Biomedical Sciences
20%of exam
Medicinal Chemistry & Biopharmaceutics
10%of exam
Pharmacokinetics & Pharmacodynamics
10%of exam
ADMEHalf-Life & ClearanceReceptor TheoryDose-Response
Pharmacology & Toxicology
15%of exam
Adverse Drug ReactionsDrug InteractionsAntidotesMechanism of Action
Therapeutics & Patient Care
45%of exam
Quick Facts
- Exam
- OPRA
- Body
- APC / Pearson VUE
- Questions
- 120 (90% scored)
- Time
- 150 min
- Result
- Pass / Unsuccessful
- Fee
- AU$2,245 (2026)
- Format
- Closed-book, CBT
- Blueprint
- March 2025 launch
Physiology & Pathophysiology
- Homeostasis
- Stable internal balance
- Negative feedback
- Reverses change, restores balance
- Sepsis criteria
- qSOFA or SIRS markers
- Acid-base balance
- pH, CO2, bicarbonate control
- Electrolyte imbalance
- Na, K, Ca disturbance
- Inflammation markers
- CRP, ESR, WCC
Microbiology & Immunology
- Gram stain
- Positive purple, negative pink
- Innate immunity
- Fast, non-specific defence
- Adaptive immunity
- Specific, memory-based response
- Antibiotic resistance
- Beta-lactamase, efflux, target change
- Vaccine types
- Live, inactivated, subunit, mRNA
Formulation & Drug Delivery
- Bioavailability
- Fraction reaching systemic circulation
- First-pass metabolism
- Liver reduces oral bioavailability
- Enteric coating
- Delays release until intestine
- Sustained release
- Slow, prolonged drug release
- Solubility factors
- pH, particle size, temperature
- Drug stability
- Resists degradation over time
Pharmaceutical Microbiology & QC
- Sterility testing
- Confirms no microbial contamination
- Preservatives
- Prevent microbial growth
- Aseptic technique
- Prevents contamination during compounding
- Endotoxin limit
- Pyrogen safety threshold
ADME Order
Absorption, Distribution, Metabolism, Excretion — in sequence
A: gut/site uptakeD: spreads through tissuesM: liver transforms drugE: kidney/bile removes drug
Zero-Order vs First-Order Kinetics
Zero-order kinetics
- Constant amount eliminated
- Rate independent of concentration
First-order kinetics
- Constant fraction eliminated
- Rate depends on concentration
Fixed amount vs fixed fraction
Pharmacokinetics Core
- ADME
- Absorption, distribution, metabolism, excretion
- Half-life
- Time to halve concentration
- Volume of distribution
- Apparent body drug spread
- Clearance
- Volume cleared per time
- Steady state
- ~5 half-lives to reach
- Loading dose
- Fast target concentration achieved
- Zero-order kinetics
- Constant amount eliminated
- First-order kinetics
- Constant fraction eliminated
Agonist vs Antagonist
Agonist
- Binds, activates receptor
- Produces a response
Antagonist
- Binds, blocks receptor
- No response produced
Turns on vs turns off
Pharmacodynamics Core
- Agonist
- Activates receptor response
- Antagonist
- Blocks receptor response
- Therapeutic index
- Toxic dose over effective dose
- ED50
- Effective dose in 50%
- Tolerance
- Reduced response, repeated exposure
- Dose-response curve
- Effect size versus dose
Type A vs Type B ADR
Type A ADR
- Dose-related, predictable
- Common, extension of effect
Type B ADR
- Not dose-related
- Rare, idiosyncratic or allergic
Predictable vs unpredictable reaction
Antidote Picker
- Paracetamol overdose→N-acetylcysteine
- Opioid overdose/respiratory depression→Naloxone
- Benzodiazepine overdose→Flumazenil(Rarely used, seizure risk)
- Warfarin overdose/bleeding→Vitamin K
- Iron overdose→Desferrioxamine
- Organophosphate/nerve agent exposure→Atropine
ADRs & Drug Interactions
- Type A ADR
- Predictable, dose-related reaction
- Type B ADR
- Unpredictable, idiosyncratic reaction
- CYP450 inhibitor
- Raises interacting drug levels
- CYP450 inducer
- Lowers interacting drug levels
- Serotonin syndrome
- SSRI + MAOI risk
- QT prolongation
- Risk of torsades de pointes
Toxicology & Antidotes
- Paracetamol overdose
- Antidote: N-acetylcysteine
- Opioid overdose
- Antidote: naloxone
- Benzodiazepine overdose
- Antidote: flumazenil
- Warfarin overdose
- Antidote: vitamin K
- Iron overdose
- Antidote: desferrioxamine
- Organophosphate poisoning
- Antidote: atropine
Scheduling Ladder
S2 to S8: control increases with each schedule
S2: pharmacy self-selectS3: pharmacist supply onlyS4: prescription requiredS8: controlled, high risk
S3 vs S4 Scheduling
S3 Pharmacist Only
- No script needed
- Pharmacist supply + advice
S4 Prescription Only
- Script required
- Prescriber authorises use
Pharmacist supply vs prescriber required
Medicine Scheduling Picker
- Self-selected, pharmacist advice available→S2 Pharmacy Medicine
