MCQ Quiz: Pharmaceutical Incompatibilities

Pharmaceutical incompatibilities are undesirable reactions that can occur when mixing drug substances and excipients, potentially affecting the safety, efficacy, and appearance of a formulation. For B.Pharm students, mastering the ability to identify, prevent, and correct physical, chemical, and therapeutic incompatibilities is a fundamental aspect of compounding and dispensing. This quiz will test your knowledge of this critical subject, which is essential for ensuring patient safety.


  1. A pharmaceutical incompatibility is an unintended reaction between two or more components of a prescription that results in an undesirable:
    • Therapeutic effect
    • Product
    • Cost
    • Flavor
    Answer: Product
  2. Which of the following is a primary classification of pharmaceutical incompatibilities?
    • Physical
    • Chemical
    • Therapeutic
    • All of the above
    Answer: All of the above
  3. The formation of a liquid when two solid substances are mixed together is an example of:
    • Precipitation
    • Immiscibility
    • A eutectic mixture
    • Hydrolysis
    Answer: A eutectic mixture
  4. When the action of one drug is opposed by another drug, it is known as:
    • Synergism
    • Potentiation
    • Antagonism
    • Addition
    Answer: Antagonism
  5. The mixing of oil and water, which results in two separate layers, is a classic example of:
    • Insolubility
    • Immiscibility
    • Precipitation
    • Liquefaction
    Answer: Immiscibility
  6. An incompatibility that involves a chemical reaction, resulting in the formation of new chemical compounds, is a:
    • Physical incompatibility
    • Chemical incompatibility
    • Therapeutic incompatibility
    • Intentional incompatibility
    Answer: Chemical incompatibility
  7. Prescribing a drug to which a patient is allergic is an example of:
    • Physical incompatibility
    • Chemical incompatibility
    • Therapeutic incompatibility
    • A eutectic mixture
    Answer: Therapeutic incompatibility
  8. The precipitation of an alkaloidal salt from an aqueous solution upon the addition of an alkaline substance is a common example of:
    • A physical incompatibility
    • A chemical incompatibility
    • A therapeutic incompatibility
    • An intended reaction
    Answer: A chemical incompatibility
  9. How can the liquefaction of a eutectic mixture be prevented?
    • By heating the mixture
    • By mixing the components with an inert adsorbent powder separately
    • By adding more water
    • By storing it in a humid place
    Answer: By mixing the components with an inert adsorbent powder separately
  10. A change in the physical state, such as solubility or appearance, without a change in chemical structure is a ______ incompatibility.
    • physical
    • chemical
    • therapeutic
    • pharmacological
    Answer: physical
  11. The evolution of carbon dioxide gas when carbonates or bicarbonates are mixed with an acidic substance is a:
    • Physical incompatibility
    • Chemical incompatibility
    • Therapeutic incompatibility
    • Desirable reaction
    Answer: Chemical incompatibility
  12. What is the first step a pharmacist should take upon detecting a therapeutic incompatibility?
    • Dispense the prescription as written
    • Modify the prescription without consultation
    • Contact the prescriber for clarification or correction
    • Inform the patient that the prescription is invalid
    Answer: Contact the prescriber for clarification or correction
  13. “Salting out,” the precipitation of a substance from a solution by the addition of an electrolyte, is a type of:
    • Chemical incompatibility
    • Therapeutic incompatibility
    • Physical incompatibility
    • Redox reaction
    Answer: Physical incompatibility
  14. Oxidation-reduction (redox) reactions are a common cause of:
    • Physical incompatibility
    • Chemical incompatibility
    • Therapeutic incompatibility
    • Immiscibility
    Answer: Chemical incompatibility
  15. A prescription for a tetracycline antibiotic with an antacid containing calcium is an example of a potential:
    • Physical incompatibility (eutectic)
    • Chemical incompatibility (color change)
    • Therapeutic incompatibility (decreased absorption)
    • Physical incompatibility (immiscibility)
    Answer: Therapeutic incompatibility (decreased absorption)
