Vaginal drug delivery offers both localized treatment and systemic absorption with partial avoidance of first-pass hepatic metabolism. It is used for managing infections, providing contraception, and delivering hormone replacement therapy. Dosage forms include vaginal tablets, creams, suppositories (pessaries), gels, rings, and foams. This MCQ quiz explores formulation characteristics, anatomical considerations, pharmacokinetics, and clinical applications essential for Pharm.D. students.
1. Vaginal drug delivery is commonly used for:
- A. Asthma therapy
- B. Skin conditions
- C. Infections, contraception, and hormone delivery
- D. Cardiac arrest
Correct answer: C. Infections, contraception, and hormone delivery
2. Which of the following is a vaginal dosage form?
- A. Syrup
- B. Suppository (pessary)
- C. Tablet for swallowing
- D. Inhaler
Correct answer: B. Suppository (pessary)
3. What is an advantage of vaginal drug delivery?
- A. Avoids local action
- B. Causes gastric irritation
- C. Bypasses partial first-pass metabolism
- D. Slower onset of action
Correct answer: C. Bypasses partial first-pass metabolism
4. Which dosage form is inserted vaginally and releases drug over weeks or months?
- A. Ring
- B. Foam
- C. Cream
- D. Lotion
Correct answer: A. Ring
5. Vaginal tablets typically dissolve and release drug through:
- A. The liver
- B. Vaginal fluid
- C. Stomach acid
- D. Lung alveoli
Correct answer: B. Vaginal fluid
6. The vaginal route is especially useful for:
- A. Immediate brain delivery
- B. Avoiding all metabolism
- C. Local treatment with minimal systemic exposure
- D. Targeting heart tissue
Correct answer: C. Local treatment with minimal systemic exposure
7. Which of the following is a common condition treated via vaginal drug delivery?
- A. Hypertension
- B. Vaginal candidiasis
- C. Diabetes
- D. Liver cirrhosis
Correct answer: B. Vaginal candidiasis
8. A pessary is a:
- A. Vaginal ring
- B. Vaginal tablet or suppository
- C. Transdermal patch
- D. Rectal formulation
Correct answer: B. Vaginal tablet or suppository
9. Which hormone is commonly delivered through vaginal rings?
- A. Testosterone
- B. Cortisol
- C. Estrogen
- D. Thyroxine
Correct answer: C. Estrogen
10. What is a key advantage of vaginal gels?
- A. Inability to coat tissues
- B. Quick expulsion
- C. Good spreadability and retention
- D. No mucoadhesion
Correct answer: C. Good spreadability and retention
11. Vaginal foams are typically used for:
- A. Bone density management
- B. Contraception
- C. Pain relief
- D. Muscle relaxation
Correct answer: B. Contraception
12. Which of the following can influence vaginal drug absorption?
- A. Ambient temperature
- B. Menstrual cycle phase
- C. Food intake
- D. Liver enzymes
Correct answer: B. Menstrual cycle phase
13. The ideal pH of a vaginal formulation for infection control is:
- A. 3.5–4.5
- B. 6.5–8.0
- C. 9.0–10.5
- D. 1.0–2.0
Correct answer: A. 3.5–4.5
14. Which vaginal formulation is designed for extended drug release and long-term use?
- A. Cream
- B. Tablet
- C. Ring
- D. Foam
Correct answer: C. Ring
15. The vaginal mucosa has which type of epithelial lining?
- A. Simple columnar
- B. Stratified squamous non-keratinized
- C. Cuboidal
- D. Ciliated columnar
Correct answer: B. Stratified squamous non-keratinized
16. A disadvantage of vaginal drug delivery is:
- A. First-pass metabolism
- B. Invasiveness and patient discomfort
- C. Rapid onset of action
- D. High accuracy
Correct answer: B. Invasiveness and patient discomfort
17. Vaginal rings are typically made from:
- A. Metal
- B. Polymers such as silicone or ethylene vinyl acetate
- C. Glass
- D. Cotton
Correct answer: B. Polymers such as silicone or ethylene vinyl acetate
18. Which type of release is seen in most vaginal rings?
- A. Delayed
- B. Immediate
- C. Sustained
- D. None
Correct answer: C. Sustained
19. Vaginal creams are useful for:
- A. Bone disorders
- B. Localized symptoms like itching or dryness
- C. Asthma
- D. Hypertension
Correct answer: B. Localized symptoms like itching or dryness
20. Which of the following is a limitation of vaginal dosage forms?
- A. Ease of application
- B. Local irritation or leakage
- C. Sustained delivery
- D. Avoidance of enzymes
Correct answer: B. Local irritation or leakage
21. Vaginal drug delivery is unsuitable for:
- A. Hormone therapy
- B. Local infection treatment
- C. Large-molecule biologics
- D. Contraception
Correct answer: C. Large-molecule biologics
22. Which dosage form provides both lubrication and drug delivery?
- A. Suppository
- B. Foam
- C. Cream
- D. Enema
Correct answer: C. Cream
23. Which hormone therapy product is available as a vaginal tablet?
- A. Levothyroxine
- B. Estradiol
- C. Insulin
- D. Cortisol
Correct answer: B. Estradiol
24. Mucoadhesive vaginal formulations aim to:
- A. Increase systemic metabolism
- B. Shorten residence time
- C. Improve contact and retention on mucosal surfaces
- D. Reduce viscosity
Correct answer: C. Improve contact and retention on mucosal surfaces
25. Which factor can influence residence time of vaginal formulations?
- A. Sunlight
- B. Vaginal discharge or menstrual flow
- C. Age
- D. Air exposure
Correct answer: B. Vaginal discharge or menstrual flow
