How to Study the AMH for OPRA and Intern Exams: A Practical Guide

The Australian Medicines Handbook (AMH) is a key reference in Australian pharmacy. You can't take it into the closed-book OPRA, but it can support your study. You may take one original paper copy into the restricted open-book Intern Written Exam, along with one of the Australian Pharmaceutical Formulary and Handbook (APF).

But owning a copy and knowing how to use it effectively are different things. This guide is about the second part. GdayPharmacist is independent of the APC, the Pharmacy Board and Ahpra. The APC does not endorse any exam preparation program, including ours, so start with its free exam guide and sample content. The tips below are our own: neither the APC nor the AMH has reviewed them.

Why the AMH Matters for Exams

For OPRA (Closed-Book)

The OPRA exam tests biomedical, pharmaceutical and clinical science knowledge, with Therapeutics and patient care making up 45% of the questions. The APC's guide says it does not examine practice issues specific to Australia or New Zealand, such as legislation or practice standards. You cannot bring the AMH into the OPRA exam: it is entirely closed-book. No reference materials and no notes. You can bring a calculator (scientific or standard, with no internet, text storage or camera), and Pearson provides an online calculator and a whiteboard notebook.

The AMH can still be a useful study reference, but the APC does not say the OPRA follows it. The guide says exam content draws on peer-reviewed journals, clinical practice guidelines and textbooks, so don't rely on one book.

Key implication for OPRA: You must memorise key drug information — doses, interactions, contraindications, counselling points — because you cannot look anything up during the exam. The AMH is a study tool, not your exam reference.

For the Intern Written Exam (Restricted Open-Book)

The Intern Written Exam is restricted open-book. You may bring one original paper copy (any edition) of each of the AMH and the APF. Printed PDFs and scans are not allowed, and the invigilator inspects your books before you enter the exam room. With 75 questions in 120 minutes (96 seconds per question, our calculation), you can't look up everything, and the APC warns that not all the information you need will be in the permitted books. The AMH helps with specific lookups — confirming a dose, checking an interaction — but only if you already know where to look.

Key implication for Intern Written: Speed of navigation matters, but it will not replace knowledge. As a rough target of our own, aim to find information in under 30 seconds. The AMH is your verification tool, not your learning tool.

Understanding AMH Structure

The AMH's publisher says its chapters are arranged by organ system and therapeutic use, not alphabetically by drug name, and that the index lets you look up a disease, drug class, generic name or brand name. Chapter names and order may change between editions, so check the contents page of the copy you will take.

Study Areas (Our Own Grouping)

This table is our own grouping of common drug classes for study planning. It is not the AMH's list of chapters:

Study area	Key Drug Classes
Cardiovascular	ACEi, ARBs, CCBs, beta-blockers, diuretics, anticoagulants, antiplatelets, statins
Respiratory	Beta-2 agonists, ICS, LAMA, LABA, leukotriene antagonists
Gastrointestinal	PPIs, H2 antagonists, laxatives, antiemetics, IBD drugs
Central Nervous System	Antidepressants, antipsychotics, anxiolytics, opioids, antiepileptics
Musculoskeletal	NSAIDs, paracetamol, gout drugs, DMARDs, biologics
Endocrine	Insulins, metformin, SGLT2i, GLP-1 RAs, thyroid drugs, corticosteroids
Infections	Penicillins, cephalosporins, macrolides, fluoroquinolones, antifungals, antivirals
Malignant Disease	Cytotoxics, targeted therapies, immunotherapies
Immunology	Vaccines, immunoglobulins, immunosuppressants
Nutrition and Blood	Iron, B12, folate, anticoagulants, antiplatelets
Dermatology	Topical corticosteroids, antifungals, retinoids, acne treatments
Eye, Ear, Nose	Glaucoma drops, antibiotic drops, nasal corticosteroids
Urogenital	BPH drugs, overactive bladder, UTI treatments, contraceptives

Within Each Chapter

The publisher describes these building blocks:

1. Therapeutic information: summarises evidence and practice for a condition and compares treatments
2. Class statements: information common to drugs of the same class, so you can compare them
3. Drug monographs: specific information for individual drugs
4. Practice points: tips and advice

