P.O.

Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

1. A 6 years old boy has been sent by his father to yor phamarcy /dispensing unit with a prescription
where by the doctor has prescribed Captopril tab. 25mg od 2/52 will you give the medicine to the
child? Give reasons
2. After a critical diagnosis at your hospital, Mr. Kamu was found severely infected with Treponema
Palidum. The head of therapeutic committee called you to help in suggesting a proper medication for
this patient. Which medication, dose, dosage & duration would you advise the physicians to prescribe
to Mr. Kamu?
3. You have cephalexin, cefadroxil, cephadrine,cefuroxime and cefotaxime on hand and Anicetha is
chronically suffering from Escherichia Coli. Which drug among those would you opt to issue her?
What other advice will you provide her with?
4. The following biochemical substances are responsible for inhibition of which enzymes? Vancomycin,
Cloxacillin, Flucloxacillin, Clavulanic acid
5. Carbidopa is responsible for inhibition of which enzyme?
6. Why is Acetyl salicylic acid not recommended in Asthmatic patients and children below 12 years?
a. A pregnant woman with UTI comes to you with a prescription where by a doctor has
prescribed ciprofloxacin 500mg bd for five days. Explain the action you will take and
reason(s) for the action taken
b. A patient comes to with a prescription for amoxicillin. After calculating you confirm that 30
capsules are needed. And the total price for the medicine is 8000 shillings but the patient

By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

informs you that she only has 1500 shillings and requests for half-a dose. Describe the action
you will take
c. Mikeprosper is three years and 10kg body weight. Mike is suffering from UTI and the doctor
has ordered Amoxycillin syrup 20mg/kg tds for 1/52. 1 bottle contains 100mls. The strength
of the syrup is 5mls/125mg. Calculate the dose in ml. how many bottles will you dispense?

7. A seventeen years girl comes to your dispensing unit asking for Misoprostol which she Claims She
wants for peptic ulcers for her grandmother. Will you provide her with the medicine? If No, why?
8. Madam Simpifana came to your dispensing unit with a prescription containing Metformin 1000mg bd
30/7. As you were issuing her tablets she told you that usually she experiences sensations of
numbness, tingling and burning as well throbbing pain. What do you think was her problem and how
could you have helped her?

9. Mrs. Paul just experienced excessive bleeding immediately after giving birth. You had two drugs on
hand, Aspirin and Tranexamic Acid. Which one would you use to manage the condition? Explain the
reason for your choice. Apart from the drug you have chosen what other drugs can be used to manage
the situation?
10. On a prescription issued to Kalimanzira; the following regimen was prescribed; Inj. Ampicillin 500mg
+ inj. Gentamycin 80mg od 3/7. Which kind of infection do you think Kalimanzira was suffering

By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

from? Why do you think ampicillin was combined with gentamycin? Apart from Gentamycin what
other substances could bring about the same effect? Mention 3 common side effects of Gentamycin?
11. A 19 years old student on treatment with penicillin suddenly suffered from penicillin allergic reaction.
Taking into account that she was to be cured immediately what other alternative would you have
provided?
12. Jarife’s prescription contained Zidovudine/Lamivudine + Nevirapine as well as Co-trimoxazole
960mg bd 30/7. Not only that but also it contained Fluconazole 150mg od 30/7. Explain why Co-
trimoxazole and Fluconazole tabs were prescribed to him. On continous adimistration of co-
trimoxazole, Jarife is likely to suffer from what side effects? As a pharmaceutical personnel, how
would do you have helped him to overcome such side-effects?
13. What happens when you dispense oral contraceptives to a woman who is on first line anti-TB drugs?
14. What advice will you give to a patient taking paracetamol for headache but on the hand he wants also
to take alcohol so that he cannot feel more pain? Give a scientific justification for your

15. What are the procedures you will explain to the patient/guardian when dispensing Cephalexin powder
for suspension?
16. Explain how disulfirum like reaction occurs
a) Mention 10 manifestations which occur during disulfirum like reaction.
b) Mention five drugs from different groups which may cause disulfirum like reaction when
concomitantly administered with alcohol.