  16. Insolubility of a prescribed drug in the vehicle is an example of:
    • Physical incompatibility
    • Chemical incompatibility
    • Therapeutic incompatibility
    • A contraindicated drug
    Answer: Physical incompatibility
  17. A color change in a formulation due to a chemical reaction indicates a(n) ______ incompatibility.
    • physical
    • chemical
    • therapeutic
    • acceptable
    Answer: chemical
  18. An error in the dosage regimen, such as prescribing an overdose, is considered a:
    • Physical incompatibility
    • Chemical incompatibility
    • Therapeutic incompatibility
    • Formulation error
    Answer: Therapeutic incompatibility
  19. How can the precipitation of a resinous tincture when added to water be prevented?
    • By adding the tincture very slowly to the water with vigorous stirring
    • By heating the water
    • By adding an acid
    • By adding salt
    Answer: By adding the tincture very slowly to the water with vigorous stirring
  20. Hydrolysis is a chemical reaction involving the breakdown of a substance by:
    • Air
    • Light
    • Water
    • An enzyme
    Answer: Water
  21. Which of the following would NOT be considered a pharmaceutical incompatibility?
    • A change in the color of a solution over time
    • The formation of a precipitate when two solutions are mixed
    • A patient experiencing an expected side effect at a normal dose
    • The liquefaction of a powder mixture
    Answer: A patient experiencing an expected side effect at a normal dose
  22. The use of amber-colored bottles is a common method to prevent which type of chemical incompatibility?
    • Hydrolysis
    • Oxidation
    • Photochemical degradation
    • Acid-base reaction
    Answer: Photochemical degradation
  23. The combination of two drugs leading to a greater effect than the sum of their individual effects is known as:
    • Antagonism
    • Synergism
    • Tolerance
    • Idiosyncrasy
    Answer: Synergism
  24. Which of the following is a physical incompatibility?
    • A drug overdose
    • A drug-drug interaction
    • Insolubility
    • A redox reaction
    Answer: Insolubility
  25. The formation of an insoluble precipitate when solutions of lead acetate and zinc sulfate are mixed is due to a:
    • Physical change
    • Double decomposition reaction
    • Eutectic mixture
    • Redox reaction
    Answer: Double decomposition reaction
  26. What is the most common reason for therapeutic incompatibility?
    • The pharmacist’s error
    • An error in the prescription by the prescriber
    • The patient not following instructions
    • The drug being expired
    Answer: An error in the prescription by the prescriber
  27. Altering the order of mixing is a common way to correct some ______ incompatibilities.
    • physical
    • chemical
    • therapeutic
    • all
    Answer: physical
  28. The use of antioxidants like ascorbic acid can prevent:
    • Hydrolysis
    • Oxidation
    • Precipitation
    • Eutectic formation
    Answer: Oxidation
  29. Which of the following is a classic example of a eutectic mixture?
    • Camphor and menthol
    • Sodium chloride and water
    • Oil and water
    • Aspirin and antacid
    Answer: Camphor and menthol
  30. A prescription containing contraindicated drugs is a type of ______ incompatibility.
    • physical
    • chemical
    • therapeutic
    • procedural
    Answer: therapeutic
  31. Adding a suspending agent can be a correction for which incompatibility?
    • Immiscibility of two liquids
    • Insolubility of a solid in a liquid
    • A chemical reaction
    • A drug overdose
    Answer: Insolubility of a solid in a liquid
  32. A change in the consistency of an ointment or cream upon mixing ingredients is a ______ incompatibility.
    • physical
    • chemical
    • therapeutic
    • dosage
    Answer: physical
  33. A chemical incompatibility that has been adjusted for by the pharmacist (e.g., by changing a component after consulting the prescriber) is sometimes called a(n):
    • Absolute incompatibility
    • Tolerated incompatibility
    • Adjusted incompatibility
    • Unavoidable incompatibility
    Answer: Adjusted incompatibility
  34. Prescribing the wrong drug for a particular disease is a form of ______ incompatibility.
    • physical
    • chemical
    • therapeutic
    • formulation
    Answer: therapeutic
  35. The reaction between an oxidizing agent (like KMnO₄) and a reducing agent (like glycerin) is a ______ incompatibility.
