Nasal and pulmonary routes – advantages and challenges MCQs With Answer

Introduction

Understanding nasal and pulmonary drug delivery is essential for B.Pharm students, as these routes offer rapid systemic absorption, non-invasive administration, and first-pass metabolism avoidance. This introduction covers advantages — fast onset, high bioavailability, targeted local therapy, and reduced systemic side effects — and challenges such as mucociliary clearance, enzymatic degradation, particle deposition, formulation stability, and device-dependent dose variability. Key concepts include anatomy and physiology of nasal and pulmonary regions, absorption mechanisms, particle size (MMAD), aerosol generation devices (MDIs, DPIs, nebulizers), and strategies like mucoadhesives or permeation enhancers. Mastery of these topics prepares you for formulation design and clinical application. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which of the following is a primary advantage of nasal delivery over oral delivery for systemic drugs?

• Avoidance of first-pass hepatic metabolism
• Longer drug half-life
• Guaranteed drug targeting to the lungs
• Increased gastric stability

Correct Answer: Avoidance of first-pass hepatic metabolism

Q2. The Mass Median Aerodynamic Diameter (MMAD) most directly influences which pulmonary deposition mechanism?

• Diffusion in the alveoli
• Inertial impaction in upper airways
• Systemic absorption through nasal mucosa
• Enzymatic degradation rate

Correct Answer: Inertial impaction in upper airways

Q3. Which particle size range (MMAD) is optimal for alveolar deposition and systemic absorption via the lungs?

• >10 µm
• 5–10 µm
• 1–5 µm
• <0.1 µm

Correct Answer: 1–5 µm

Q4. Mucociliary clearance primarily affects which route of administration?

• Intravenous
• Dermal
• Nasal
• Oral

Correct Answer: Nasal

Q5. Which formulation strategy can increase nasal residence time and improve absorption?

• Use of volatile solvents
• Addition of mucoadhesive polymers
• Decreasing formulation viscosity
• Reducing osmolarity drastically

Correct Answer: Addition of mucoadhesive polymers

Q6. Which device type is most appropriate for delivering a dry powder formulation to the lungs?

• Metered dose inhaler (MDI)
• Dry powder inhaler (DPI)
• Jet nebulizer
• Syringe pump

Correct Answer: Dry powder inhaler (DPI)

Q7. Which lung region provides the largest surface area for systemic absorption of inhaled drugs?

• Nasal vestibule
• Trachea
• Bronchi
• Alveolar region

Correct Answer: Alveolar region

Q8. Which barrier is most significant for drug transport across the nasal epithelium?

• Stratum corneum
• Tight junctions between epithelial cells
• Basement membrane calcification
• Keratinized squamous layer

Correct Answer: Tight junctions between epithelial cells

Q9. Which mechanism dominates deposition of submicron aerosol particles (<0.5 µm) in the lungs?

• Inertial impaction
• Gravitational sedimentation
• Brownian diffusion
• Electrostatic attraction

Correct Answer: Brownian diffusion

Q10. Which of the following is a major enzymatic challenge for peptide drugs delivered intranasally?

• Cytochrome P450 oxidation
• Proteolytic degradation by nasal peptidases
• Glucuronidation in nasal mucosa
• Phosphorylation by kinases

Correct Answer: Proteolytic degradation by nasal peptidases

Q11. Which excipient type is commonly used as a permeation enhancer in nasal formulations?

• Chitosan
• Paraffin oil
• Sodium chloride at hyperosmotic levels
• Polyethylene glycol 4000

Correct Answer: Chitosan

Q12. For delivery of vaccines via the nasal route, which immune tissue is most relevant for inducing mucosal immunity?

• Waldeyer’s tonsillar ring
• Peyer’s patches
• NALT (nasal-associated lymphoid tissue)
• Bronchus-associated lymphoid tissue (BALT)

Correct Answer: NALT (nasal-associated lymphoid tissue)

Q13. Which factor most strongly affects dose variability with patient-operated inhalers?

• Color of the inhaler
• Inspiratory flow rate and technique
• Ambient humidity only
• Manufacturer location

Correct Answer: Inspiratory flow rate and technique

Q14. Lipid-based nanoparticles for pulmonary delivery primarily help to:

• Increase mucociliary clearance
• Enhance drug stability and control release
• Ensure drug binds irreversibly to macrophages
• Convert drug to gaseous form

Correct Answer: Enhance drug stability and control release

Q15. Which adverse outcome is a specific safety concern for pulmonary delivery of particulate formulations?

• Hepatotoxicity due to first-pass metabolism
• Alveolar macrophage overload leading to inflammation
• Gastrointestinal ulceration
• Renal tubular necrosis

Correct Answer: Alveolar macrophage overload leading to inflammation

Q16. A hygroscopic powder used in DPI formulations can lead to which stability issue?

