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Key Facts: Iran Pharm.D. End-of-Course Exam Exam

Twice/year

National test administrations scheduled annually by Sanjesh Pezeshki (Mordad/Shahrivar & Bahman)

Sanjesh Pezeshki Assessment Calendar

GPA > 14

Cumulative GPA threshold granting graduation exemption with defended thesis

Ministry of Health and Medical Education, Deputy for Education

Negative marking penalty: incorrect answers receive zero points without penalty

Sanjesh Pezeshki Examination Regulations

5 Subjects

Subjects in the published reading list: Pharmaceutics, Clinical Pharmacy, Pharmacology and Toxicology, Medicinal Chemistry, Pharmacognosy

Published منابع for the Pharm.D. end-of-course examination

National

Centrally coordinated exam administered across accredited medical sciences universities in Iran

Sanjesh Pezeshki Examination Rules

The Iranian Pharm.D. End-of-Course Examination is the national exit milestone required for Pharm.D. graduation in Iran, administered by Sanjesh Pezeshki without negative marking. Under current regulations, students with a cumulative GPA above 14 and a defended thesis receive a graduation waiver, while others must pass the exam.

Sample Iran Pharm.D. End-of-Course Exam Practice Questions

Try these sample questions to review concepts for the Iran Pharm.D. End-of-Course Exam exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Adrenaline (epinephrine), noradrenaline and dopamine are rapidly inactivated by catechol-O-methyltransferase (COMT) and have negligible oral activity. Which structural feature of these molecules is responsible for their susceptibility to COMT?

A.The benzylic hydroxyl group at the beta position of the side chain

B.The secondary aliphatic amine on the ethylamine side chain

C.The catechol nucleus, an aromatic ring bearing hydroxyl groups at positions 3 and 4

D.The unsubstituted aromatic ring, independent of which substituents it carries

Explanation: COMT transfers a methyl group from S-adenosylmethionine to one of the two adjacent phenolic hydroxyls of the catechol (3,4-dihydroxyphenyl) nucleus, and this ortho-dihydroxy arrangement is an absolute requirement for the enzyme. Extensive COMT and monoamine oxidase metabolism in the gut wall and liver is why catecholamines must be given parenterally. Medicinal chemists exploit this by removing or relocating a phenolic hydroxyl: salbutamol replaces the 3-hydroxyl with a hydroxymethyl group and ephedrine lacks ring hydroxyls altogether, both of which resist COMT and are orally active.

2A 48-year-old patient with type 2 diabetes mellitus and an estimated glomerular filtration rate (eGFR) of 55 mL/min/1.73 m² is initiating metformin. What is the primary cellular mechanism of action by which metformin lowers blood glucose concentrations?

A.Inhibition of mitochondrial respiratory chain complex I leading to activation of AMP-activated protein kinase (AMPK) and reduced hepatic gluconeogenesis

B.Direct stimulation of pancreatic beta-cell insulin secretion via closure of ATP-sensitive potassium channels

C.Competitive inhibition of intestinal brush-border alpha-glucosidase enzymes delaying carbohydrate digestion

D.Selective agonism of peroxisome proliferator-activated receptor gamma (PPAR-gamma) enhancing peripheral insulin sensitivity

Explanation: Metformin lowers blood glucose primarily by suppressing hepatic gluconeogenesis and, to a lesser extent, enhancing peripheral glucose uptake in skeletal muscle. Mechanistically, it inhibits complex I of the mitochondrial respiratory chain, increasing intracellular AMP/ATP ratios and activating AMP-activated protein kinase (AMPK), which suppresses key gluconeogenic genes and inhibits fructose-1,6-bisphosphatase.

3A 24-year-old non-pregnant woman presents to the community pharmacy with acute dysuria, urgency, and suprapubic discomfort, consistent with uncomplicated cystitis. Which of the following represents a recommended first-line antimicrobial agent for acute uncomplicated cystitis?

