OPRA Exam Study Guide (2026)
Everything the OPRA Exam (APC Overseas Pharmacist Readiness Assessment) tests, topic by topic: what each section covers, the facts that come up most, and how to study it. Pair it with the free 15-question practice test.
The exam at a glance
| Questions | 120 multiple-choice questions (90% scored, 10% unscored), each with one correct answer and 3 incorrect options |
|---|---|
| Time | 150 minutes (2.5 hours) |
| Passing score | Not published. APC uses scaled scoring against a standard set by experts and reports pass or fail only; practise to 70% or higher |
| Format | Closed book, computer-based |
| Certifying body | Australian Pharmacy Council (APC) |
| Test provider | Pearson VUE test centres in Australia and overseas |
Mind map: the whole exam on one screen
Read the complete OPRA study notes for “Biomedical Sciences”
Our first full set of comprehensive notes, about 15 minutes of reading: Acid-base disorders in three steps · The anion gap · Electrolytes worth knowing by heart · Microbiology at a glance · Immunology and vaccines · Anaemia by cell size, a worked exam example, the traps examiners use and a one-minute recap. Create a free account to read it and see how premium notes work before you decide.
1. Biomedical Sciences
20% of OPRA: normal physiology, pathophysiology, microbiology, immunology, fluid, electrolyte and acid-base disorders, blood disorders, and the signs, symptoms and lab tests that go with them.
Key facts
- Acid-base in three steps: pH (acidaemia or alkalaemia), then whether PaCO2 or bicarbonate explains it (respiratory or metabolic), then whether the other value has compensated.
- Anion gap = Na+ − (Cl− + HCO3−). A high anion gap metabolic acidosis suggests ketoacidosis, lactic acidosis, kidney failure or toxins such as methanol, ethylene glycol and salicylates.
- Hyperkalaemia gives peaked T waves, then P-wave loss and a wide QRS; hypokalaemia gives flattened T waves and U waves. ACE inhibitors, ARBs, spironolactone and trimethoprim raise potassium.
- Gram-positive cocci in clusters are staphylococci; in chains, streptococci. Atypical organisms (Mycoplasma, Chlamydia, Legionella) lack a usable cell wall target, so beta-lactams don't work against them.
- Hypersensitivity: type I (IgE, immediate, anaphylaxis), type II (antibody against cells, haemolytic anaemia), type III (immune complexes, serum sickness), type IV (T-cell, delayed, contact dermatitis).
- Anaemia by red cell size: microcytic (iron deficiency, thalassaemia), macrocytic (vitamin B12 or folate deficiency, alcohol, some drugs such as methotrexate), normocytic (acute blood loss, chronic disease).
- Live vaccines (such as MMR, varicella) are generally avoided in pregnancy and significant immunosuppression; inactivated vaccines are not.
Flashcards
Exam tip: For acid-base questions, decide acidaemia or alkalaemia from the pH before you look at anything else. Most wrong answers come from reading compensation as the primary problem.
2. Medicinal Chemistry and Biopharmaceutics
10% of OPRA: physicochemical properties of drugs, ionisation, solubility, stability and degradation kinetics, dosage forms and formulation, and pharmaceutical microbiology (preservation and sterilisation).
Key facts
- Henderson-Hasselbalch: for a weak acid, log(ionised/un-ionised) = pH − pKa; for a weak base, log(ionised/un-ionised) = pKa − pH. The un-ionised form crosses membranes more easily.
- Hydrolysis attacks esters (aspirin, procaine) and amides; oxidation affects drugs such as adrenaline and ascorbic acid. Protect with pH control, antioxidants, chelating agents, dry storage and light-resistant packaging.
- Zero-order degradation loses a constant amount per unit time (suspensions often behave this way); first-order loses a constant fraction, with t90 = 0.105 ÷ k and t½ = 0.693 ÷ k.
- Higher temperature speeds degradation (Arrhenius relationship); that's the basis of accelerated stability testing.
- Suspensions need suspending agents and a 'shake well' label; emulsions need emulsifying agents and can cream (reversible) or crack (irreversible).
- Moist-heat sterilisation (autoclaving) is commonly 121°C for 15 minutes; heat-sensitive solutions are sterilised by filtration through a 0.22 µm filter.
- Multi-dose aqueous preparations need a preservative; preservative-free eye drops are single-use.
Flashcards
Exam tip: In ionisation questions, write down whether the drug is an acid or a base before you subtract. Swapping the formula for acids and bases is the classic slip.