    • physical
    • chemical
    • therapeutic
    • intentional
    Answer: chemical
  36. Which of the following is a physical incompatibility?
    • Adsorption of a drug onto the container
    • A drug-drug interaction
    • An incorrect dose
    • An allergic reaction
    Answer: Adsorption of a drug onto the container
  37. The use of a chelating agent like EDTA can prevent chemical incompatibilities caused by:
    • Light
    • Air
    • Trace metal ions
    • Water
    Answer: Trace metal ions
  38. The separation of an emulsion into two distinct layers is a type of ______ incompatibility.
    • physical
    • chemical
    • therapeutic
    • intentional
    Answer: physical
  39. Which of these is NOT a method for correcting a chemical incompatibility?
    • Changing the solvent
    • Using a different salt form of the drug
    • Adding a buffering agent
    • Adding a suspending agent
    Answer: Adding a suspending agent
  40. A pharmacist is responsible for detecting and resolving which types of incompatibilities?
    • Physical and Chemical
    • Therapeutic
    • Both A and B
    • None of the above
    Answer: Both A and B
  41. The interaction between two prescribed drugs is a type of:
    • Physical incompatibility
    • Chemical incompatibility
    • Therapeutic incompatibility
    • Formulation incompatibility
    Answer: Therapeutic incompatibility
  42. Adding an emulsifying agent is a method to correct the incompatibility of:
    • Two immiscible liquids
    • Two eutectic solids
    • An insoluble solid in a liquid
    • An acid and a base
    Answer: Two immiscible liquids
  43. A precipitate forms due to a pH change. This is best described as a(n):
    • Physicochemical incompatibility
    • Therapeutic incompatibility
    • Absolute incompatibility
    • Drug-drug interaction
    Answer: Physicochemical incompatibility
  44. Which is a common outcome of a chemical incompatibility?
    • Improved therapeutic effect
    • Loss of drug potency
    • Increased solubility
    • A more elegant preparation
    Answer: Loss of drug potency
  45. The presence of both synergism and antagonism falls under which category of incompatibility?
    • Physical
    • Chemical
    • Therapeutic
    • Formulation
    Answer: Therapeutic
  46. How is the incompatibility of an insoluble powder in a liquid vehicle typically handled?
    • By adding an emulsifier
    • By adding a suspending agent to form a suspension
    • By changing the drug
    • By heating the liquid
    Answer: By adding a suspending agent to form a suspension
  47. The term “tolerated” incompatibility refers to a reaction where:
    • The prescription is dispensed as is, despite the reaction.
    • The chemical reaction is minimized by altering the mixing order, but not completely eliminated.
    • The prescriber is contacted to change the drug.
    • The patient tolerates the side effects.
    Answer: The chemical reaction is minimized by altering the mixing order, but not completely eliminated.
  48. Which of the following best describes a physical incompatibility?
    • It is always visible to the naked eye.
    • It involves the formation of a new molecule.
    • It is a change that is undesirable but does not involve a chemical reaction.
    • It only occurs in liquid dosage forms.
    Answer: It is a change that is undesirable but does not involve a chemical reaction.
  49. A prescription for a solution of strychnine hydrochloride (an alkaloidal salt) and aromatic spirit of ammonia (alkaline) would result in:
    • A eutectic mixture
    • Precipitation of the free strychnine base
    • A synergistic therapeutic effect
    • A clear, stable solution
    Answer: Precipitation of the free strychnine base
  50. The ultimate responsibility for identifying and resolving incompatibilities before dispensing rests with the:
    • Patient
    • Prescriber
    • Pharmacist
    • Nurse
    Answer: Pharmacist

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