🚀 Mostly Medicine is in free beta — every feature unlocked. We’d love your feedback as we iterate.

AMC MCQ · Pharmacology

AMC Pharmacology MCQ Practice — 150+ Questions for IMGs

Prescribing, drug interactions, PBS rules and SafeScript — AMC MCQ pharmacology MCQs for IMGs.

185 questions in the full bank · 5 free samples below · Spaced repetition + AI explanations on the free tier.

Unlock full Pharmacology bankAll specialties

Why Pharmacology matters in AMC MCQ

Pharmacology contributes 6–8 questions to AMC MCQ, with a uniquely Australian flavour: PBS authority criteria, SafeScript real-time prescription monitoring, S8 controlled drug regulations, and the Australian Medicines Handbook (AMH) recommendations all feature heavily. IMGs trained outside Australia commonly underestimate this domain.

Mostly Medicine’s pharmacology bank is mapped to the AMH, Therapeutic Guidelines, and the PBS Schedule. You’ll practise items on opioid prescribing under SafeScript, anticoagulant choice and reversal, paediatric dosing, pregnancy/lactation drug categories, drug interactions (warfarin + macrolide, SSRIs + tramadol, MAOI + tyramine), and adverse drug reaction reporting via the TGA.

AMC pharmacology vignettes typically present a patient on a polypharmacy regimen with a new symptom, then ask which medication is most likely responsible or what to substitute. Practising 150+ Australian-aligned pharmacology MCQs is the fastest path to mastery. Sign up free to unlock the full bank.

5 free Pharmacology sample MCQs

Below are five sample questions taken straight from the Mostly Medicine pharmacology bank. The correct answer is highlighted, with the worked explanation tucked inside a collapsed panel so you can self-test first.

Question 1Prescribing · medium

A 75-year-old man is prescribed gentamicin for Gram-negative bacteraemia. He has CKD (eGFR 28). Which parameter requires adjustment for aminoglycosides in renal impairment?

  1. A.Increase the dose to compensate for poor absorption
  2. B.Extend the dosing interval (reduce frequency)Correct
  3. C.Halve the dose and maintain normal frequency
  4. D.Aminoglycosides are absolutely contraindicated in CKD
  5. E.No adjustment needed — gentamicin is hepatically metabolised
Show explanation

Aminoglycosides (gentamicin, tobramycin): renally cleared, nephrotoxic and ototoxic. In renal impairment: extend dosing interval (same peak dose, longer interval — maintains bactericidal peak while allowing trough to fall). Once-daily dosing (Hartford protocol) preferred. Monitor levels: pre-dose trough <1 mg/L, post-dose peak 8–10 mg/L for once-daily. Avoid with other nephrotoxins.

Question 2Drug Interactions · hard

A 60-year-old man on warfarin (INR 2.8) is started on clarithromycin for a chest infection. He returns 5 days later with gum bleeding and INR 6.2. What is the mechanism?

  1. A.Clarithromycin is a potent CYP3A4 inhibitor — reduces warfarin metabolism → ↑INRCorrect
  2. B.Clarithromycin is a CYP3A4 inducer — increases warfarin metabolism → should have ↓INR
  3. C.Clarithromycin displaces warfarin from protein binding
  4. D.Clarithromycin kills gut bacteria → reduces vitamin K production
  5. E.Clarithromycin has intrinsic anticoagulant properties
Show explanation

Warfarin is metabolised by CYP2C9 (mainly) and CYP3A4. Clarithromycin (macrolide) inhibits CYP3A4 → reduced warfarin metabolism → ↑plasma levels → supratherapeutic INR. Also reduces gut flora (vitamin K). Management: close INR monitoring when adding any CYP inhibitor/inducer to warfarin. Strong CYP2C9 inhibitors: fluconazole, amiodarone, metronidazole, trimethoprim. P-glycoprotein inhibitors also increase DOACs.

Question 3Drug Interactions · medium

A 45-year-old woman on sertraline 100 mg/day is started on tramadol for back pain. Which serious drug interaction should be warned about?

