MCQ Quiz: Pulmonary Drug Delivery

Pulmonary drug delivery enables targeted drug deposition in the respiratory tract for rapid onset and enhanced efficacy, especially in respiratory diseases like asthma and COPD. It also serves as a non-invasive route for systemic drug delivery. This quiz explores devices, formulation science, lung anatomy, pharmacokinetics, and patient counseling—tailored for Pharm.D. students.

1. Pulmonary drug delivery involves administration through the:

  • A. Oral cavity
  • B. Skin
  • C. Nasal or oral route into the lungs
  • D. Rectum
    Correct answer: C. Nasal or oral route into the lungs

2. The primary advantage of pulmonary drug delivery is:

  • A. Slow onset
  • B. Avoidance of systemic effects
  • C. Rapid onset and localized action
  • D. High hepatic metabolism
    Correct answer: C. Rapid onset and localized action

3. Which device is used for delivering aerosols in pulmonary therapy?

  • A. Nebulizer
  • B. Oral syringe
  • C. Patch
  • D. Capsule
    Correct answer: A. Nebulizer

4. Which is a dry powder inhaler (DPI)?

  • A. Diskus
  • B. MDI with spacer
  • C. Nebulizer
  • D. Soft mist inhaler
    Correct answer: A. Diskus

5. The particle size ideal for alveolar deposition is:

  • A. >20 µm
  • B. 10–15 µm
  • C. 1–5 µm
  • D. <0.5 µm
    Correct answer: C. 1–5 µm

6. The main site for gas exchange and drug absorption in the lungs is the:

  • A. Trachea
  • B. Bronchi
  • C. Alveoli
  • D. Bronchioles
    Correct answer: C. Alveoli

7. Which condition is commonly treated with inhaled corticosteroids?

  • A. Hypertension
  • B. Asthma
  • C. Diabetes
  • D. Pneumonia
    Correct answer: B. Asthma

8. Which of the following is a metered-dose inhaler (MDI)?

  • A. Respimat
  • B. ProAir HFA
  • C. Diskhaler
  • D. Accuhaler
    Correct answer: B. ProAir HFA

9. Spacer devices are used with MDIs to:

  • A. Reduce absorption
  • B. Increase dose variability
  • C. Improve deposition in the lungs and reduce oropharyngeal deposition
  • D. Enhance taste
    Correct answer: C. Improve deposition in the lungs and reduce oropharyngeal deposition

10. What is a key formulation challenge in pulmonary drug delivery?

  • A. Rapid GI metabolism
  • B. Small surface area
  • C. Achieving proper particle size for deep lung delivery
  • D. Rapid hepatic clearance
    Correct answer: C. Achieving proper particle size for deep lung delivery

11. Pulmonary delivery avoids:

  • A. Pulmonary circulation
  • B. First-pass hepatic metabolism
  • C. Respiratory tract absorption
  • D. Oxygen transport
    Correct answer: B. First-pass hepatic metabolism

12. Which drug is commonly used as a bronchodilator in inhalers?

  • A. Hydrocortisone
  • B. Albuterol
  • C. Penicillin
  • D. Ibuprofen
    Correct answer: B. Albuterol

13. Nebulizers are preferred in:

  • A. Oral medication therapy
  • B. Patients with poor inhalation coordination
  • C. Pediatric IV therapy
  • D. Transdermal drug delivery
    Correct answer: B. Patients with poor inhalation coordination

14. Soft mist inhalers (SMIs) deliver drugs:

  • A. As a powder
  • B. Via injection
  • C. As a slow-moving aerosol cloud
  • D. Orally
    Correct answer: C. As a slow-moving aerosol cloud

15. Which of the following improves drug solubility in inhalation aerosols?

  • A. Surfactants
  • B. Sodium chloride
  • C. Lactose
  • D. Ethanol
    Correct answer: A. Surfactants