26. Which drug delivery method offers highest patient adherence?
- A. Daily vaginal tablets
- B. Weekly vaginal creams
- C. Monthly vaginal rings
- D. Daily foams
Correct answer: C. Monthly vaginal rings
27. Vaginal tablets are usually:
- A. Sugar-coated
- B. Enteric-coated
- C. Uncoated and fast dissolving
- D. Made of gelatin
Correct answer: C. Uncoated and fast dissolving
28. The systemic absorption from vaginal mucosa is enhanced by:
- A. Hydrophobic drug design
- B. Highly ionized compounds
- C. Lipophilic, low molecular weight drugs
- D. Sugar coating
Correct answer: C. Lipophilic, low molecular weight drugs
29. Which statement is true about vaginal rings?
- A. They are removed and replaced daily
- B. They offer burst release
- C. They can provide contraception for up to one month
- D. They dissolve completely
Correct answer: C. They can provide contraception for up to one month
30. Which excipient enhances vaginal drug residence time?
- A. Ethanol
- B. Glycerin
- C. Carbopol
- D. Water
Correct answer: C. Carbopol
31. Vaginal delivery avoids first-pass metabolism through the:
- A. Stomach
- B. Colon
- C. Rectal route
- D. Vaginal venous plexus
Correct answer: D. Vaginal venous plexus
32. One reason for contraceptive failure in vaginal delivery is:
- A. High potency
- B. Premature expulsion
- C. Slow dissolution
- D. Large molecular size
Correct answer: B. Premature expulsion
33. Vaginal drug delivery is especially suitable for:
- A. Continuous protein infusions
- B. Rapid systemic effects in local disorders
- C. Oral insulin delivery
- D. Anticoagulants
Correct answer: B. Rapid systemic effects in local disorders
34. Vaginal pH in reproductive-aged women is typically:
- A. 2–3
- B. 3.5–4.5
- C. 6–7
- D. >8
Correct answer: B. 3.5–4.5
35. The shelf life of vaginal rings depends on:
- A. Color only
- B. Polymer matrix and storage conditions
- C. Humidity alone
- D. Ring shape
Correct answer: B. Polymer matrix and storage conditions
36. Which of the following is a progestin vaginal ring?
- A. NuvaRing
- B. Implanon
- C. Mirena
- D. Depo-Provera
Correct answer: A. NuvaRing
37. The vaginal route is preferred over oral for some drugs because:
- A. It requires a hospital setting
- B. It enhances hepatic metabolism
- C. It allows local treatment with lower doses
- D. It is less invasive
Correct answer: C. It allows local treatment with lower doses
38. A vaginal douche is:
- A. A contraceptive
- B. A cleansing solution
- C. A suppository
- D. A gel
Correct answer: B. A cleansing solution
39. Vaginal tablets are inserted using:
- A. An oral dropper
- B. An applicator
- C. A needle
- D. A pill cutter
Correct answer: B. An applicator
40. What is the most appropriate counseling for vaginal ring users?
- A. Insert ring only before intercourse
- B. Do not remove even during menstruation
- C. Store in the freezer
- D. Swallow with water
Correct answer: B. Do not remove even during menstruation
41. Common patient concern with vaginal dosage forms is:
- A. Delayed onset
- B. Odor and leakage
- C. Rapid absorption
- D. No systemic absorption
Correct answer: B. Odor and leakage
42. Which of the following drugs is NOT suitable for vaginal delivery?
- A. Estradiol
- B. Clotrimazole
- C. Heparin
- D. Progesterone
Correct answer: C. Heparin
43. Which formulation may provide both antimicrobial and spermicide action?
- A. Vaginal ring
- B. Vaginal gel
- C. Foam containing nonoxynol-9
- D. Cream with estriol
Correct answer: C. Foam containing nonoxynol-9
44. A challenge in vaginal drug formulation is:
- A. Excess saliva
- B. Rapid drug metabolism
- C. Variable absorption due to pH and secretions
- D. Small mucosal surface
Correct answer: C. Variable absorption due to pH and secretions
45. Ultimately, vaginal drug delivery is used to:
- A. Replace IV therapy
- B. Deliver large peptide hormones
- C. Provide localized treatment and systemic absorption with partial hepatic bypass
- D. Avoid local effects
Correct answer: C. Provide localized treatment and systemic absorption with partial hepatic bypass
46. Which of the following vaginal dosage forms is typically designed for single-dose use and rapid action?
- A. Vaginal ring
- B. Suppository
- C. Foam
- D. Vaginal tablet
Correct answer: C. Foam
47. Patient counseling for vaginal suppositories should include:
- A. Avoid refrigeration
- B. Insert while standing
- C. Use at bedtime to reduce leakage
- D. Chew before insertion
Correct answer: C. Use at bedtime to reduce leakage
48. What feature of the vaginal route allows for systemic absorption of some medications?
- A. Thick keratinized epithelium
- B. Rich vascularization and large surface area
- C. Acidic stomach environment
- D. Enzyme activity in saliva
Correct answer: B. Rich vascularization and large surface area
49. Which factor does NOT typically affect vaginal drug absorption?
- A. Vaginal pH
- B. Presence of infection
- C. Menstrual cycle
- D. Drug’s color
Correct answer: D. Drug’s color
50. The ultimate goal of vaginal formulations is to:
- A. Achieve muscle relaxation
- B. Improve taste of medication
- C. Provide targeted therapy with minimal systemic effects
- D. Promote pulmonary excretion
Correct answer: C. Provide targeted therapy with minimal systemic effects