  1. A.Tramadol reduces sertraline absorption
  2. B.Serotonin syndrome — tremor, hyperthermia, agitation, clonus, diarrhoeaCorrect
  3. C.QT prolongation only
  4. D.Reduced analgesic effect of tramadol
  5. E.Increased bleeding risk
Show explanation

Serotonin syndrome: tramadol (weak SNRI + weak opioid agonist) + SSRI → excess serotonergic activity. Features: triad of cognitive changes (agitation, confusion), neuromuscular abnormalities (clonus, hyperreflexia, tremor), and autonomic instability (hyperthermia, tachycardia, diaphoresis). Severe: life-threatening hyperthermia, seizures. Distinguish from NMS (onset hours vs days, clonus vs rigidity). Treatment: stop offending drugs, cyproheptadine, benzodiazepines.

Question 4Adverse Effects · hard

A 55-year-old man on amiodarone for AF develops a dry cough, progressive dyspnoea, and bilateral reticular infiltrates on CXR. PFTs show a restrictive pattern with reduced DLCO. What is the diagnosis?

  1. A.ACE inhibitor cough — switch to ARB
  2. B.Amiodarone pulmonary toxicity — stop amiodaroneCorrect
  3. C.Heart failure exacerbation — increase diuretics
  4. D.IPF — start pirfenidone
  5. E.Amiodarone-induced hypothyroidism
Show explanation

Amiodarone toxicities (HELP mnemonic): Hepatic (↑LFTs), Eyes (corneal microdeposits), Lungs (pulmonary toxicity - serious, 5%), Pigmentation (grey-blue skin), thyroid (hypo or hyperthyroidism). Pulmonary toxicity: bilateral infiltrates, restrictive PFTs, low DLCO, ↑KL-6. Stop amiodarone; steroids if severe. Amiodarone has many interactions — inhibits CYP2C9 (↑warfarin), P-gp (↑digoxin). Long half-life (40–55 days) — toxicity may persist after stopping.

Question 5Medication Review · easy

A 78-year-old woman is on amlodipine, metoprolol, aspirin, simvastatin, alendronate, omeprazole, ibuprofen, and temazepam. She presents with bilateral ankle oedema and elevated BP. Which medication is most likely causing her ankle oedema?

  1. A.Metoprolol
  2. B.Simvastatin
  3. C.Amlodipine (calcium channel blocker)Correct
  4. D.Aspirin
  5. E.Omeprazole
Show explanation

Amlodipine (dihydropyridine CCB): common side effect is dose-dependent peripheral oedema from pre-capillary arteriolar dilation without corresponding venous dilation → increased hydrostatic pressure → dependent oedema. Not due to fluid retention (diuretics won't help). Management: reduce dose, switch to another antihypertensive, or add ACEi/ARB (reduces CCB-induced oedema). Ankle oedema with CCBs is worse in elderly, hot weather, prolonged standing.

Want the other 180+ pharmacology MCQs?

The full pharmacology bank, AI-generated follow-up questions, weak-area analytics and spaced repetition are free to access — no credit card required.

Sign up free →

Pharmacology FAQ

What is SafeScript and is it tested?

SafeScript is Australia’s real-time prescription monitoring system covering Schedule 4D and Schedule 8 drugs (e.g. opioids, benzodiazepines, gabapentinoids). Doctors must check it before prescribing or dispensing. AMC tests scenarios where SafeScript review changes management.

How are drug interactions tested?

Common stems: warfarin + macrolides/fluconazole, SSRIs + tramadol/MAOI (serotonin syndrome), statins + amiodarone (myopathy), digoxin + verapamil (toxicity), and lithium + NSAIDs/ACE inhibitors.

What PBS rules should I know?

Know the difference between Streamlined Authority, Telephone Authority, and Restricted Benefit listings. Common authority drugs include biologics, novel anticoagulants in specific indications, and high-dose opioids beyond 100 mg oral morphine equivalent per day.

Are pregnancy categories on the AMC blueprint?

Yes. The TGA uses Australian categories A, B1–B3, C, D, X (not the FDA letters). Know which drugs are absolutely contraindicated (Category X: thalidomide, isotretinoin, valproate in epilepsy where alternatives exist).

How many pharmacology MCQs are free?

Five sample pharmacology MCQs with explanations on this page. The full 150+ bank unlocks with a free Mostly Medicine account.