MCQ Quiz: Objects and Tools and Patent Medicines

The history of pharmacy is rich with unique objects, tools, and remedies that tell the story of the profession’s evolution from ancient apothecaries to modern clinical practice. From iconic tools like the mortar and pestle to the controversial era of patent medicines, these artifacts shaped the need for regulation and evidence-based care. This quiz explores some of the historical tools of the trade and the phenomenon of patent medicines.

1. Which of the following is the most iconic and enduring symbol of the pharmacy profession, used for grinding and mixing substances?

• a. A beaker and a flask
• b. A pill roller
• c. A show globe
• d. A mortar and pestle

Answer: d. A mortar and pestle

2. The large, ornamental glass vessels filled with colored water, often displayed in apothecary windows, are known as:

• a. Distillation flasks
• b. Show globes
• c. Titration burettes
• d. Mortars

Answer: b. Show globes

3. “Patent medicines” of the 19th and early 20th centuries were:

• a. Medications with a government-issued patent on their unique chemical formula.
• b. Secret-formula, over-the-counter remedies, where the name was often trademarked but the ingredients were not disclosed.
• c. The first prescription-only medications.
• d. Injectable antibiotics.

Answer: b. Secret-formula, over-the-counter remedies, where the name was often trademarked but the ingredients were not disclosed.

4. A common and often primary ingredient in many 19th-century patent medicines was:

• a. Penicillin
• b. Acetaminophen
• c. Alcohol
• d. Aspirin

Answer: c. Alcohol

5. The process of grinding a solid substance into a fine powder in a mortar is called:

• a. Levigation
• b. Titration
• c. Trituration
• d. Distillation

Answer: c. Trituration

6. A historical pharmacy tool with a flat board and a long-handled cutter used to roll out a pill mass and cut it into uniform pieces was a:

• a. Suppository mold
• b. Pill machine or pill roller
• c. Spatula
• d. Graduate

Answer: b. Pill machine or pill roller

7. Which landmark U.S. legislation was passed in 1906, largely in response to the dangers of misbranded and adulterated patent medicines?

• a. The Harrison Narcotic Act
• b. The Pure Food and Drug Act
• c. The Durham-Humphrey Amendment
• d. The Kefauver-Harris Amendment

Answer: b. The Pure Food and Drug Act

8. Many patent medicines, often marketed to women and children, contained which of the following addictive substances?

• a. Opium or morphine
• b. Cocaine
• c. Alcohol
• d. All of the above

Answer: d. All of the above

9. The purpose of a suppository mold was to:

• a. Create uniformly shaped tablets.
• b. Create uniformly shaped suppositories from a melted base like cocoa butter.
• c. Measure liquid volumes.
• d. Store herbs.

Answer: b. Create uniformly shaped suppositories from a melted base like cocoa butter.

10. A graduated cylinder is a piece of pharmacy equipment used for:

• a. Precisely measuring the volume of liquids.
• b. Weighing solid powders.
• c. Grinding tablets.
• d. Storing chemicals.

Answer: a. Precisely measuring the volume of liquids.

11. The marketing for patent medicines often relied on:

• a. Peer-reviewed clinical trial data.
• b. Exaggerated claims and patient testimonials.
• c. Recommendations from physicians.
• d. Understated and modest advertising.

Answer: b. Exaggerated claims and patient testimonials.

12. A “nostrum” is another term for a:

• a. Highly effective prescription drug.
• b. A patent medicine or secret remedy with questionable efficacy.
• c. A compounded sterile product.
• d. A vaccine.

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

13. Which of the following was a famous patent medicine from the 19th century?

• a. Penicillin V
• b. Metformin
• c. Atorvastatin
• d. Lydia E. Pinkham’s Vegetable Compound

Answer: d. Lydia E. Pinkham’s Vegetable Compound

14. A conical graduate differs from a cylindrical graduate in its shape. For the most accurate measurement, a pharmacist should:

• a. Use a graduate that is closest to the volume being measured.
• b. Always use the largest graduate available.
• c. Always use a beaker instead.
• d. Estimate the volume by sight.

Answer: a. Use a graduate that is closest to the volume being measured.

15. Before the mass production of tablets, pharmacists hand-made most solid dosage forms, such as:

• a. Pills
• b. Cachets
• c. Troches (lozenges)
• d. All of the above

Answer: d. All of the above

16. The Pure Food and Drug Act of 1906 required patent medicines to:

• a. Be proven effective.
• b. Be proven safe.
• c. Accurately list the presence and amount of dangerous or addictive ingredients on the label.
• d. Be available only by prescription.

Answer: c. Accurately list the presence and amount of dangerous or addictive ingredients on the label.

