compounding recipes.
• d. Appreciate how much better things are now.

Answer: a. Understand the context of the modern profession and its future trajectory.