The APC does not publish a list of tested drugs or conditions, so no one can honestly give you "the topics that will come up". What you can do is rank topics by evidence: the official weights (therapeutics 45%), the APC's own subtopic list, and the themes visible in the APC's 25-question sample content, such as warfarin and INR, opioid overdose, vancomycin dosing, infusion and millimole calculations, phenytoin, lithium and migraine treatment. This guide ranks topics in three tiers and explains how to study each tier. The ranking is editorial, not a prediction.
How we ranked topics
Three inputs, in order of reliability. First, the official content weights: biomedical sciences 20%, medicinal chemistry and biopharmaceutics 10%, pharmacokinetics and pharmacodynamics 10%, pharmacology and toxicology 15%, therapeutics and patient care 45%. Second, the APC's published subtopic list for each area. Third, the sample content the APC released in 2026, which spreads 25 questions as 5 biomedical, 3 medicinal chemistry and biopharmaceutics, 4 pharmacokinetics and pharmacodynamics, 4 pharmacology and toxicology and 9 therapeutics. The sample is small, so we use it only to confirm which kinds of reasoning the APC likes. We do not reproduce its questions.
A topic is "high yield" here if it meets two tests: it sits under a heavily weighted area or crosses several areas, and its facts are stable enough to learn once and use many times. Warfarin is a clear example. It appears in pharmacology (mechanism), pharmacokinetics (metabolism, interactions), therapeutics (INR targets) and toxicology (reversal).
Tier 1: learn first and learn cold
| Topic | Why it ranks here | What to be able to do |
|---|---|---|
| Dose and infusion calculations | Named in the APC subtopics for therapeutics; present in the sample content | Convert units, set up weight-based doses, rates in mL/hour and mg/hour, millimoles from mass |
| Pharmacokinetic principles | Ten percent on its own and it supports pharmacology and therapeutics | Link half-life to steady state, clearance to dose, volume of distribution to loading dose |
| Warfarin and other anticoagulants | Cross-area theme; the sample content includes INR management and interactions | State the mechanism, major interactions, monitoring and the reversal approach |
| Narrow therapeutic index drugs | Lithium, digoxin, phenytoin, vancomycin, gentamicin, theophylline recur as monitoring and toxicity topics | Say what raises and lowers levels, signs of toxicity and when to monitor |
| Opioids and overdose | Appears in the sample content; links to harm minimisation | Mechanism, adverse effects, naloxone, tolerance and substitution therapy at a principle level |
| Drug interactions | Official subtopic under pharmacology and toxicology | Separate enzyme-based from pharmacodynamic interactions and predict direction of effect |
Treat Tier 1 as non-negotiable. A weakness here costs marks in several areas at once. Our pharmacokinetics page and calculations page cover the mechanics.
Tier 2: broad therapeutics coverage
Therapeutics is 45%, and its breadth is what overwhelms candidates. You cannot learn every drug, so learn each condition as a short decision: what makes it that condition, the usual first-line class and why, what to monitor, what to avoid in special groups, and when to refer.
- Cardiovascular: hypertension, heart failure, angina, atrial fibrillation, lipids, venous thromboembolism.
- Respiratory: asthma and COPD therapy, inhaler technique and device choice.
- Endocrine and metabolic: type 2 diabetes, insulin regimens, hypoglycaemia, thyroid disease, osteoporosis, gout.
- Renal and gastrointestinal: chronic kidney disease and dose adjustment, reflux and ulcers, inflammatory bowel disease.
- Infections: pneumonia, urinary tract infection, skin and soft tissue infection, antibiotic allergy, resistance and stewardship, plus tuberculosis, HIV and hepatitis at a principle level.
- Central nervous system and pain: epilepsy, depression, bipolar disorder, schizophrenia, Parkinson's disease, migraine, acute and chronic pain.
- Special populations: pregnancy and breastfeeding, children, older people, renal and hepatic impairment.
The three therapeutics domain pages break these into study sets: body systems, infections, central nervous system, pain, skin and oncology and calculations, screening, primary care and safe use of medicines.
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Tier 3: science foundations that earn steady marks
Biomedical sciences carry 20% of the exam, and medicinal chemistry and biopharmaceutics 10%. Both are heavy on recall, and the APC says 55% of questions overall test recall. These are the areas where careful memorisation pays.
- Physiology that explains drug action: cardiac cycle and blood pressure control, nephron sites and diuretics, acid-base balance, thyroid and adrenal axes, clotting cascade.
- Pathophysiology of the big diseases: heart failure, diabetes, asthma and COPD, pulmonary embolism, chronic kidney disease.
- Microbiology and immunology: Gram stain groups, resistance mechanisms, hypersensitivity types, transplant rejection.
- Fluids and electrolytes: sodium, potassium, calcium and magnesium disorders and their causes and consequences.
- Physical pharmacy: pKa and ionisation, partition coefficient, Henderson-Hasselbalch, solubility, dissolution, stability, formulation and sterile products.
See biomedical sciences and medicinal chemistry and biopharmaceutics for what is tested in each.
Cross-cutting facts worth memorising
These are textbook-level statements. Confirm exact numbers and doses in the Australian Medicines Handbook, Therapeutic Guidelines or TGA Product Information before you rely on them in a calculation.
