Pharmacology Must-Knows for the AKT Exam

One of the most important and often underestimated areas in the RACGP Applied Knowledge Test (AKT) is pharmacology. From choosing the safest drug for a pregnant patient to calculating the correct pediatric dose, your ability to prescribe safely and appropriately is constantly evaluated.

This guide breaks down the AKT pharmacology essentials, focusing on drugs to know for RACGP, high-yield topics, and how to prepare for the RACGP exam.

 

 

Why Pharmacology Matters in the AKT?

The AKT assesses more than clinical knowledge, it tests how that knowledge is applied in real-world GP settings. Medication safety is a key priority in general practice. Expect at least 10–15% of AKT questions to focus on:

• Choosing the correct drug
• Understanding contraindications
• Identifying side effects
• Adjusting doses for age, weight, or comorbidities
• Following local medication guidelines

The ability to navigate pharmacological decisions confidently can significantly influence your score.

 

High-Yield AKT Pharmacology Topics

Here’s what to focus on when studying pharmacology for the AKT:

 

1. Antibiotics

Antimicrobial stewardship is a priority in Australian healthcare, and the RACGP closely aligns with Therapeutic Guidelines (eTG).

Key areas to know:

• First-line treatment for common infections (UTI, otitis media, pneumonia, cellulitis)
• Safe antibiotics in pregnancy and breastfeeding
• Duration and dosage adjustments in renal impairment

Example: For uncomplicated cystitis in a woman, know that nitrofurantoin is often preferred, unless renal function is compromised.

 

2. Psychotropic Medications

Mental health conditions are common in general practice. The AKT often includes questions about antidepressants, antipsychotics, and anxiolytics.

Key concepts:

• First-line SSRI choices for depression and anxiety
• Monitoring for serotonin syndrome
• Initiating and tapering antidepressants
• Side effects of common agents like mirtazapine and venlafaxine

Also be aware of medication safety in adolescents and pregnancy.

 

3. Chronic Disease Management

Chronic conditions like diabetes, hypertension, and asthma form the backbone of general practice, and feature prominently in AKT pharmacology questions.

For diabetes:

• Know the place of metformin, SGLT2 inhibitors, and GLP-1 agonists
• Side effect profiles, contraindications, and renal dosing adjustments

For hypertension:

• Understand the guidelines on ACE inhibitors vs calcium channel blockers
• Be able to manage polypharmacy and drug interactions

For asthma/COPD:

• Stepwise approach to inhaler therapy
• Corticosteroid dosing and side effects
• Spacer usage and inhaler techniques

 

 

4. Pediatric Dosing

Dosing in children must be precise. You’re expected to calculate appropriate dosages based on weight, route, and frequency.

Common scenarios involve:

• Paracetamol and ibuprofen
• Antibiotic dosing (e.g., amoxicillin for otitis media)
• Asthma reliever and preventer regimens

Use online calculators and reference the Children’s Dosing Guidelines in eTG for preparation.

 

5. Medications in Pregnancy and Lactation

You must know which drugs are safe, risky, or contraindicated during pregnancy and breastfeeding.

Key safe medications include:

• Paracetamol (preferred analgesic)
• Loratadine (antihistamine of choice)
• Amoxicillin (safe penicillin)

Avoid:

• Doxycycline
• ACE inhibitors
• Statins
• Certain antidepressants (e.g., paroxetine in the first trimester)

Use the Australian Medicines Handbook (AMH) or MotherSafe for evidence-based answers.

 

GP Exam Medication Guidelines to Follow

To ensure your answers match RACGP expectations, refer to these official sources:

• Therapeutic Guidelines (eTG): Gold-standard for antimicrobial, asthma, diabetes, and pain management
• Australian Medicines Handbook (AMH): For dosages, side effects, interactions
• RACGP Clinical Guidelines: Preventive care, medication safety, and chronic disease protocols

Familiarity with these resources ensures your choices reflect what’s expected in Australian general practice.

 

 

Tips for Mastering AKT Pharmacology

1.    Practice Under Exam Conditions: Use AKT-style pharmacology questions to test your application skills. Time yourself and justify your answers using AMH or eTG.

2.    Flag Common Side Effects: Know the common adverse effects of frequently prescribed medications, especially those that require action (e.g., angioedema with ACE inhibitors, lactic acidosis with metformin).

3.    Review Case-Based Questions: Use online platforms for AKT pharmacology quizzes and mock exam simulations. They offer detailed explanations linked to AMH and eTG guidelines.

Pharmacology is a high-scoring opportunity in the AKT if you approach it strategically. Focus on common conditions, dosing safety, and align your preparation with GP exam medication guidelines. Mastering the drugs to know for RACGP will not only improve your exam performance but also prepare you for confident prescribing in real practice.