By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

17. What antibacterial agents can also be effective to Plasmodium species?

18. Martina is now on treatment with medication X. she suddenly starts to experience Atrial fibrillation,
Arrythimias, irregular pulse, loss of appetite, Nausea, vomiting, diarrhea, blurred vision and
confusion. What do you think was the source of her problem? How do you call this phenomenon?
How do you manage such a situation?
19. Griseofulvine can concomitantly be administered with Milk unlike tetracycline. Explain the
pharmacological reason behind this.
20. Why is a person taking grieofulvin advised not to stay on direct sunlight?
21. Why does a person taking chlorpheniramine maleate experience drowsiness?
22. a patient comes to the pharmacy asking for help on how to use her metered dose inhaler (mdi) for
acute asthma. describe to this patient five (5) steps involved in using the device

By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

23. You have learnt that patients with co-morbidity of heart failure and bronchial asthma
cannot be treated with Propranolol even though this drug would be very helpful in patients
with heart failure. Explain why so?
24. Kamanga is chronically hypertensive. He started taking antihypertensive drugs 6 years
ago. One time, he came to your pharmacy complaining of swollen knee, ankle, foot joints
characterized with redness, severe pain which suddenly come at night. What specifically
was his problem? What is the possible cause of his problem? What best drugs would fit
this problem? What would you advise him after issuing him the medication?
25. From the knowledge you have acquired during your pharmacological studies and other
experience in the course of practical training. explain how type II diabetes mellitus is
treated in a pregnant woman

26. Explain how you can manage TB in the following groups; Pregnant women, breastfeeding
women, People with renal failure/disease, Liver failure/disease, HIV positive patients,
women taking oral contraceptives and Babies of mothers with PTB

27. It is typical of HIV positive patients to suffer from Genital warts, Post-Herpetic Neuralgia
and Herpes Zoster. Explain how you would help such patients

28. There is a famous drug known as Augmentin which has frequently been used in treatment
of chronic infections. State why this drug is in combination. What components make up
this drug combination?

29.
Exptain why methotraxate when used as anticancer may cause anemia and
a. State how this condition can be avoided

By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

30. Occasionaly a pharmacist dispenses a drug to a patient with Parkinsonism syndrome.

Explain why you don't give these patients dopamine therapy even though the disease is
caused by dopamine insufficiency?

31. A pregnant mother came to your pharmacy with a prescription which requires her to be
provided with tetracycline tabs. Would you dispense the medicine to her? If no/yes
why?

32. Canis is on her 3rd trimester of pregnancy but highly uncomfortable due to her problem
of Osteoporosis and peptic ulcers as she highly complains of stomach pain. After
visiting your hospital she was provided with the following prescription

Misoprostol 200mcg bd 15/7

Aspirin 600mg tds 5/7
Relcer gel 10ml tds 5/7
Vitamin D/Ca2+ supplements 1tab od 4/52

Comment on this prescription and provide the way forward if any.

By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

33. Antimicrobial resistance is currently a burning issue, which contributes to high rate
morbidity and mortality especially in Tanzania: clearly describe common practices in
hospital and pharmacy settings which contribute to antimicrobial resistance. And
clearly describe the ways on which this can be prevented.
34. Which ART regimen is effective in the management of Hepatitis B?

35. A diabetic patient was issued with the following prescription

Tabs. Metformin 500mg od 30/7

Tabs. NAT B, 1tab od 30/7

Why do you think NAT B was issued to this patient?

36. A pregnant mother came complaining of fatigue. Palpitation, dizziness, glositis,

koilonychia (spoon shaped nails) and pica (eating soil, chalk e.t.c). On diagnosis it was
found that the mother had Iron deficiency Anemia.
a) What is the normal range of Hb in pregnant women?
b) What drug could be used in management of her case?
c) What are the side effects of the drug above?
d) What food/diet could you advise the patient above to take?
37. You are a pharmaceutical personnel at Buhongwa district Hospital and appointed to
educate Misungwi residents on the alarming hypertension, what are the preventive
measures would you recommend them to take?

38. A patient with peptic ulcer is prescribed with Aspirin for 3 days. What instructions would
you give the patient?

39. A pregnant woman (Mrs. Eligadi) aged 28 years had been admitted at the hospital and
diagnosed with uncomplicated malaria,
40. What medicines are used in treatment of malaria in pregnancy during first, second and
third trimester?