- Steady state is reached after about four to five half-lives.
- Most drugs follow first-order kinetics. Phenytoin and ethanol show saturable (zero-order) kinetics at higher concentrations, so small dose rises can give large concentration rises.
- Enzyme inhibitors (macrolides, azoles, amiodarone, metronidazole) tend to raise warfarin effect. Inducers (rifampicin, carbamazepine) tend to lower it.
- Lithium toxicity is made worse by dehydration and by NSAIDs, ACE inhibitors and thiazides.
- Combining an NSAID, an ACE inhibitor (or angiotensin receptor blocker) and a diuretic raises the risk of acute kidney injury. This is often called the "triple whammy".
- Naloxone reverses opioid effects. Acetylcysteine treats paracetamol overdose.
- Vancomycin and gentamicin are renally cleared, so dose adjustment and level monitoring matter in renal impairment.
- Valproate, warfarin, ACE inhibitors, isotretinoin and methotrexate are well-known teratogens.
- Serotonin syndrome, neuroleptic malignant syndrome and QT prolongation are the standard adverse-reaction syndromes to be able to recognise.
Topics that test together
The APC organises content into five areas, but a question rarely respects the boundaries. Pairs of topics that tend to appear in the same stem make good joint study sets.
| Pair | Why they connect |
|---|---|
| Renal physiology and diuretics | Site of action explains effect, electrolyte changes and interactions |
| Clotting cascade and anticoagulants | Mechanism explains monitoring, reversal and bleeding risk |
| pKa and absorption | Ionisation at the pH of the stomach or urine explains absorption and excretion |
| Cytochrome P450 and interactions | Inducers and inhibitors predict changes in effect and toxicity |
| Renal impairment and dose adjustment | Clearance, half-life and accumulation connect pharmacokinetics to therapeutics |
| Antimicrobial mechanism and resistance | Microbiology explains first-line choice and stewardship |
When you study one half of a pair, spend ten minutes on the other. Over a plan, this builds the links that comprehension questions reward.
Calculation priorities
Calculations cross the areas, so they deserve their own ranking. In order of frequency in the APC sample content and subtopic list: infusion rates and weight-based doses, millimole conversions, dilutions and percentage strengths, and renal dose adjustments. Practise them daily from the start of your plan. The setup is where marks are lost, so write the units on every line and test whether the result is plausible.
What not to over-invest in
- Legislation and practice standards. The APC says OPRA does not test Australian or New Zealand legislation or practice standards. Keep the Poisons Standard schedules (S2, S3, S4, S8) and PBS rules as background, and do not memorise statute detail.
- Rare diseases and brand names. The APC uses TGA-approved generic names. Learn generics.
- Recalled questions. Memorised answers from other candidates are unreliable, and exam content changes across versions. Learn the reasoning behind each answer.
How to turn the tiers into a schedule
Do not study the tiers strictly one after another. Tier 1 topics are the spine of the plan, and they should return every week in some form: a calculation set, an interaction drill, a monitoring-drug review. Tier 2 topics are the bulk of your reading and should be taken system by system. Tier 3 topics are best studied in short, repeated sessions because they are recall-heavy, and recall improves with spacing.
A useful proportion for a 12-week plan is about 30% of study time on Tier 1 material (including calculations), 50% on Tier 2 and 20% on Tier 3. These numbers are our planning suggestion, and they mirror the official weights only loosely. If your baseline shows a gap in Tier 3 science, shift time towards it early, since foundations support everything that follows.
Finally, keep a list of topics that you find hard and review it every Sunday. Hard topics tend to be the ones you avoid, and avoidance is the commonest reason for an uneven profile across the five areas.
A weekly rhythm for high-yield topics
- Monday to Wednesday. Learn one Tier 1 or Tier 2 topic per day: mechanism, use, adverse effects, interactions, monitoring.
- Thursday. Calculation set: five problems by hand, covering at least three of the types listed on the calculations page.
- Friday. Mixed block of 30 questions from topics seen that week. Log each error as a rule.
- Weekend. One Tier 3 topic and a cumulative review of the error log.
That rhythm fits inside any of the plans in our study plan guide. For the overall picture of the exam, start at the OPRA hub.
Frequently asked questions
Does the APC publish a list of OPRA topics?
It publishes five content areas with weights and a list of subtopics for each. It does not publish a list of specific drugs or conditions that will be examined.
What are the most important OPRA topics?
Therapeutics carries 45 percent, so cover it first alongside dose calculations and pharmacokinetics. Warfarin, narrow therapeutic index drugs, opioids and drug interactions cross several areas. This ranking is editorial, not a prediction.
Should I memorise Australian guidelines for OPRA?
Learn the treatment logic and use the Australian Medicines Handbook and Therapeutic Guidelines as your reference. The APC says OPRA does not test Australian legislation or practice standards.
Do OPRA questions use brand names?
The APC exam guide says TGA-approved drug names are used. Learn generic names such as paracetamol, adrenaline and salbutamol.
Are the APC sample questions a guide to topics?
They show style and some themes, such as warfarin and INR, opioid overdose, vancomycin and infusion calculations. The sample is only 25 questions, so it is not a full picture of the exam.