A.Amoxicillin (500 mg orally three times daily for 7 days)

B.Ciprofloxacin (500 mg orally twice daily for 7 days)

C.Nitrofurantoin monohydrate/macrocrystals (100 mg orally twice daily for 5 days)

D.Azithromycin (500 mg orally once followed by 250 mg daily for 4 days)

Explanation: First-line empiric therapy for acute uncomplicated lower urinary tract infection (cystitis) in women includes nitrofurantoin (100 mg twice daily for 5 days), trimethoprim-sulfamethoxazole (160/800 mg twice daily for 3 days where local resistance is <20%), or fosfomycin trometamol (3 g single dose). Nitrofurantoin achieves high concentrations in urine with minimal systemic absorption and low resistance rates among uropathogenic E. coli.

4A 26-year-old patient diagnosed with mild persistent asthma is counseled on proper inhaler technique. According to the Global Initiative for Asthma (GINA) guidelines, which strategy is recommended as the preferred track 1 reliever therapy across all severity steps?

A.Scheduled oral theophylline twice daily with as-needed SABA

B.As-needed short-acting beta-2 agonist (SABA) monotherapy

C.Oral montelukast taken once daily as monotherapy

D.As-needed low-dose inhaled corticosteroid (ICS) combined with formoterol

Explanation: GINA guidelines recommend as-needed low-dose ICS-formoterol (SMART / MART strategy) as the preferred track 1 reliever across all asthma steps. Formoterol provides rapid-onset bronchodilation comparable to albuterol/salbutamol, while the simultaneous delivery of ICS reduces the risk of severe exacerbations by treating airway inflammation at every symptom occurrence.

5Senna leaf and pod (Senna alexandrina, formerly Cassia species) are dispensed as a stimulant laxative. Which constituents are responsible for the laxative effect, and how do they act?

A.Mucilaginous polysaccharides that swell in the intestinal lumen and act purely by adding faecal bulk

B.Sennosides A and B, dianthrone glycosides that reach the colon unabsorbed and are hydrolysed and reduced by colonic bacteria to rhein anthrone, which stimulates propulsive motility and reduces net water absorption

C.Volatile monoterpenes that irritate the gastric mucosa and produce a reflex increase in colonic transit

D.Cardiac glycosides that inhibit sodium-potassium ATPase in small intestinal enterocytes

Explanation: Senna contains dianthrone glycosides, chiefly sennoside A and sennoside B. The sugar moieties prevent absorption in the small intestine, so the glycosides act as natural prodrugs delivered intact to the colon. Colonic bacterial glycosidases and reductases liberate the active metabolite rhein anthrone, which stimulates the myenteric plexus to increase propulsive contractions and alters mucosal electrolyte handling so that net water secretion increases. The 8 to 12 hour delay before an effect reflects the time required for colonic transit and bacterial activation.

6A patient with acute acetaminophen (paracetamol) poisoning is admitted 6 hours after ingesting a toxic quantity. Which specific antidote is indicated to replenish hepatic glutathione stores and detoxify the reactive metabolite N-acetyl-p-benzoquinone imine (NAPQI)?

A.Deferoxamine mesylate

B.Pralidoxime (2-PAM)

C.N-Acetylcysteine (NAC)

D.Flumazenil

Explanation: N-Acetylcysteine (NAC) is the specific antidote for acetaminophen overdose. In overdose, CYP2E1 metabolism generates excess NAPQI, depleting endogenous glutathione. NAC acts as a glutathione precursor (supplying L-cysteine) and can directly conjugate NAPQI, preventing covalent binding to hepatocyte proteins and hepatocellular necrosis. It is highly protective when administered within 8-10 hours post-ingestion.

7Which of the following pharmacological agents is classified as a cardioselective (beta-1 specific) adrenergic antagonist at standard therapeutic doses?

A.Propranolol

B.Metoprolol

C.Timolol

D.Nadolol

Explanation: Metoprolol (along with atenolol, bisoprolol, and nebivolol) selectively antagonizes beta-1 adrenergic receptors located predominantly in cardiac tissue at standard therapeutic doses. This selectivity reduces chronotropic and inotropic cardiac responses while minimizing bronchoconstriction mediated by beta-2 receptor blockade, though selectivity is dose-dependent and diminishes at higher doses.