Drug Monograph Structure: The Key Sections to Know

The publisher says most drug monographs are shorter than an A5 page and give brief summaries of the items below. Knowing them helps you find information faster:

Item	What to look for
Mode of action	How the drug works
Indications	What the drug is used for
Precautions	Cautions for the drug. Check how your edition presents pregnancy, breastfeeding, and renal and hepatic impairment
Adverse effects	Common and serious side effects
Dosage	Doses
Patient counselling	Key points to tell the patient
Practice points	Practical advice
Products	Brand names, formulations and PBS information

The publisher describes a substantial drug interactions section in the appendices. Learn this structure on your own copy. Once you know where information lives, you can find a specific detail faster.

Navigation Strategies

1. Use the Index

The publisher describes an index where you can look up a disease, drug class, generic name or brand name, with substantial cross-referencing. For the restricted open-book exam:

• Search by drug name when you know the name
• Search by disease or class when you know the condition but not the drug

Practise both until you can find a drug in under 10 seconds (our own target).

2. Learn the Layout of Your Copy

We can't confirm from public AMH pages how each edition marks its chapters, so go by your own copy:

• You should be able to open directly to the cardiovascular section, the CNS section, or the infections section without checking the contents page
• Your own small tabs (maximum 12mm x 44mm) can help
• Drill: Close the AMH, then open it directly to the infections chapter. Time yourself. Repeat until it is quick.

3. Know the Appendices

The publisher lists these appendices:

• Drug interactions: a substantial section on interactions that are established and clinically important, or theoretical with potential for serious consequences
• Specialised drugs and late additions
• Laboratory reference ranges
• A key to abbreviations

For the restricted open-book exam, flag these with small tabs. Before exam day, also work out where your edition presents pregnancy, breastfeeding, and renal and hepatic impairment information.

4. Navigation Speed Drills

Practise these timed exercises regularly:

Level 1 — Drug Lookup (target: <10 seconds):

• Find the monograph for metformin
• Find the monograph for warfarin
• Find the monograph for amoxicillin

Level 2 — Specific Information (target: <30 seconds):

• Find the maximum daily dose of paracetamol
• Find warfarin's INR target for atrial fibrillation
• Find metformin's dose adjustment in renal impairment

Level 3 — Clinical Scenarios (target: <45 seconds):

• A patient on lithium starts an NSAID — find the interaction
• A pregnant woman needs an antidepressant — find the pregnancy information for sertraline
• A patient with eGFR 25 is prescribed metformin — find the renal dosing guidance

These time targets are our own. If you can't find a fact in the book, note that too: the APC says not everything you need is in the permitted books.

OPRA Strategy: What to Memorise from the AMH

Since OPRA is closed-book, you need to internalise key drug information, from the AMH and your other sources. Focus on memorising:

Must-Memorise Drug Information

1. First-line treatments for common conditions (e.g., first-line antihypertensive, first-line antibiotic for UTI)
2. Key dose ranges for commonly used drugs (not exact to the microgram, but the right ballpark)
3. Critical contraindications — the ones that cause harm (e.g., methotrexate in pregnancy, ACEi in bilateral renal artery stenosis)
4. Major drug interactions — the clinically dangerous ones (warfarin + NSAIDs, lithium + thiazides, methotrexate + trimethoprim)
5. Essential counselling points — what patients must be told (e.g., take on empty stomach, avoid grapefruit, don't stop suddenly)
6. Monitoring requirements — which drugs need blood tests and why (INR for warfarin, lithium levels, thyroid function on amiodarone)

Suggested Drug Groups for OPRA Study

The APC doesn't publish a list of the most-tested drugs. These are our own suggested starting points:

• Anticoagulants: Warfarin (INR targets, interactions), DOACs (renal dosing, reversal)
• Diabetes medications: Metformin (renal), sulfonylureas (hypo risk), SGLT2i (DKA risk), insulin types
• Antibiotics: First-line for UTI, pneumonia, cellulitis, otitis media
• Cardiovascular: ACEi (cough), ACEi and ARBs (hyperkalaemia), statins, antiplatelets
• CNS: SSRIs (serotonin syndrome), opioids (respiratory depression), benzodiazepines (dependence)
• Respiratory: Asthma step therapy, COPD inhalers, ICS vs SABA