17. The decline of patent medicines was hastened by:

• a. Increased government regulation.
• b. Muckraking journalism exposing their contents.
• c. The rise of scientific medicine and the pharmaceutical industry.
• d. All of the above.

Answer: d. All of the above.

18. A historical pharmacist’s balance would have been used with a set of:

• a. Beakers
• b. Precision weights (e.g., in apothecary units like grains and drams).
• c. Rulers
• d. Thermometers

Answer: b. Precision weights (e.g., in apothecary units like grains and drams).

19. What historical object was used to neatly fold compounded powders into paper for dispensing?

• a. A pill tile
• b. A powder folder
• c. A funnel
• d. A beaker

Answer: b. A powder folder

20. The original formula for Coca-Cola contained which two stimulating substances?

• a. Ephedrine and caffeine
• b. Caffeine and alcohol
• c. Cocaine (from coca leaves) and caffeine (from kola nuts)
• d. Nicotine and cocaine

Answer: c. Cocaine (from coca leaves) and caffeine (from kola nuts)

21. A “spatula” in pharmacy compounding is used for:

• a. Measuring liquids.
• b. Grinding powders.
• c. Transferring and mixing ointments and creams on a slab.
• d. Counting tablets.

Answer: c. Transferring and mixing ointments and creams on a slab.

22. What was the purpose of the colored water in show globes?

• a. It was a universal antidote.
• b. It was purely decorative and a symbol of the profession.
• c. The color indicated the health of the town (e.g., red for plague).
• d. Both b and c are historical theories.

Answer: d. Both b and c are historical theories.

23. The lack of regulation for patent medicines meant that they were often:

• a. Adulterated
• b. Misbranded
• c. Ineffective or harmful
• d. All of the above

Answer: d. All of the above

24. The term “snake oil salesman” originated from the marketing of:

• a. Regulated pharmaceuticals
• b. Patent medicines with fraudulent claims
• c. Surgical instruments
• d. Early automobiles

Answer: b. Patent medicines with fraudulent claims

25. A pill tile was a slab of glass or porcelain used for:

• a. Rolling out and cutting pills.
• b. Mixing ointments and creams.
• c. Counting out tablets.
• d. Both a and b.

Answer: d. Both a and b.

26. Which of the following would NOT be found in a 19th-century apothecary?

• a. A mortar and pestle
• b. A computerized prescription processing system
• c. Glass-stoppered bottles for chemicals
• d. A balance with brass weights

Answer: b. A computerized prescription processing system

27. The development of evidence-based medicine was a direct response to the era of:

• a. Compounding pharmacy
• b. Unproven therapies like patent medicines.
• c. Clinical pharmacy
• d. Managed care

Answer: b. Unproven therapies like patent medicines.

28. What is the primary difference between historical compounding and modern compounding?

• a. There is no difference.
• b. Modern compounding is subject to strict quality standards (e.g., USP chapters) and regulations.
• c. Historical compounding used more effective ingredients.
• d. Modern compounding does not use a mortar and pestle.

Answer: b. Modern compounding is subject to strict quality standards (e.g., USP chapters) and regulations.

29. The process of reducing particle size by mixing a powder with a small amount of liquid in which the solid is not soluble is called:

• a. Trituration
• b. Levigation
• c. Sublimation
• d. Precipitation

Answer: b. Levigation

30. An “elixir” was a common dosage form for patent medicines because:

• a. It was a sweetened hydroalcoholic solution that could dissolve ingredients and mask unpleasant tastes.
• b. It was non-alcoholic.
• c. It was a solid tablet.
• d. It was for external use only.

Answer: a. It was a sweetened hydroalcoholic solution that could dissolve ingredients and mask unpleasant tastes.

31. Understanding the history of patent medicines helps a modern pharmacist to:

• a. Appreciate the importance of the FDA and drug regulation.
• b. Critically evaluate the claims of modern dietary supplements.
• c. Understand the public’s historical desire for self-care remedies.
• d. All of the above.

Answer: d. All of the above.

32. The apothecary system of measurement used units like:

• a. Grams and milligrams
• b. Milliliters and liters
• c. Grains, scruples, and drams
• d. Inches and feet

Answer: c. Grains, scruples, and drams

33. The transition from the compounding era to the “count and pour” era was driven by:

• a. The clinical pharmacy movement.
• b. The mass production of prefabricated dosage forms by the pharmaceutical industry.
• c. A shortage of pharmacists.
• d. Stricter laws against compounding.

Answer: b. The mass production of prefabricated dosage forms by the pharmaceutical industry.