3. Pharmacokinetics and Pharmacodynamics
10% of OPRA: absorption, distribution, metabolism and excretion, clearance, half-life, steady state, loading and maintenance doses, dose adjustment in kidney and liver disease, and receptor pharmacodynamics.
Key facts
- Steady state takes about 4 to 5 half-lives, regardless of dose. A loading dose gets you to target faster.
- Loading dose = target concentration × Vd ÷ F. Maintenance dose rate = clearance × target concentration ÷ F.
- Half-life = 0.693 × Vd ÷ CL, so half-life rises when clearance falls or volume of distribution rises.
- Highly protein-bound drugs (warfarin, phenytoin) are affected by low albumin: the free fraction rises, so total levels can mislead.
- Phenytoin has saturable (non-linear) kinetics: small dose increases can cause large rises in level.
- Potency is the dose needed for an effect (EC50); efficacy is the maximum effect (Emax). A partial agonist has lower efficacy than a full agonist and can act as an antagonist in its presence.
- Narrow therapeutic index drugs (digoxin, lithium, aminoglycosides, vancomycin, phenytoin) need concentration monitoring and dose adjustment in kidney impairment.
Flashcards
Exam tip: PK calculation questions almost always reduce to one formula. Write it, put the units in, and check the answer is a believable dose before you choose.
Test yourself on these topics
Take the free 15-question OPRA test, then save your results to unlock your Readiness Score and the mistakes bank.
4. Pharmacology and Toxicology
15% of OPRA: mechanisms of action, receptor effects, adverse drug reactions, drug interactions (especially CYP-mediated), overdose, toxidromes and antidotes.
Key facts
- Strong CYP3A4 inhibitors: clarithromycin, erythromycin, azole antifungals (itraconazole, ketoconazole), ritonavir, grapefruit juice. Strong inducers: rifampicin, carbamazepine, phenytoin, St John's wort.
- Simvastatin with a strong CYP3A4 inhibitor raises myopathy risk; warfarin's INR rises with metronidazole, fluconazole and trimethoprim-sulfamethoxazole.
Flashcards
Exam tip: For interaction questions, name the enzyme first: who's the substrate, who's the inhibitor or inducer. The answer follows from the direction of the change.
5. Cardiovascular, Renal and Endocrine Therapeutics
Part of the 45% Therapeutics and patient care area: hypertension, heart failure, atrial fibrillation, lipids, diabetes, thyroid disease and kidney disease, as Australian references (eTG, AMH) present them.
Key facts
- First-line antihypertensive classes: ACE inhibitor or ARB, dihydropyridine calcium channel blocker, thiazide or thiazide-like diuretic. Never combine an ACE inhibitor with an ARB; both are contraindicated in pregnancy.
- HFrEF: ACE inhibitor, ARB or sacubitril/valsartan; a beta-blocker (bisoprolol, carvedilol, metoprolol succinate or nebivolol); a mineralocorticoid receptor antagonist; and an SGLT2 inhibitor. Avoid verapamil, diltiazem and NSAIDs.
Flashcards
Exam tip: HbA1c may be given in mmol/mol or %. Know the pairs: 48 mmol/mol = 6.5%, 53 = 7.0%, 64 = 8.0%.
6. Infection, Respiratory and CNS Therapeutics
Part of the 45% Therapeutics and patient care area: empirical antibiotic choices in Australian practice, asthma and COPD, depression and anxiety, psychosis, epilepsy, Parkinson's disease and pain.
Key facts
- Uncomplicated cystitis in non-pregnant women (eTG): trimethoprim, cefalexin or nitrofurantoin. Low-severity community-acquired pneumonia: amoxicillin, or doxycycline.
- Clindamycin and broad-spectrum antibiotics carry the highest risk of C. difficile infection. Tetracyclines and fluoroquinolones bind calcium, iron and magnesium.
Flashcards
Exam tip: When two antibiotics both cover the organism, the exam usually wants the narrower one that Australian guidelines list first. Broad-spectrum options are often distractors.
7. Primary Care, Special Populations and Calculations
Part of the 45% Therapeutics and patient care area: screening calculations, dose calculations, non-prescription care and referral, medicines in pregnancy, breastfeeding, children and older people, harm minimisation and confidentiality.
Key facts
- Cockcroft-Gault with creatinine in µmol/L: CrCl (mL/min) = (140 − age) × weight (kg) ÷ (0.814 × serum creatinine), multiplied by 0.85 for women.
- BMI = weight (kg) ÷ height (m)². Body surface area (Mosteller) = √(height (cm) × weight (kg) ÷ 3600).
