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NMC CBT·MEDICINES-MANAGEMENT · Module 5: Medicines Management and Pharmacology·UnitMEDICINES-MANAGEMENT · Unit 03Access: Premium

Unit 5.3: Drug Classifications and Common Medicines

Prepare for Unit 5.3: Drug Classifications and Common Medicines with NMC CBT practice questions covering 4 topics. Part of Module 5: Medicines Management and Pharmacology — build your knowledge and track your progress with NMC Prep.

Questions
141
Topics
4
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What’s in it.

4 topics
  • Topic 01

    Analgesics and Pain Management

    42 questions
  • Topic 02

    Antibiotics

    36 questions
  • Topic 03

    Cardiovascular Drugs

    33 questions
  • Topic 04

    Respiratory, Psychiatric, and Diabetic Drugs

    30 questions

Sample questions

3 of many

A few questions from this unit, with the answer and a full explanation. The complete bank is available when you start practising.

  1. A patient with severe COPD on Trelegy Ellipta develops a COPD exacerbation with a chest X-ray showing new right lower lobe consolidation consistent with pneumonia. What ICS-related risk does this illustrate, and what management step should be considered?

    • The ICS component of Trelegy should be permanently discontinued in COPD patients following any pneumonia episode
    • ICS in COPD increase the risk of pneumonia; the ICS component of Trelegy should be reviewed, and the patient should receive appropriate antibiotics and systemic steroids for the exacerbation
      Correct answer
    • The LABA component of Trelegy, not the ICS, is responsible for the increased pneumonia risk in COPD
    • ICS have no association with pneumonia risk; the consolidation is coincidental and unrelated to Trelegy use
    Explanation

    Multiple large randomised controlled trials (TORCH, INSPIRE, SUMMIT) and meta-analyses have demonstrated that ICS use in COPD significantly increases the risk of pneumonia. This is a known risk-benefit consideration acknowledged in NICE NG115, BNF, and the product SPC for ICS-containing COPD inhalers.

    Following a pneumonia episode, the clinical team should review whether ICS is still indicated (particularly if exacerbation frequency is low). Acute management includes antibiotics, systemic corticosteroids, and bronchodilators. ICS should not be abruptly stopped without clinical review.

  2. Which ARB is commonly prescribed for heart failure with reduced ejection fraction as an alternative to ACE inhibitors?

    • Spironolactone
    • Bisoprolol
    • Amlodipine
    • Candesartan
      Correct answer
    Explanation

    Candesartan (and valsartan) are ARBs that have evidence for reducing mortality and morbidity in heart failure with reduced ejection fraction (HFrEF), making them appropriate alternatives when ACE inhibitors are not tolerated (typically due to cough). The CHARM trial established candesartan's benefit in HFrEF.

    Amlodipine is a calcium channel blocker; spironolactone is an aldosterone antagonist; furosemide is a loop diuretic; bisoprolol is a beta blocker; digoxin is a cardiac glycoside.

  3. Which LABA has a fast enough onset of action to also be used as a reliever inhaler in MART therapy?

    • Ipratropium
    • Salmeterol
    • Formoterol (eformoterol)
      Correct answer
    • Tiotropium
    Explanation

    Formoterol (eformoterol) has a faster onset of action than salmeterol (within 1–3 minutes vs 10–20 minutes), making it suitable for use as both a maintenance and reliever inhaler in MART (Maintenance And Reliever Therapy). In MART, a single budesonide/formoterol inhaler provides both regular preventive ICS/LABA therapy and on-demand reliever bronchodilation, reducing over-reliance on separate SABA inhalers.

    Salmeterol, tiotropium, and vilanterol are longer-acting agents not suitable as relievers.