Intern Written Exam Strategy: Tabbing and Annotation

Tabbing Strategy

For the restricted open-book exam, you're allowed small sticky flags or tabs (max 12mm × 44mm). These are our own suggestions for using them:

Suggested tabs (do these first):

1. Start of each major therapeutic chapter (cardiovascular, CNS, infections, endocrine)
2. Drug interactions appendix
3. Laboratory reference ranges appendix
4. Drugs you look up often or consider high risk: for example warfarin, metformin, lithium, digoxin, phenytoin, amiodarone

The APC's guide says questions focus on evidence-based guideline recommendations and frequently prescribed or high-risk medicines, but may include less frequently used ones.

Colour-code your tabs:

• Red — drug monographs you look up most
• Blue — appendices
• Green — therapeutic chapter starts

Limit your tabs: We suggest 20–30 maximum (the APC limits their size, not their number). More than 30 tabs defeats the purpose — you can't distinguish between them quickly.

Highlighting Tips

The APC allows simple highlighting and brief annotations (single words or brief phrases).

• Highlight sparingly — if everything is highlighted, nothing stands out
• Use a colour system:
  • Yellow — doses (the number you need to verify)
  • Pink — contraindications (the "do NOT use" information)
  • Green — key interactions (the combinations to watch for)
• Focus on facts you frequently forget or need to verify under time pressure

What NOT to Do

• Don't write extensive notes in margins: the APC does not allow extensive handwritten notes
• Don't attach loose pages or inserts: your book must not contain loose sheets
• Don't bring printed PDFs, scans or electronic versions: only original paper copies are allowed
• Don't flag every page — it defeats the purpose
• Don't rely on the AMH as your primary learning tool in the exam — it's for verification only

Suggested Priorities for Pharmacy Exams

The APC doesn't rank therapeutic areas or publish how often they appear, so the tiers below are our own study suggestion. For the OPRA, the APC publishes five content areas: Therapeutics and patient care 45%, Biomedical sciences 20%, Pharmacology and toxicology 15%, Medicinal chemistry and biopharmaceutics 10%, and Pharmacokinetics and pharmacodynamics 10%. The Intern Written guide lists a wide range of topics, from anti-infectives and cardiovascular to vaccination and women's health.

Tier 1: Start Here

• Cardiovascular — antihypertensives (ACEi, ARBs, CCBs, diuretics), anticoagulants (warfarin, DOACs), antiplatelets, statins, heart failure drugs
• Endocrine — diabetes medications (metformin, sulfonylureas, SGLT2i, GLP-1 RAs, insulin), thyroid drugs, corticosteroids
• Infections — antibiotics (know first-line for common infections), antifungals, antivirals
• CNS — antidepressants (SSRIs, SNRIs, TCAs), antipsychotics, anxiolytics, opioid analgesics, antiepileptics

Tier 2: Know Well

• Respiratory — asthma/COPD inhalers, preventer vs reliever, step therapy
• Gastrointestinal — PPIs, H2 antagonists, laxatives, antiemetics
• Musculoskeletal — NSAIDs, paracetamol, gout medications, DMARDs
• Immunology — vaccines and immunoglobulins

Tier 3: Know the Basics

• Dermatology — topical corticosteroid potency, antifungals, acne treatments
• Eye/Ear — glaucoma drops, antibiotic eye drops
• Urogenital — BPH medications, UTI treatments, contraceptives

AMH vs Other References

AMH vs Therapeutic Guidelines (eTG)

• AMH gives comparative medicines information: drug monographs, class statements and therapeutic information
• Therapeutic Guidelines (available at tg.org.au) describes itself as a point-of-care clinical resource from an independent not-for-profit organisation
• The APC says exam content draws on journals, clinical practice guidelines and textbooks, so don't study from one source alone
• Only the AMH and the APF can be brought into the Intern Written Exam, as original paper copies. Therapeutic Guidelines cannot

