Welcome, PharmD students, to this MCQ quiz on the Nonsterile Compounding of Suppositories! Suppositories are solid dosage forms intended for insertion into body orifices like the rectum, vagina, or urethra, where they melt, soften, or dissolve to exert local or systemic effects. Compounding suppositories allows for customized medication delivery for patients who cannot take oral medications or require targeted local action. This quiz will test your understanding of suppository bases, preparation methods like fusion molding, calculations including density displacement, quality control, and patient counseling.
1. Which of the following is NOT a typical base used in suppository compounding?
- A. Cocoa butter
- B. Polyethylene glycol
- C. Gelatin
- D. Carboxymethylcellulose
Correct answer: D. Carboxymethylcellulose
2. What is the ideal characteristic of a suppository base for rectal use?
- A. High melting point
- B. Water insolubility
- C. Melts or dissolves at body temperature
- D. Non-biocompatible
Correct answer: C. Melts or dissolves at body temperature
3. Which of the following is a disadvantage of cocoa butter as a suppository base?
- A. Rapid melting
- B. Non-irritating
- C. Polymorphism
- D. Water solubility
Correct answer: C. Polymorphism
4. Suppositories are primarily intended for which of the following routes?
- A. Oral
- B. Rectal
- C. Intravenous
- D. Transdermal
Correct answer: B. Rectal
5. Which type of base would be preferred for a water-soluble drug?
- A. Oleaginous base
- B. Hydrophilic base
- C. Aqueous base
- D. Emulsifying base
Correct answer: A. Oleaginous base
6. What is the main mechanism of drug absorption from rectal suppositories?
- A. Passive diffusion
- B. Active transport
- C. Facilitated diffusion
- D. Phagocytosis
Correct answer: A. Passive diffusion
7. Which of the following factors does NOT affect drug absorption from rectal suppositories?
- A. Particle size
- B. Lipid solubility
- C. Rectal fluid volume
- D. Enterohepatic circulation
Correct answer: D. Enterohepatic circulation
8. What is the usual shape of adult rectal suppositories?
- A. Cone
- B. Cylindrical
- C. Bullet
- D. Torpedo
Correct answer: C. Bullet
9. For pediatric patients, suppositories are typically how long?
- A. 1 inch
- B. 2 inches
- C. 0.5 inch
- D. 1.5 inches
Correct answer: C. 0.5 inch
10. Which excipient is commonly used to adjust the melting point of suppositories?
- A. Surfactants
- B. Waxes
- C. Glycerin
- D. Gelatin
Correct answer: B. Waxes
11. Which of the following is used as a water-soluble base in suppositories?
- A. Theobroma oil
- B. Beeswax
- C. Polyethylene glycol (PEG)
- D. Lanolin
Correct answer: C. Polyethylene glycol (PEG)