By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

41. If she is anaemic with Hb10.6g/dl. What medicines and dosage will be given to her to
correct the problem?

42. The prescription below belongs to Antia, who is hardly struggling not to conceive
because of her confidential reasons.

i. Comment on the prescription

Makolongo referral Hospital
Antia Barana
Tabs COCS 1tab od 30/7
Tabs RHZE od 30/7
Dr. Davidson MMari

43. A customer visited your community pharmacy at 10:00am with a prescription requiring
him to be provided with Arthemether Lumefantrine tablets. On enquiry you found that
she was pregnant in her third trimester and her weight was 49kg.
a. Provide instructions to the client on how to take her medicine
b. What other advice will you give the patient?
44. Mariam came to your pharmacy while complaining of change in the colour of stool,
saliva, skin, urine, saliva, teeth and skin; stinging and numbness. After interviewing her
you revealed that she was on her RHZE regimen. What do you think was the problem and
how would you have assisted her?
45. Kokutona visted your hospital while complaining of dizziness and severe headache.
After diagnosis her Hb level was found to be 9.0g/dl. After interviewing her you
revealed that she was on her first line ARV regimen with zidovudine/Lamivudine +
Efavirenz. What do you think was the cause of the probem? How would you have
managed the situation?
46. In 2003 ponsian was provided with RHZE treatment regimen due to his problem of
TB. After 6 months he was totally cured. Later on he started suffering from the same
disease. Explain how you would have managed the situation.

By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

47. A 2 years old child is brought to the hospital by his grandma. His mother died last year
With AIDS. The child was diagnosed HIV positive 2 months ago. His CD4 wass less
than 20%. Weight 12kg and height 1 meter.
a. What ART regimen would you give?
b. What is the ART regimen for children 3 years old and above?
48. Through the prescription, List the errors and missing contents

Makoko Health Centre

Shehe 3 years
Tab ciprofloxacin 1300mg qid x 1/52
Dr. Innocent Koka

49. A known alcoholic patient was dispensed with Metronidazole on management of

Amoebic dysentery. Two days after he came complaining of nausea. Severe vomiting
flushing, dizziness and general hangover
a) What might have caused this?
b) How could this have been prevented?
50. Mr. Jacob Steven presented with the prescription with; Rx Metronidazole 1200mg start
then 200mg tds 7/7.
a) What does 1200mg dose indicate?
b) Why was this dose given?
51. Mrs. Donald presented with the prescriptions with; Rx Methylprednisolone 20mg bd for
the first week. Then 10mg bd for the second week followed by 5mg bd for one week.
a. What is the name of this approach/practice?
b. Why was this done?
52. Anna Joachim a 20 year-old student came to your pharmacy complaining of burning or
stinging Sensation when passing urine (dysuria) and she visits the toilet much more
frequently and soo you referred to her to the hospital for further check-up. She returns the
next day with a prescription with Augmentin (Amoxycillin (500 mg) + Clavulanic Acid
(125 mg) orally every 12 hours for 7 days for Urinary Tract Infection (UTI).
a. What are THERAPEUTIC implications of two combinations?
b. What other advice would you offer Anna to avoid future recurrence?
53. Steven Shundi, a 30 years Old boy was dispensed with Ampiclox caps in hospital
pharmacy and instructed to take them on empty stomach or at least one hour before or 2

By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

hours after a meal. Explain why he was recommended this instruction. What other
instructions could you give?
54. Artemether/Lumefantrine is the first line regimen in management of uncomplicated
malaria. Why are these drugs combined in a single formulation?
55. It is not advised to use nonsteroidal antinflammatory drugs like Aspirin, Ibuprofen,
Diclofenac, etc in management of Dengue fever. Why?
56. A patient came complaining of (muscular pain, headache, rash, myalgia, anorexia,
nausea and abdominal pain. On series of test it was revealed that the patient had
Dengue fever. As a pharmaceutical personnel at the health center, what could be your
advice on treatment of Dengue fever?