AMH vs MIMS

• AMH says it is independent of government and industry and takes no advertising or sponsorship
• MIMS is a separate medicines reference, which describes itself as independently edited
• MIMS is not one of the books you may take into the Intern Written Exam. The APC does not name a set text for study

AMH vs Product Information (PI)

• PI is the TGA-approved document for each brand
• AMH says its monographs go further than the PI
• Use the PI when you need the exact approved wording

AMH Online vs AMH Print

• AMH Online (amhonline.amh.net.au) suits studying because you can use it on a computer, tablet or phone. AMH says the content is updated twice a year, in January and July
• AMH Print is what you bring to the exam — practise with the physical book
• Study with online, practise navigation with print

Practice Exercises

Exercise 1: Speed Drills

Set a timer. Find the following information in your AMH as fast as possible:

1. Maximum daily dose of paracetamol in an adult
2. Warfarin's INR target for atrial fibrillation
3. First-line antibiotic for uncomplicated UTI
4. Metformin dose adjustment in renal impairment
5. Common drug interactions with lithium
6. Amlodipine maximum dose
7. Prednisolone dose for acute asthma in adults
8. Digoxin therapeutic range

Target: Under 30 seconds per lookup. If it takes longer, you need more practice. If a fact isn't in your copy, note that instead.

Exercise 2: Monograph Familiarity

Pick 5 drugs. For each, without looking, write down:

• Class and mechanism
• Main indication
• Key contraindication
• Most important drug interaction
• Essential counselling point

Then verify against the AMH. This identifies knowledge gaps.

Exercise 3: Clinical Scenarios

Present yourself with clinical scenarios and use the AMH to confirm your answers:

• "A patient on warfarin is prescribed fluconazole. What happens?"
• "A diabetic patient has an eGFR of 25. Can they continue metformin?"
• "A pregnant woman needs an antidepressant. What are the options?"
• "A patient on an ACE inhibitor develops a dry cough. What do you recommend?"
• "A patient is started on amiodarone. What monitoring is required?"

This builds the habit of checking your reasoning against a reference.

Exam Day Strategy

For the Restricted Open-Book Intern Written Exam

1. Answer what you know first — don't open the AMH for questions you can answer from memory
2. Move on and come back — if a question needs a long lookup, note it on your whiteboard notebook and return to it. Try Pearson's online sample test to see what the exam software allows
3. Use the index efficiently — know whether to search by drug name, disease or class
4. Verify, don't learn — the AMH is for confirming your answer, not for finding it from scratch
5. Time check at question 25 and 50 — at 96 seconds a question you should be at 40 minutes and 80 minutes respectively (our calculation)
6. Use your tabs — go directly to flagged sections rather than flipping through pages

For OPRA (Closed Book): Before Exam Day

7. Study the AMH content so you internalise the information — not just recognise it, but recall it
8. Focus on therapeutic information, class statements and practice points
9. Know dose ranges for commonly used drugs rather than exact figures
10. Understand drug interactions conceptually, not just as memorised pairs (e.g., understand WHY warfarin + NSAIDs is dangerous, not just that it is)

Preparing for OPRA? See our OPRA exam preparation page for lessons, practice questions and mock exams. For the intern exam, see our Intern Written Exam guide and our Intern Written course.

Key Takeaways

1. Learn the AMH structure — therapeutic chapters, monograph format, appendices
2. Practise navigation speed — index use, your own tabs, appendix location
3. OPRA is closed-book — memorise key drug information; use the AMH as one study source
4. Intern Written is restricted open-book — one original paper copy each of the AMH and APF. Focus on navigation speed and verification, and remember not everything is in the books
5. Start with our Tier 1 suggestions — cardiovascular, endocrine, infections, CNS
6. Highlight and flag strategically — less is more, use a colour system, limit to 20–30 tabs
7. Use the AMH to verify, not to learn during the exam
8. Do timed practice lookups — 30 seconds per item is your target

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References (re-checked 7 November 2026): Australian Medicines Handbook public product and FAQ pages (shop.amh.net.au); Therapeutic Guidelines and MIMS public home pages; Australian Pharmacy Council OPRA Exam Guide (30 July 2026, version 2.3), Intern Written Exam Guide (30 July 2026, version 2.2), and the exam day preparation pages.