12. Glycerinated gelatin suppositories are mostly used for:
- A. Ophthalmic administration
- B. Rectal administration
- C. Vaginal administration
- D. Oral cavity administration
Correct answer: C. Vaginal administration
13. Which base is hygroscopic and can cause irritation when used rectally?
- A. PEG
- B. Cocoa butter
- C. Hard fat
- D. Beeswax
Correct answer: A. PEG
14. What is the density factor used for in suppository compounding?
- A. Flavor enhancement
- B. Texture improvement
- C. Adjusting drug amount for base displacement
- D. Color stabilization
Correct answer: C. Adjusting drug amount for base displacement
15. In rectal drug delivery, which vein bypasses the first-pass metabolism?
- A. Inferior vena cava
- B. Inferior rectal vein
- C. Superior rectal vein
- D. Hepatic portal vein
Correct answer: B. Inferior rectal vein
16. Which of the following methods is most commonly used to prepare suppositories?
- A. Hand rolling
- B. Compression molding
- C. Fusion molding
- D. Freeze-drying
Correct answer: C. Fusion molding
17. Which of the following components can be used as a surfactant in suppositories?
- A. Span 80
- B. Acacia
- C. Polyethylene oxide
- D. Stearic acid
Correct answer: A. Span 80
18. What is the role of lubricants in suppository molds?
- A. Enhance drug absorption
- B. Prevent sticking
- C. Increase disintegration time
- D. Lower melting point
Correct answer: B. Prevent sticking
19. The maximum volume typically used for rectal suppositories is:
- A. 0.5 mL
- B. 1 mL
- C. 2 mL
- D. 4 mL
Correct answer: D. 4 mL
20. What is the ideal storage condition for cocoa butter suppositories?
- A. Room temperature
- B. Refrigerated
- C. Frozen
- D. Heated cabinet
Correct answer: B. Refrigerated
21. What is the typical weight of an adult rectal suppository?
- A. 1 g
- B. 2 g
- C. 5 g
- D. 10 g
Correct answer: B. 2 g
22. What characteristic is most important for a suppository base when considering drug release?
- A. Color
- B. Melting point
- C. Viscosity
- D. Water content
Correct answer: B. Melting point
23. Which of the following drugs is suitable for rectal administration due to extensive first-pass metabolism?
- A. Morphine
- B. Metoprolol
- C. Hydrocortisone
- D. Diazepam
Correct answer: D. Diazepam
24. Glycerinated gelatin base must be:
- A. Stored at room temperature
- B. Lubricated before insertion
- C. Used for oral administration
- D. Sterilized before use
Correct answer: B. Lubricated before insertion
25. Which of the following does NOT influence the drug release from suppositories?
- A. Base type
- B. Storage temperature
- C. Particle size
- D. Drug molecular weight
Correct answer: B. Storage temperature
26. The ‘hand rolling’ method of suppository preparation is best suited for:
- A. Heat-sensitive drugs
- B. PEG bases
- C. Mass production
- D. Hydrophilic drugs
Correct answer: A. Heat-sensitive drugs
27. Which is NOT a benefit of rectal drug administration?
- A. Avoidance of gastric irritation
- B. Precise dosing control
- C. Partial avoidance of first-pass metabolism
- D. Useful in vomiting patients
Correct answer: B. Precise dosing control
28. Polyethylene glycol (PEG) suppositories:
- A. Are greasy
- B. Melt at body temperature
- C. Dissolve in body fluids
- D. Are used only for rectal administration
Correct answer: C. Dissolve in body fluids
29. Which of the following bases can support microbial growth and require preservatives?
- A. PEG
- B. Cocoa butter
- C. Glycerinated gelatin
- D. Hard fat
Correct answer: C. Glycerinated gelatin
30. Rectal absorption is affected least by:
- A. Drug solubility
- B. Rectal fluid volume
- C. Patient hydration
- D. Rectal motility
Correct answer: C. Patient hydration
31. Which of the following is considered a drawback of rectal drug delivery?
- A. Avoids hepatic metabolism
- B. Patient discomfort
- C. Useful in unconscious patients
- D. Rapid systemic absorption
Correct answer: B. Patient discomfort
32. Suppositories for vaginal use are typically called:
- A. Boluses
- B. Inserts
- C. Pessaries
- D. Troches
Correct answer: C. Pessaries
33. What is the common storage requirement for PEG suppositories?
- A. Freezer
- B. Room temperature
- C. Fridge
- D. Dry heat oven
Correct answer: B. Room temperature
34. Which of these statements about PEG bases is TRUE?
- A. They melt quickly at body temperature
- B. They require refrigeration
- C. They dissolve rather than melt
- D. They are always used with oil-based drugs
Correct answer: C. They dissolve rather than melt
35. What does “displacement value” help calculate?
- A. Quantity of flavoring agent
- B. Drug release rate
- C. Amount of base replaced by active ingredient
- D. Stability period of the suppository
Correct answer: C. Amount of base replaced by active ingredient
36. Vaginal suppositories can be used for:
- A. Antiemetics only
- B. Antihypertensives only
- C. Antifungals and contraceptives
- D. Analgesics only
Correct answer: C. Antifungals and contraceptives
37. Which factor most significantly affects melting point depression in cocoa butter formulations?
- A. Drug solubility
- B. Mixing speed
- C. Drug concentration
- D. Mold material
Correct answer: C. Drug concentration
38. Which type of base is most likely to leak from the rectum?
- A. PEG
- B. Glycerinated gelatin
- C. Cocoa butter
- D. Hydrogenated vegetable oil
Correct answer: C. Cocoa butter
39. When using fusion molding, the temperature should be:
- A. Just below the base’s melting point
- B. Equal to the boiling point of water
- C. Very high to dissolve the drug
- D. Higher than the flash point
Correct answer: A. Just below the base’s melting point
40. Which method is least likely used in suppository production for personalized medicine?
- A. Fusion molding
- B. Compression molding
- C. Hand rolling
- D. 3D printing
Correct answer: D. 3D printing
41. For which patient condition is rectal suppository administration particularly advantageous?
- A. Dysphagia
- B. Constipation
- C. Bradycardia
- D. Hyperthyroidism
Correct answer: A. Dysphagia
42. Which analytical method is commonly used to test drug content in compounded suppositories?
- A. IR Spectroscopy
- B. UV-Vis Spectrophotometry
- C. NMR
- D. Chromatography
Correct answer: B. UV-Vis Spectrophotometry
43. What is the typical pH range of rectal fluids?
- A. 4.0 – 5.0
- B. 5.5 – 7.0
- C. 7.5 – 8.5
- D. 8.5 – 9.5
Correct answer: B. 5.5 – 7.0
44. Which of these ingredients is used to stiffen a suppository base?
- A. Stearic acid
- B. Propylene glycol
- C. Sodium chloride
- D. Acacia
Correct answer: A. Stearic acid
45. Which condition would require a lubricant for rectal suppository insertion?
- A. Hemorrhoids
- B. Hyperlipidemia
- C. Asthma
- D. Gout
Correct answer: A. Hemorrhoids
46. What is the advantage of a PEG base over a cocoa butter base?
- A. Requires refrigeration
- B. Less irritation
- C. Stable at room temperature
- D. Faster drug release
Correct answer: C. Stable at room temperature
47. Suppositories made with water-soluble bases are better for drugs that are:
- A. Lipophilic
- B. Hydrophilic
- C. Amphipathic
- D. Volatile
Correct answer: A. Lipophilic
48. Which test evaluates uniformity of drug content in suppositories?
- A. Melting point analysis
- B. Weight variation test
- C. Content uniformity test
- D. Dissolution test
Correct answer: C. Content uniformity test
49. What is a sign of improper storage in cocoa butter suppositories?
- A. Increased hardness
- B. Blooming
- C. Improved odor
- D. Color darkening
Correct answer: B. Blooming
50. Which is TRUE about glycerin in suppositories?
- A. Decreases moisture content
- B. Acts as a laxative
- C. Reduces drug absorption
- D. Causes lipid oxidation
Correct answer: B. Acts as a laxative