a. A 7 months pregnant mother came to your pharmacy with the following

prescription; Rx Quinine 600mg tds 1/52. Will you dispense the medicine? If
YES/NO why?
57. Give the reason why Quinine is contraindicated in pregnant mother at third trimester.
58. Write a first recommended dosage regimen for the treatment of HIV/AIDS and as per
STG
59. During the pharmacy week you have been given a chance to educate the society on the
management of Malaria. And on your presentation you clearly state that malaria should
be treated immediately to avoid complications that might result when the disease is not
treated. What are those complications that you will point out (point out at least 7
complications).
60. A 20 years old patient presented to you the prescription with Ciprofloxacin 100mg tds
5/7'? Will you dispense the drug? If no/yes why?
61. Mr. Rajab visited the pharmacy with Rx Ampicillin and Cloxacillin caps 500mg tds 5/7.
a. What is the ratio of the two drugs in this combination and what is the reason of
this combination.
62. For archiving a total eradication of Helicobacter Pylori; the drugs for management of
peptic ulcers are combined in the kit called H. pylori kit. List all the drugs included in
this kit
63. Mrs. Benson presented a child of 10 years with 24hrs history of vomiting and diarrhea
to her physician and came to your pharmacy with prescription with five Sachets of ORS
and pedzinc sulphate 20mg od 2/52
a) The letters ORS stand for what?
By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

b) Describe the ORS reconstitution instruction to Mrs. Benson

c) What is the rationale of including zinc sulfate in this therapy?
64. You are in the village and you lack access to ORS; what alternative way can you employ
to prepare such a preparation as you are looking for further treatment.
65. Julio is suffering from hemorrhoids and his physician prescribed Anusol suppository to
be inserted nocte for 7/7 what instruction will provide to this patient in the course of
dispensing?
66. Mr. Karungu is a newly discovered asthmatic patient and present the prescription with
Salbutamol inhaler two puff od. Explain to Mr. Karungu important steps on the proper
use of the device

67. A 33-years-old man is diagnosed with essential hypertension. He is provided with the
following medication (Hydrochlothiazide and Propranolol) and later on he started
experiencing wheezing. Shortness of breath, chest tightness and cough. On medical
checkup it was diagnosed that he is asthmatic and the attack was moderate.
a) As a hospital pharmacist what appropriate medicine would you
advice to manage his Asthma?
b) Do you need to change the
dosage regime of his blood pressure? If yes why?
68. Joanitha is a 20 years old patient who experienced light headedness and nausea therefore
she decided to go to Mawenzi hospital for a medical checkup. After a series of tests it
was determined that she was one month pregnant and had an unusual low CD4 count.
Due to this; a series of other tests was conducted and confirmed that Joanitha was
already HIV positive.
a. As a medication expert at Mawenzi Hospital, discuss the measures that need to
be taken right after the tests have been done mentioning any drugs if any and
what is supposed to be done after Joanitha delivers her baby.
69. A pregnant mother on her first trimester was diagnosed and foung to be malaria positive.
She was admitted and given quinine as infusion.
a. Why intravenous administration of quinine should be as an infusion?
b. Which type of infusion do we use when administering quinine and why?
c. What happens when quinine is administered directly in the vein (intravenously)?

By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

d. Why do you think this mother was given quinine and not Artesunate injection?
70. In management of Parkinson’s disease. Levodopa is co-administered with Carbidopa.
Why?
71. During wound dressing of a patient who was HIV positive, accidently Doto was cut with
the blade. Suddenly she lost hope and she was totally depressed. As a pharmaceutical
personnel, how would you have helped her?
72. Why Verapamil is contraindicated in patients with heart failure?
73. Mention out two (2) advantages of combining Artemether and Lumefantrine in
management of Malaria.
74. Mention three (3) Artemisinin based combination therapies (ACTs) approved for
treatment of P. Falciparum Malaria
75. Why is advised to administer lumefantrine with high fat meal?
76. Mention dosage ratio of Artemether/Lumefåntrine and Dihydroartemisinin and
piperaquine
77. Why do we need to consider dose tapering when using corticosteroid (eg. Prednisolone).
78. Why Aminoglycoside antibiotics are not used by oral route?
79. Give reasons why the following drug are administered to patient with an anaphylactic
shock?
a) Adrenaline injection
b) Methyl prednisolone
80. Give at least three (3) difference between adverse drug reaction (ADRs and side effects
of drug
81. A Pregnant woman was admitted with severe hypertension at regional hospital. Mention
at least two drugs that are appropriate in management of her case
82. Prof. is taking warfarin at a dose of 3mg daily. As he started using cimetidine for
stomach ulcer his warfarin dose was lowered to 2mg daily. After three months his ulcer
healed and cimetidine was stopped.
a) Why was the warfarin dose lowered to 2mg?
b) Suppose Prof must continue using warfarin after his ulcers healed; will
the
c) Will the dose remain 2mg? If Yes/No, why?
D) Suppose there was an overdose of warfarin to Prof. How would you
have helped him?