- Needs pharmacist supply, no script→S3 Pharmacist Only
- Needs doctor's prescription→S4 Prescription Only
- High addiction/abuse potential→S8 Controlled Drug
- Banned from general sale→S9 Prohibited Substance
- Uncertain schedule→Check current SUSMP
PBS & Dispensing
- PBS
- Subsidises listed prescription medicines
- General co-payment
- Up to AU$25 (2026)
- Concessional co-payment
- AU$7.70 per script (2026)
- Safety Net threshold
- AU$1,748.20 general (2026)
- Concessional Safety Net
- AU$277.20 threshold (2026)
- Authority prescription
- Needs PBS approval first
- Repeats
- Authorised refills without new script
PBS Safety Net Order
Co-payment first, then Safety Net threshold, then reduced cost
Pay co-payment each scriptReach annual threshold amountConcession: free after thresholdGeneral: cheaper after threshold
OPRA vs KAPS
OPRA (current, 2025+)
- 120 MCQs, 150 minutes
- Clinical judgement emphasis
- Therapeutics weighted 45%
KAPS (retired 2024)
- Legacy knowledge-only exam
- Less patient-care weighting
OPRA current; KAPS retired
PBS Supply Picker
- Concession card holder→Concessional co-payment applies
- General patient, no card→General co-payment applies
- Restricted PBS indication→Authority prescription required
- Repeat needed, script allows→Dispense authorised repeat
- Patient nears Safety Net→Track cumulative PBS spend
- Non-PBS item requested→Private/full price script
Scheduling: SUSMP & Poisons Standard
- S2
- Pharmacy Medicine, self-selection
- S3
- Pharmacist Only, no script
- S4
- Prescription Only Medicine
- S8
- Controlled Drug, addiction risk
- S9
- Prohibited substance
- SUSMP
- TGA Poisons Standard document
Five Competency Domains
Professionalism, Communication, Medicines, Leadership, Education — five domains
D1: professionalism and ethicsD2: communication and collaborationD3: medicines management, patient careD4: leadership and managementD5: education and research
AHPRA vs Pharmacy Board
AHPRA
- National registration body
- Handles notifications, all professions
Pharmacy Board of Australia
- Sets pharmacist practice standards
- Profession-specific decisions
Registers everyone vs sets standards
Law, Ethics & Regulators
- AHPRA
- National registration + notifications body
- Pharmacy Board of Australia
- Sets pharmacist practice standards
- National Law
- Health practitioner regulation legislation
- Mandatory notification
- Reports impairment, misconduct, risk
- Code of conduct
- Professional behaviour expectations
- Provisional registration
- Intern pharmacist pathway status
General vs Concessional Co-payment
General co-payment
- Up to AU$25
- No concession card
Concessional co-payment
- Fixed AU$7.70
- Concession card required
Card status sets the fee
Counselling & Patient Safety
- CMI
- Consumer Medicine Information leaflet
- MedsCheck
- Community pharmacy medicine review
- HMR
- Home Medicines Review, GP-referred
- DAA/Webster pack
- Dose administration aid
- Health literacy
- Ability to understand health information
- Adherence
- Following agreed treatment plan
Special Populations & Harm Minimisation
- Pregnancy categories
- A to X risk scale
- Renal dose adjustment
- Based on eGFR/CrCl
- Paediatric dosing
- Weight-based, mg/kg calculation
- Opioid substitution therapy
- Methadone or buprenorphine treatment
- Needle and syringe program
- Reduces blood-borne virus spread
- Elderly high-risk medicines
- Anticholinergics, sedatives, falls risk
Common Traps
OPRA ≠ KAPS
OPRA is current 2025+ exam ≠ KAPS retired November 2024
S3 ≠ S4 scheduling
S3 needs no script ≠ S4 needs a prescription
AHPRA ≠ Pharmacy Board
AHPRA runs registration admin ≠ Board sets practice standards
General ≠ concessional co-payment
General up to AU$25 ≠ Concession fixed at AU$7.70
Scored ≠ unscored questions
90% of items scored ≠ 10% unscored, uncounted trial
Zero-order ≠ first-order kinetics
Zero-order: fixed amount removed ≠ First-order: fixed fraction removed
Type A ≠ Type B ADR
Type A dose-related, predictable ≠ Type B idiosyncratic, unpredictable
Last Minute
- 1.120 MCQs, 150 minutes total
- 2.90% scored, 10% unscored trial
- 3.Therapeutics and patient care: 45%
- 4.Biomedical sciences weighted at 20%
- 5.Pharm/tox weighted at 15%
- 6.PK/PD and chemistry each 10%
- 7.Result is pass or unsuccessful
- 8.No published fixed pass mark
- 9.S3 no script, S4 needs script
- 10.AHPRA registers; Board sets standards
- 11.General co-pay ~AU$25, concession AU$7.70
- 12.OPRA replaced KAPS, March 2025
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