8A 35-year-old patient presents with acute organophosphate poisoning characterized by miosis, excessive salivation, bronchospasm, bradycardia, and muscle fasciculations. What is the immediate pharmacological mechanism by which atropine reverses life-threatening muscarinic toxicity?

A.Irreversible blockade of nicotinic acetylcholine receptors at the neuromuscular junction

B.Direct chemical reactivation of phosphorylated acetylcholinesterase enzyme

C.Competitive antagonism of acetylcholine at postganglionic muscarinic acetylcholine receptors

D.Enhancement of acetylcholinesterase synthesis in the liver

Explanation: Atropine is a competitive, reversible antagonist at central and peripheral muscarinic acetylcholine receptors (M1-M5). In organophosphate poisoning, irreversible inhibition of acetylcholinesterase leads to massive accumulation of acetylcholine. Atropine blocks muscarinic manifestations—drying bronchial secretions, reversing bronchoconstriction, resolving bradycardia, and reducing diaphoresis and salivation. It does not affect nicotinic symptoms (muscle fasciculations or paralysis), which require oximes like pralidoxime.

9A patient taking warfarin for non-valvular atrial fibrillation is prescribed a 14-day course of oral amiodarone for ventricular ectopy. What is the expected pharmacokinetic drug interaction between amiodarone and warfarin?

A.Amiodarone induces CYP2C9 and CYP3A4, decreasing warfarin concentrations and increasing thromboembolic risk

B.Amiodarone inhibits CYP2C9, significantly increasing warfarin plasma levels and INR, necessitating a proactive warfarin dose reduction

C.Amiodarone binds warfarin irreversibly in the gastrointestinal lumen, preventing its systemic absorption

D.Amiodarone enhances renal excretion of warfarin by inhibiting tubular organic anion transporters

Explanation: Amiodarone is a potent inhibitor of cytochrome P450 enzymes, particularly CYP2C9, which is the primary metabolic pathway for the more potent (S)-enantiomer of warfarin. Co-administration decreases warfarin clearance, leading to elevated warfarin plasma levels, prolonged prothrombin time, and sharply elevated INR with substantial bleeding risk. When initiating amiodarone, the standard clinical recommendation is to reduce the warfarin dose by 30% to 50% empirically and monitor INR closely.

10Which of the following antiepileptic medications exhibits non-linear (Michaelis-Menten / zero-order) elimination kinetics within its therapeutic plasma concentration range (10 to 20 mg/L)?

A.Levetiracetam

B.Valproic acid

C.Phenytoin

D.Lamotrigine

Explanation: Phenytoin exhibits saturable (Michaelis-Menten) pharmacokinetics within its usual therapeutic range of 10 to 20 mg/L (total phenytoin). Hepatic metabolic enzymes (primarily CYP2C9 and CYP2C19) become saturated at therapeutic concentrations. Once saturated, elimination shifts from first-order (constant fraction eliminated per unit time) to zero-order (constant amount eliminated per unit time), meaning small dose increments can produce disproportionately large increases in serum concentration and precipitate severe neurotoxicity.

About the Iran Pharm.D. End-of-Course Exam Exam

The Comprehensive Pharm.D. End-of-Course Examination (آزمون پایان دوره دکتری عمومی داروسازی) is the national educational milestone examination that pharmacy students in the Islamic Republic of Iran must pass to qualify for graduation and subsequent registration with the Medical Council of the Islamic Republic of Iran (IRIMC) as licensed pharmacists. Formerly known as the 180-unit comprehensive examination (آزمون جامع ۱۸۰ واحدی داروسازی), the examination was restructured and renamed by resolution of the Supreme Council for Medical Sciences Planning (شورای عالی برنامه‌ریزی علوم پزشکی), approved in Tir 1402 and applied to students entering from 1399-1400 onward, to assess competency upon completion of all coursework and clinical clerkships (کارآموزی در عرصه). The reading list (منابع) published for the examination allocates 200 questions across five subjects: Pharmaceutics 50 items (25%), Clinical Pharmacy and Therapeutics 50 items (25%), Pharmacology and Toxicology 50 items combined (25%), Medicinal Chemistry 30 items (15%) and Pharmacognosy 20 items (10%), each tied to a named reference text. For recent cohorts, an educational policy grants an exemption from the exam for students with a cumulative GPA above 14 who have successfully defended their thesis, while requiring those with lower GPAs to pass the assessment. This question bank is an independent English-language MCQ study adaptation authored by OpenExamPrep. It features 100 practitioner-focused questions weighted to the five subjects of the published reading list, with comprehensive clinical and formulation rationales and an explanation for every wrong option. It is an educational study aid and is neither an official translation nor affiliated with Sanjesh Pezeshki.