• Improved aerosolization in humid environments
• Moisture uptake, particle agglomeration, and poor dispersibility
• Immediate chemical inertness
• Conversion to liquid aerosol without device

Correct Answer: Moisture uptake, particle agglomeration, and poor dispersibility

Q17. Which measurement describes the spread of particle aerodynamic sizes in an aerosol?

• MMAD only
• Geometric Standard Deviation (GSD)
• pH value
• Viscosity

Correct Answer: Geometric Standard Deviation (GSD)

Q18. Which statement about intranasal insulin delivery is correct?

• It bypasses the blood-brain barrier completely for CNS delivery
• It can offer rapid systemic absorption and potential nose-to-brain transport
• It replaces the need for any inhalation device
• It has no enzymatic or clearance barriers in the nasal cavity

Correct Answer: It can offer rapid systemic absorption and potential nose-to-brain transport

Q19. Which parameter is NOT typically critical when designing a nasal spray formulation?

• Spray pattern and plume geometry
• pH and osmolarity
• Melting point of the active ingredient
• Viscosity and droplet size distribution

Correct Answer: Melting point of the active ingredient

Q20. Which clearance mechanism is more relevant in the deep lung (alveolar) than in the nasal cavity?

• Mucociliary clearance
• Phagocytosis by alveolar macrophages
• Rapid epithelial enzymatic degradation
• Swallowing and GI absorption

Correct Answer: Phagocytosis by alveolar macrophages

Q21. Which physical property of aerosol droplets strongly influences upper airway deposition?

• Surface charge only
• Droplet diameter
• Color of formulation
• Boiling point of solvent

Correct Answer: Droplet diameter

Q22. Which regulatory challenge is unique to inhalation therapeutics compared to oral tablets?

• Bioequivalence assessment based on device performance and particle characterization
• Requirement for color stability data
• Mandatory transdermal absorption studies
• Single-dose pharmacokinetic testing only

Correct Answer: Bioequivalence assessment based on device performance and particle characterization

Q23. Which approach can reduce enzymatic degradation of peptides administered nasally?

• Adding protease inhibitors or using enzyme-resistant analogs
• Increasing room temperature storage
• Decreasing formulation viscosity to near zero
• Using hypertonic saline only

Correct Answer: Adding protease inhibitors or using enzyme-resistant analogs

Q24. Which statement about nebulizers is correct?

• Nebulizers always produce monodisperse aerosols
• Nebulizers can deliver large volumes and are useful for poorly soluble drugs
• Nebulizers eliminate the need to consider particle size
• Nebulizers are unsuitable for pediatric patients

Correct Answer: Nebulizers can deliver large volumes and are useful for poorly soluble drugs

Q25. Which property of nasal mucosa facilitates direct nose-to-brain delivery?

• Presence of olfactory epithelium and associated neuronal pathways
• High degree of keratinization preventing transport
• Absence of lymphoid tissue
• Continuous mucus layer without cell junctions

Correct Answer: Presence of olfactory epithelium and associated neuronal pathways

Q26. In DPI design, why are carrier particles like lactose commonly used?

• To chemically react with drug and form new compound
• To improve powder flow and disperse fine drug particles during inhalation
• To increase hygroscopicity intentionally
• To reduce aerodynamic diameter of drug particles below 0.1 µm

Correct Answer: To improve powder flow and disperse fine drug particles during inhalation

Q27. Which inhalation parameter increases peripheral (deep lung) deposition of aerosol particles?

• Rapid, forceful exhalation
• Slow, deep inhalation with breath-hold
• Short shallow breaths only
• Holding the inhaler horizontally

Correct Answer: Slow, deep inhalation with breath-hold

Q28. Which challenge is specific to nasal sprays containing preservatives like benzalkonium chloride?

• They enhance permeation without safety concerns
• Potential to cause local irritation and disrupt epithelial integrity over time
• Complete prevention of microbial growth without toxicity
• Guaranteed increase in systemic absorption

Correct Answer: Potential to cause local irritation and disrupt epithelial integrity over time

Q29. Which of the following best describes transcytosis as a pulmonary absorption pathway?

• Passive diffusion through tight junctions
• Active transport through ion channels only
• Vesicle-mediated transport across epithelial cells
• Immediate enzymatic degradation in mucosa

Correct Answer: Vesicle-mediated transport across epithelial cells

Q30. When formulating an inhaled corticosteroid for asthma, which combination is most desirable?

• Large particle size, high mucociliary clearance, low lung retention
• Optimal MMAD for bronchial deposition, low systemic bioavailability, minimal local irritation
• Highly hygroscopic particles that agglomerate in device
• Strong protease activity in formulation to degrade drug

Correct Answer: Optimal MMAD for bronchial deposition, low systemic bioavailability, minimal local irritation

G S Sachin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.

Mail- Sachin@pharmacyfreak.com