16. A DPI requires the patient to:

  • A. Shake before use
  • B. Use a spacer
  • C. Inhale forcefully and deeply
  • D. Insert an IV
    Correct answer: C. Inhale forcefully and deeply

17. The respiratory epithelium acts as a barrier and:

  • A. Enhances taste
  • B. Stimulates absorption
  • C. Has mucociliary clearance to remove particles
  • D. Blocks oxygen
    Correct answer: C. Has mucociliary clearance to remove particles

18. The pH of pulmonary fluids is typically:

  • A. 2–3
  • B. 7–8
  • C. 4–5
  • D. 1–2
    Correct answer: B. 7–8

19. A primary systemic drug delivered by pulmonary route is:

  • A. Naloxone
  • B. Salbutamol
  • C. Insulin
  • D. Atorvastatin
    Correct answer: C. Insulin

20. Inhalation route is advantageous for peptide drugs because it:

  • A. Requires oral dissolution
  • B. Destroys proteins
  • C. Avoids GI degradation
  • D. Enhances taste
    Correct answer: C. Avoids GI degradation

21. Pulmonary route is not ideal for:

  • A. Rapid action
  • B. Local drug effect
  • C. Unstable drugs in air
  • D. Systemic delivery of insulin
    Correct answer: C. Unstable drugs in air

22. The role of propellants in MDIs is to:

  • A. Add flavor
  • B. Create pressure and deliver the drug as aerosol
  • C. Enhance stability
  • D. Prevent coughing
    Correct answer: B. Create pressure and deliver the drug as aerosol

23. Breath-actuated inhalers are beneficial for:

  • A. Older adults only
  • B. Reducing coordination problems
  • C. Children with seizures
  • D. Delivering IM injections
    Correct answer: B. Reducing coordination problems

24. Inhaled anticholinergics like tiotropium are used in:

  • A. COPD
  • B. Glaucoma
  • C. Parkinson’s disease
  • D. Hypertension
    Correct answer: A. COPD

25. Inhalation therapy improves therapeutic index by:

  • A. Increasing dose frequency
  • B. Targeting the lungs directly and reducing systemic exposure
  • C. Decreasing potency
  • D. Enhancing taste
    Correct answer: B. Targeting the lungs directly and reducing systemic exposure

26. The onset of action for inhaled albuterol is usually within:

  • A. 5 seconds
  • B. 1 minute
  • C. 15–20 minutes
  • D. 2 hours
    Correct answer: B. 1 minute

27. Large aerosol particles (>10 µm) are mostly deposited in the:

  • A. Alveoli
  • B. Bronchioles
  • C. Oropharynx
  • D. Capillaries
    Correct answer: C. Oropharynx

28. Hygroscopic carriers in DPIs are used to:

  • A. Color the drug
  • B. Prevent dosing
  • C. Absorb moisture and protect particles
  • D. Cause sneezing
    Correct answer: C. Absorb moisture and protect particles

29. Inhaled corticosteroids can cause:

  • A. Hepatitis
  • B. Oral candidiasis
  • C. Hair growth
  • D. Constipation
    Correct answer: B. Oral candidiasis

30. Which of the following is NOT an advantage of pulmonary delivery?

  • A. Needle-free delivery
  • B. Large surface area for absorption
  • C. Bypasses hepatic metabolism
  • D. Consistent bioavailability for all drugs
    Correct answer: D. Consistent bioavailability for all drugs

31. Spacers are especially useful in:

  • A. Reducing lung deposition
  • B. Children and elderly with coordination issues
  • C. DPIs
  • D. Nebulizer setups
    Correct answer: B. Children and elderly with coordination issues

32. What is a soft mist inhaler (SMI) example?

  • A. Turbuhaler
  • B. Respimat
  • C. Diskus
  • D. Accuhaler
    Correct answer: B. Respimat

33. Inhaled amphotericin B is used to treat:

  • A. Fungal lung infections
  • B. Viral hepatitis
  • C. Malaria
  • D. Ringworm
    Correct answer: A. Fungal lung infections