Exam sponsor: National Center for Health Assessment / Sanjesh Pezeshki (مرکز سنجش آموزش پزشکی). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Administered nationally up to twice per academic year by the National Center for Health Assessment (مرکز سنجش آموزش پزشکی - Sanjesh Pezeshki) under the Deputy for Education (معاونت آموزشی) of the Ministry of Health and Medical Education. The test consists of four-option multiple-choice questions administered in Persian without negative marking. A recent administrative regulation allows students who have completed all didactic and clerkship coursework, defended their doctoral thesis, and achieved a cumulative GPA above 14 to be exempted from the examination; students with a GPA below 14 must sit the examination or retake key coursework.

Time Limit

Timed per sitting guidelines (Sanjesh Pezeshki)

Passing Score

Threshold determined per sitting by Sanjesh Pezeshki; GPA > 14 exemption applies

Exam / Certification Fees

Set annually by the Ministry of Health and Medical Education, payable online via sanjeshp.ir

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

25%

Pharmaceutics (فارماسیوتیکس)

50 of the 200 items in the published reading list (منابع). Dosage form design and manufacture from Aulton's Pharmaceutics: powders and granulation, tablets and coating, disperse systems, sterile and ophthalmic products, rheology, stability and biopharmaceutics/pharmacokinetics.

25%

Clinical Pharmacy and Therapeutics (داروسازی بالینی)

50 of the 200 items. Drawn from Applied Therapeutics and the Persian درسنامه جامع درمان‌شناسی: laboratory test interpretation, general principles of antibiotic use, and drug therapy of gastrointestinal, urinary, respiratory, cardiovascular, renal, neurological, endocrine, haematological, rheumatological, psychiatric and dermatological disease.

25%

Pharmacology and Toxicology (فارماکولوژی و سم‌شناسی)

50 of the 200 items combined. Pharmacology from Katzung's Basic and Clinical Pharmacology, with toxicology from selected chapters of Casarett and Doull's Toxicology and the antidote section of Olson's Poisoning and Drug Overdose.

15%

Medicinal Chemistry (شیمی دارویی)

30 of the 200 items. Drawn from Foye's Principles of Medicinal Chemistry: physicochemical properties and ionisation, prodrug design, metabolism, and structure-activity relationships across the major therapeutic classes specified in the reading list.

10%

Pharmacognosy (فارماکوگنوزی)

20 of the 200 items. Drawn from Trease and Evans Pharmacognosy (section 5) and the Persian گزیده فارماکوگنوزی: crude drugs of biological origin, secondary metabolite classes, and the Iranian medicinal plants of commercial importance.

Preparing for the Iran Pharm.D. End-of-Course Exam Exam

What You Need to Know

Passing score: Threshold determined per sitting by Sanjesh Pezeshki; GPA > 14 exemption applies
Assessment: Administered nationally up to twice per academic year by the National Center for Health Assessment (مرکز سنجش آموزش پزشکی - Sanjesh Pezeshki) under the Deputy for Education (معاونت آموزشی) of the Ministry of Health and Medical Education. The test consists of four-option multiple-choice questions administered in Persian without negative marking. A recent administrative regulation allows students who have completed all didactic and clerkship coursework, defended their doctoral thesis, and achieved a cumulative GPA above 14 to be exempted from the examination; students with a GPA below 14 must sit the examination or retake key coursework.
Time limit: Timed per sitting guidelines (Sanjesh Pezeshki)
Exam / certification fees: Set annually by the Ministry of Health and Medical Education, payable online via sanjeshp.ir Official sources