34. The “Muckrakers” were early 20th-century journalists who:

• a. Promoted the use of patent medicines.
• b. Exposed the dangerous ingredients and fraudulent claims of the patent medicine industry.
• c. Worked for pharmaceutical companies.
• d. Were a type of pharmacist.

Answer: b. Exposed the dangerous ingredients and fraudulent claims of the patent medicine industry.

35. A “counter” in an old apothecary was not just for transactions but also served as the primary workspace for:

• a. Compounding prescriptions.
• b. Storing patient records.
• c. Eating lunch.
• d. Taking naps.

Answer: a. Compounding prescriptions.

36. Before standardized glassware, pharmacists often used equipment with poor accuracy, leading to variability in compounded products.

• a. True
• b. False

Answer: a. True

37. Which of the following is a reason why a patient might have been drawn to a patent medicine?

• a. Distrust of conventional physicians.
• b. The high cost of seeing a doctor.
• c. Persuasive advertising.
• d. All of the above.

Answer: d. All of the above.

38. The legacy of patent medicines can be seen today in the marketing of some:

• a. Prescription drugs
• b. Medical devices
• c. Dietary supplements and herbal remedies
• d. Intravenous fluids

Answer: c. Dietary supplements and herbal remedies

39. A historical “tincture” is a medicinal extract where the solvent is:

• a. Water
• b. Oil
• c. Alcohol
• d. Vinegar

Answer: c. Alcohol

40. The evolution of pharmacy tools from manual pill rollers to automated dispensing machines reflects:

• a. A decline in the profession.
• b. A shift in the pharmacist’s role from a preparer of medicines to a manager of medication therapy.
• c. The fact that pharmacists are no longer needed.
• d. A decrease in the number of available medications.

Answer: b. A shift in the pharmacist’s role from a preparer of medicines to a manager of medication therapy.

41. The symbol of the mortar and pestle is still used by many pharmacies today to represent:

• a. Their connection to the historical roots of the profession.
• b. That they only sell compounded medications.
• c. That they sell gardening supplies.
• d. That they are a new pharmacy.

Answer: a. Their connection to the historical roots of the profession.

42. The problems with patent medicines highlighted the need for what core principle in healthcare?

• a. The need for strong marketing.
• b. The need for evidence-based practice.
• c. The need for more secret formulas.
• d. The need for fewer regulations.

Answer: b. The need for evidence-based practice.

43. A historical “counting tray” was a simple tool designed to:

• a. Mix ointments.
• b. Help a pharmacist accurately count tablets or capsules without touching them by hand.
• c. Weigh powders.
• d. Measure liquids.

Answer: b. Help a pharmacist accurately count tablets or capsules without touching them by hand.

44. What is a key difference between a modern OTC product and a 19th-century patent medicine?

• a. Modern OTCs have undergone FDA review for safety and efficacy for their labeled indications.
• b. Patent medicines were more effective.
• c. There is no difference.
• d. Modern OTCs do not have labels.

Answer: a. Modern OTCs have undergone FDA review for safety and efficacy for their labeled indications.

45. A “cachet” was a historical dosage form consisting of:

• a. A liquid elixir.
• b. A hard, molded lozenge.
• c. A small, sealed disc made of wafer paper, used to enclose a dose of a bad-tasting powder.
• d. An injectable solution.

Answer: c. A small, sealed disc made of wafer paper, used to enclose a dose of a bad-tasting powder.

46. The study of the history of pharmacy provides context for the profession’s emphasis on:

• a. Patient safety
• b. Ethics
• c. Regulation
• d. All of the above

Answer: d. All of the above

47. A pharmacist today recommending an unproven herbal supplement with exaggerated claims could be compared to:

• a. A modern clinical pharmacist.
• b. A historical patent medicine vendor.
• c. A pharmaceutical researcher.
• d. A hospital administrator.

Answer: b. A historical patent medicine vendor.

48. Glass prescription bottles from the 19th century often had what feature?

• a. A child-resistant cap.
• b. A unique shape or color to distinguish poisons from regular medicines.
• c. A printed barcode.
• d. A built-in dose measuring cup.

Answer: b. A unique shape or color to distinguish poisons from regular medicines.

49. The development from manual pill rolling to automated tablet presses allowed for:

• a. Mass production and dose uniformity.
• b. Less effective medications.
• c. An increase in the need for compounding.
• d. More pharmacists to be hired for manufacturing.

Answer: a. Mass production and dose uniformity.

50. The ultimate lesson from the era of patent medicines for a modern pharmacist is the importance of:

• a. Good marketing.
• b. Selling as many products as possible.
• c. Protecting the public through evidence-based recommendations and ethical practice.
• d. Keeping your formulas a secret.

Answer: c. Protecting the public through evidence-based recommendations and ethical practice.