Part 1 Pharmacology

Top 25 NBEO Part 1 Pharmacology Questions (With Answers)

Pharmacology is one of the highest-yield subjects on the NBEO Part 1 (Applied Basic Science) examination. Rather than simply memorizing drug names, the exam tests your understanding of drug mechanisms, indications, contraindications, adverse effects, and ocular applications.

The following 25 questions review concepts that every optometry student should know before exam day.


1. Which receptor does timolol block?

Answer: β₁ and β₂ adrenergic receptors (non-selective beta blocker)

Board Pearl: Timolol lowers intraocular pressure by decreasing aqueous humor production.


2. Which glaucoma medication commonly causes eyelash growth and iris pigmentation?

Answer: Prostaglandin analogs (e.g., latanoprost)


3. Which glaucoma medication is contraindicated in patients with asthma or severe COPD?

Answer: Non-selective topical beta blockers


4. Which drug class decreases aqueous humor production by inhibiting carbonic anhydrase?

Answer: Carbonic anhydrase inhibitors

Examples include dorzolamide, brinzolamide, acetazolamide, and methazolamide.


5. Which medication is considered a miotic?

Answer: Pilocarpine


6. Which drug causes cycloplegia by blocking muscarinic receptors?

Answer: Atropine

Other examples include cyclopentolate, tropicamide, and homatropine.


7. Which antibiotic inhibits bacterial protein synthesis by binding the 30S ribosomal subunit?

Answer: Aminoglycosides (e.g., tobramycin)


8. Which antiviral medication is commonly prescribed for herpes simplex keratitis?

Answer: Oral acyclovir, valacyclovir, or topical ganciclovir.


9. Which medication is commonly associated with corneal vortex keratopathy (corneal verticillata)?

Answer: Amiodarone


10. Which systemic medication is most commonly associated with optic neuropathy?

Answer: Ethambutol


11. Which medication commonly causes floppy iris syndrome during cataract surgery?

Answer: Tamsulosin


12. Which vitamin deficiency can cause optic neuropathy?

Answer: Vitamin B12 deficiency


13. Which medication is associated with retinal toxicity requiring periodic retinal screening?

Answer: Hydroxychloroquine


14. Which glaucoma medication commonly produces a metallic taste?

Answer: Carbonic anhydrase inhibitors


15. Which glaucoma medication class may cause fatigue, depression, and bradycardia?

Answer: Topical beta blockers


16. Which corticosteroid side effect is particularly important in optometry?

Answer:

  • Elevated intraocular pressure

  • Cataract formation

  • Delayed wound healing

  • Increased susceptibility to infection


17. Which topical anesthetic should never be prescribed for home use?

Answer: Proparacaine (or other topical anesthetics)

Repeated use can lead to severe corneal toxicity.


18. Which antibiotic class inhibits bacterial DNA gyrase?

Answer: Fluoroquinolones

Examples include:

  • Moxifloxacin

  • Gatifloxacin

  • Ciprofloxacin

  • Besifloxacin


19. Which glaucoma medication commonly causes conjunctival hyperemia?

Answer: Rho kinase inhibitors


20. Which systemic medication can produce pigmentary retinopathy with long-term use?

Answer: Thioridazine


21. Which medication is commonly associated with blue-yellow color vision defects?

Answer: Sildenafil


22. Which glaucoma medication commonly causes dry mouth and fatigue?

Answer: Alpha-2 adrenergic agonists (e.g., brimonidine)


23. Which medication class should generally be avoided in patients with narrow anterior chamber angles because of its mydriatic effects?

Answer: Anticholinergic medications


24. Which anti-inflammatory medication inhibits phospholipase A₂?

Answer: Corticosteroids


25. Which prostaglandin analog is commonly dosed once nightly?

Answer: Latanoprost

Most prostaglandin analogs achieve optimal intraocular pressure reduction with once-daily evening dosing.


High-Yield Pharmacology Topics to Master Before NBEO Part 1

If you're reviewing pharmacology, make sure you're comfortable with:

  • Glaucoma medications and mechanisms of action

  • Autonomic pharmacology

  • Antibiotic classes

  • Antiviral medications

  • Corticosteroids

  • NSAIDs

  • Ocular toxicities of systemic medications

  • Drug contraindications

  • Drug side effects

  • Drug mechanisms of action

  • Drug interactions

  • Common ophthalmic dosing schedules

These concepts appear repeatedly throughout board review resources because they form the foundation of safe patient care.


Final Study Tip

When studying pharmacology, don't just memorize drug names. Ask yourself these questions for every medication:

  • What is its mechanism of action?

  • What receptor or enzyme does it target?

  • What are the most common ocular and systemic side effects?

  • What are the major contraindications?

  • When would you choose this medication over another?

Thinking through these questions will help you answer unfamiliar board questions by applying concepts rather than relying on memorization alone.

At OD on the GO, our NBEO Part 1 review program includes thousands of flashcards, board-style pharmacology questions, high-yield video lectures, and comprehensive practice exams designed to help you master the concepts most frequently tested on exam day.