Flashcards
Exam tip: OPRA uses SI units throughout. Make sure your Cockcroft-Gault formula is the µmol/L version (0.814), not the US mg/dL version (72).
How to pass
- 120 questions in 150 minutes is 75 seconds each. Recall questions (55% of the exam) should take 30 seconds, banking time for calculations and patient cases.
- Therapeutics and patient care is 45% of the exam. Learn first-line choices, contraindications and monitoring the way Australian references (eTG, AMH) present them.
- OPRA doesn't test Australian law or practice standards; those come later, in the intern exams. Spend your time on science and therapeutics.
- About 12 questions are unscored and you can't tell which. Treat every question as if it counts, and never leave one blank: there's no negative marking.
Frequently asked questions
How long should I study for the OPRA exam?
Most working candidates need 4 to 8 weeks at 45 to 60 minutes a day. Book your exam once your Readiness Score has stayed at 80 or higher for about a week.
Can I take the OPRA exam online?
No. The OPRA exam is computer-based but you sit it in person at an approved Pearson VUE test centre, in Australia or in one of many other countries. Format: closed book, computer-based. Check the Council's OPRA exam guide and exam-day preparation page for the rules.
What score do I need to pass the OPRA exam?
Not published. APC uses scaled scoring against a standard set by experts and reports pass or fail only; practise to 70% or higher. The exam has 120 multiple-choice questions (90% scored, 10% unscored), each with one correct answer and 3 incorrect options and a time limit of 150 minutes (2.5 hours).
What are the most tested topics?
The outline covers biomedical sciences, medicinal chemistry and biopharmaceutics, pharmacokinetics and pharmacodynamics, pharmacology and toxicology, cardiovascular, renal and endocrine therapeutics, infection, respiratory and cns therapeutics, primary care, special populations and calculations. Use the free practice test to see which ones you need most.
The premium OPRA study path
Premium OPRA prep is studied one topic at a time. Each step starts with that topic's key notes and flashcard deck, then its own question sets of 25, so you master one topic before you move to the next. When every topic is strong, the 6 full mock exams show you're ready.
Your step-by-step study path
- 1Biomedical Sciences9 key notes, 115 flashcards, then 450 practice questions in 18 sets of 25Notes free with an account
- 2Medicinal Chemistry and Biopharmaceutics9 key notes, 115 flashcards, then 425 practice questions in 17 sets of 25Premium
- 3Pharmacokinetics and Pharmacodynamics9 key notes, 115 flashcards, then 425 practice questions in 17 sets of 25Premium
- 4Pharmacology and Toxicology9 key notes, 115 flashcards, then 425 practice questions in 17 sets of 25Premium
- 5Cardiovascular, Renal and Endocrine Therapeutics8 key notes, 115 flashcards, then 425 practice questions in 17 sets of 25Premium
- 6Infection, Respiratory and CNS Therapeutics8 key notes, 115 flashcards, then 425 practice questions in 17 sets of 25Premium
- 7Primary Care, Special Populations and Calculations8 key notes, 110 flashcards, then 425 practice questions in 17 sets of 25Premium
- Final step: 6 full mock exams120 questions each, timed like test day. Pass them, then book your exam.Premium
Get every note, flashcard and question
Premium Monthly
- The OPRA exam: all five content areas
- 3,000 practice questions + 6 full mock exams per exam
- 800 flashcards + 60 key notes per exam, by topic, plus mind maps
- Spaced repetition + mistakes bank
- Readiness Score & detailed reports
- Video lessons as they release
- Content updates during your access
- 5 bonuses: calculations and lab values sheet, interactions and antidotes atlas, study planner and more
- Pass Guarantee: complete the prep, pass or 100% back
Renews monthly until you cancel. Cancel in two clicks from your account; you keep access until the end of the month you've paid for. No minimum term.
Premium Yearly
- The OPRA exam: all five content areas
- 3,000 practice questions + 6 full mock exams per exam
- 800 flashcards + 60 key notes per exam, by topic, plus mind maps
- Spaced repetition + mistakes bank
- Readiness Score & detailed reports
- Video lessons as they release
- Content updates during your access
- 5 bonuses: calculations and lab values sheet, interactions and antidotes atlas, study planner and more
- Pass Guarantee: complete the prep, pass or 100% back
Renews once a year until you cancel. We email you before each renewal. Cancel any time from your account; you keep access until the end of the year you've paid for.
Summarized from the Australian Pharmacy Council's official candidate information and the rules cited, checked October 2026. Confirm current requirements with Australian Pharmacy Council (APC).