By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

83. Mr. Bakari S Bakari visited your pharmacy while complaining of wound problems
caused by accidental hoe-cut during cultivation. Having told you that, he requested for
the treatment advice
a) What vaccine would you advice him to take?
b) Mr. Bakari needs to get a vaccine within how many hours from the
time of accident?
c) How many doses and dosage intervals for the mentioned vaccine
should he get?
d) How is it handled in hospital pharmacy?
84. After being in bad terms with her boyfriend, Sanlovia was presented to you in the
pharmacy and complained that she had taken the poison and the package indicated that it
was rat poison with warfarin active ingredient.
a) Define antidote
b) What is the antidote for poison above
c) In the absence of the antidote above would activated charcoal be helpful? How
does it work?
85. Kayanga, a 17 years old girl was brought to the emergency department while
unconscious and on the interrogations the relative presented Paracetamol box found in
her bag suggesting that she attempted to commit suicide due conflicts with her boyfriend.
a) What is the antidote for the poison above?
b) What organ is mostly likely to be affected?
86. Mr. January J Illigo visited your Pharmacy while complaining of snake bite as he was
working in the farm.
a) What first aid can you provide?
b) What product would you use to antagonize that poison?
c) What is the side effect of the product above?
d) How is it handled in the hospital phamarcy?
87. you are in Mabogini Pharmacy Moshi and you come across a male guy who presents to
you a piece of paper written sildenafil (kamagra) 100mg with 10000 tsh folded in it;
a) What are the indications of sildenafil?
b) What are the side-effects of this drug?
c) What are the contraindications of sildenafil?
d) Would you dispense this drug? IF YES/NO why?
By: LB & HB
 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

e) Apart from Sildenafil what other drug can bring about the same effect?

88. A 28 years – old married female wishes to use oral birth control pills and her physician
prescribed her with 0.03mg ethinylestradiol and 0.15 mg levonorgestrel
a) When do you advice her to start taking pills
b) What is the contraindication for all birth control pills?
c) What does the difference in pills color indicates?
d) Postcoital contraception ‘morning- after- pill” work within how
many hours after unprotected sexual intercource.

89. A 60 years hypertensive patient on Nifedipin, Captopril and Atenolol visited clinic with
mild dry cough. On examinations the findings showed that there was no connection of
her dry cough with asthma, respiratory infection allergy, or worms.
a) What do you think is the cause of her dry cough?
b) If her problem was medicine induced; briefly explain how does
that medicine cause dry cough?
90.Please; provide the required information in the box below
1 Condition drug Dose & Duration
dosage
Severe malaria in
1 non pregnant
women in the
first trimester
Severe malaria in
2 pregnant women
in the last
trimester
Intermittent
3 preventive
therapy
Uncomplicated
4 malaria in a male
adult
5 Complicated
malaria in non
pregnant women

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 P.O. Box 7633, MOSHI, Tanzania

Tel: +255-27-2755170 | Email: springinstitutebs@gmail.com

91. A 56 year old man is admitted to the intensive care unit (ICU) after a B-blocker
overdose. after the administration of 2L of 0.9% of sodium Chloride and 3g of calcium
gluconate ,his vital signs are as follows:BP70/40mmHg, HR 52beats/minute and RR
22breaths/minutes.
a. Identify the appropriate antidotes for the mentioned overdose.
b. Explain the mechanism of action of each antidote you mentioned.
92. Cleary explain the proper management of patient with the following drug toxicity
antidotes is inclusive
a. Antihistamines
b. Antimicrobials
c. Vitamins
d. Sedatives/hypnotics/antipsychotics
e. Antidepressants
f. Digoxin
93. Outline at least ten (10) agents for which activated charcoal is not recommended.
94. What is the difference between toxin and toxicant
95. Draw a dose response curve where chemical A is more efficacious and potent than
chemical B.
96. What are the two main classifications of dose response relationships; what are the
differences?

By: LB & HB