34. Inhalation route can be used for systemic diseases such as:

  • A. Hyperlipidemia
  • B. Diabetes (via insulin)
  • C. Bone disorders
  • D. Arthritis
    Correct answer: B. Diabetes (via insulin)

35. Which patient should NOT use a DPI?

  • A. An athlete
  • B. An elderly with weak inspiratory flow
  • C. A healthy adult
  • D. A child over 10
    Correct answer: B. An elderly with weak inspiratory flow

36. What is the primary function of lactose in DPIs?

  • A. Act as a preservative
  • B. Provide moisture
  • C. Serve as a carrier for drug particles
  • D. Enhance taste
    Correct answer: C. Serve as a carrier for drug particles

37. What should patients do after using inhaled corticosteroids?

  • A. Eat spicy food
  • B. Use a decongestant
  • C. Rinse mouth to prevent thrush
  • D. Take a nap
    Correct answer: C. Rinse mouth to prevent thrush

38. Which inhaler delivers a fine mist without using propellants?

  • A. MDI
  • B. DPI
  • C. SMI
  • D. Syringe
    Correct answer: C. SMI

39. The total surface area of lungs for drug absorption is approximately:

  • A. 0.5 m²
  • B. 1 m²
  • C. 70–100 m²
  • D. 200 m²
    Correct answer: C. 70–100 m²

40. Inhaled nitric oxide is primarily used in:

  • A. COPD
  • B. Neonatal pulmonary hypertension
  • C. Asthma
  • D. TB
    Correct answer: B. Neonatal pulmonary hypertension

41. Exubera was an inhaled form of:

  • A. Salbutamol
  • B. Cortisone
  • C. Insulin
  • D. Morphine
    Correct answer: C. Insulin

42. Which factor affects DPI performance?

  • A. Room lighting
  • B. Inhalation flow rate
  • C. Skin color
  • D. Lipid solubility
    Correct answer: B. Inhalation flow rate

43. Which type of inhaler requires shaking before use?

  • A. DPI
  • B. SMI
  • C. MDI
  • D. Nebulizer
    Correct answer: C. MDI

44. The term “actuation” in inhalers refers to:

  • A. Taste masking
  • B. Dose measurement
  • C. Device cleaning
  • D. Releasing a dose of medication
    Correct answer: D. Releasing a dose of medication

45. Ultimately, pulmonary drug delivery aims to:

  • A. Reduce lung function
  • B. Deliver drugs effectively to respiratory tract for local or systemic use with minimal side effects
  • C. Avoid oxygen absorption
  • D. Replace nasal therapy
    Correct answer: B. Deliver drugs effectively to respiratory tract for local or systemic use with minimal side effects

46. Which technique improves drug deposition in the lower lungs during inhalation?

  • A. Shallow breathing
  • B. Holding breath after inhalation
  • C. Exhaling quickly
  • D. Sneezing after dosing
    Correct answer: B. Holding breath after inhalation

47. Inhaled antibiotics like tobramycin are commonly used for which condition?

  • A. Hypertension
  • B. Cystic fibrosis
  • C. Influenza
  • D. Tuberculosis
    Correct answer: B. Cystic fibrosis

48. What is the role of surfactants in pulmonary formulations?

  • A. Enhance nasal drainage
  • B. Improve taste
  • C. Reduce surface tension and improve drug dispersion
  • D. Increase hepatic clearance
    Correct answer: C. Reduce surface tension and improve drug dispersion

49. Which pulmonary condition may impair inhaled drug absorption due to mucus overproduction?

  • A. Epilepsy
  • B. Chronic bronchitis
  • C. GERD
  • D. Hypothyroidism
    Correct answer: B. Chronic bronchitis

50. Nebulizers convert liquid medication into:

  • A. Capsules
  • B. Creams
  • C. Fine mist or aerosol
  • D. Gels
    Correct answer: C. Fine mist or aerosol

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