Using Our Practice Resources

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Iran Pharm.D. End-of-Course Exam: Suggested Study Strategy

1Give equal weight to the three largest subjects: Pharmaceutics, Clinical Pharmacy and the combined Pharmacology and Toxicology paper each carry 50 of the 200 items. Within clinical pharmacy, focus on the disease areas named in the reading list and on therapeutic drug monitoring for vancomycin, aminoglycosides, digoxin and phenytoin.

2Review Aulton's Pharmaceutics fundamentals: Understand tablet excipients, granulation methods, sterile ophthalmic and parenteral formulation requirements, and basic biopharmaceutic equations.

3Work from the named reference texts: the reading list ties each subject to a specific book - Aulton's Pharmaceutics, Applied Therapeutics with the Persian درسنامه جامع درمان‌شناسی, Katzung with Casarett and Doull's and Olson, Foye's Principles of Medicinal Chemistry, and Trease and Evans. Study the listed chapters rather than general summaries.

4Integrate medicinal chemistry with pharmacology: Understand how chemical modifications affect receptor selectivity, duration of action, and metabolic fate for major cardiovascular, antimicrobial, and CNS drug classes.

5Answer every question: Because there is zero negative marking on this milestone exam, never leave any question blank.

Frequently Asked Questions

What is the Iranian Pharm.D. End-of-Course Examination (Azmoon Payan Dowreh Darousazi)?

The Pharm.D. End-of-Course Examination (آزمون پایان دوره دکتری عمومی داروسازی) is a national qualifying examination administered by Sanjesh Pezeshki under the Ministry of Health. It replaced the previous 180-unit comprehensive exam and serves as a graduation requirement for pharmacy students completing their Doctor of Pharmacy curriculum.

Who is exempt from taking the exam under the GPA waiver policy?

Under directives issued by the Deputy for Education (معاونت آموزشی) of the Ministry of Health, pharmacy students who complete all required theoretical and practical coursework, defend their doctoral thesis before the designated deadline, and maintain a cumulative GPA above 14 (out of 20) are exempt from the exam and may graduate directly.

Is there negative marking on the Pharm.D. End-of-Course Exam?

No. The Pharm.D. End-of-Course milestone exam has no negative marking penalty. Incorrect answers receive zero points without deducting marks from correct answers, so candidates are encouraged to answer all items.

What are the primary reference textbooks for the examination?

The reading list (منابع) published for the examination ties each subject to a named text: Aulton's Pharmaceutics for pharmaceutics; Applied Therapeutics together with the Persian درسنامه جامع درمان‌شناسی for clinical pharmacy; Katzung's Basic and Clinical Pharmacology for pharmacology, with selected chapters of Casarett and Doull's Toxicology and the antidote section of Olson's Poisoning and Drug Overdose for toxicology; Foye's Principles of Medicinal Chemistry for medicinal chemistry; and Trease and Evans Pharmacognosy with the Persian گزیده فارماکوگنوزی for pharmacognosy. Specific chapters are included or excluded each year, so check the current list before studying.

Is passing this exam the same as obtaining an IRIMC license?

No. Passing this exam (or qualifying for the GPA waiver) and defending the thesis fulfills academic degree requirements. Once the Pharm.D. is conferred and mandatory human resources service obligations (tarh-e niruye ensani) are addressed, graduates register administratively with the Medical Council of Iran (IRIMC) to receive their practice licence and Technical Manager (مسئول فنی) eligibility.

Is this OpenExamPrep question bank an official Sanjesh Pezeshki resource?

No. This question bank is an independent English-language MCQ study adaptation authored by OpenExamPrep for educational practice. The official Iranian examination is administered in Persian by Sanjesh Pezeshki, and OpenExamPrep is not affiliated with or endorsed by Sanjesh Pezeshki, the Ministry of Health, or IRIMC.