Oxazepam MCQs With Answer

Oxazepam MCQs With Answer offers B.Pharm students a focused, exam-ready review of oxazepam pharmacology, pharmacokinetics, mechanisms, clinical uses, adverse effects, and drug interactions. This concise, keyword-rich introduction prepares students to understand oxazepam as a 3‑hydroxy benzodiazepine used for anxiety, insomnia, and alcohol withdrawal, highlighting hepatic glucuronidation, minimal CYP dependence, and common safety considerations. Ideal for pharmacy exams and clinical practice revision, these practice questions emphasize drug action at GABA-A receptors, dosing principles, contraindications, and monitoring. Clear explanations and targeted questions help reinforce critical concepts and clinical application. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which chemical class does oxazepam belong to?

• Benzodiazepines
• Barbiturates
• Antipsychotics
• SSRI antidepressants

Correct Answer: Benzodiazepines

Q2. What is the primary clinical use of oxazepam?

• Antibiotic therapy
• Antiepileptic maintenance
• Treatment of anxiety and insomnia
• Cholesterol lowering

Correct Answer: Treatment of anxiety and insomnia

Q3. Oxazepam acts primarily by modulating which receptor?

• NMDA receptor
• GABA-A receptor
• Serotonin 5-HT2A receptor
• Dopamine D2 receptor

Correct Answer: GABA-A receptor

Q4. Which mechanism best describes oxazepam’s action at the GABA-A receptor?

• Direct agonist opening Cl- channels independent of GABA
• Competitive antagonist at GABA binding site
• Positive allosteric modulator increasing GABAergic chloride influx
• Ionic channel blocker preventing Cl- entry

Correct Answer: Positive allosteric modulator increasing GABAergic chloride influx

Q5. Oxazepam is classified as a 3-hydroxy benzodiazepine. Which pharmacokinetic implication follows?

• It requires CYP-mediated oxidation to active metabolites
• It undergoes direct glucuronidation and has fewer CYP interactions
• It is exclusively excreted unchanged in bile
• It has a very long half-life due to storage in adipose tissue

Correct Answer: It undergoes direct glucuronidation and has fewer CYP interactions

Q6. Which statement about oxazepam metabolism is correct?

• Oxazepam is primarily metabolized by CYP3A4 to active metabolites
• Oxazepam is not metabolized and is excreted unchanged
• Oxazepam undergoes hepatic conjugation (glucuronidation) and has no active metabolites
• Oxazepam is converted to diazepam in the liver

Correct Answer: Oxazepam undergoes hepatic conjugation (glucuronidation) and has no active metabolites

Q7. Why is oxazepam often preferred in elderly patients or those with hepatic impairment?

• Because it is renally excreted unchanged
• Because it is activated by hepatic CYP enzymes
• Because it is metabolized by phase II glucuronidation with minimal CYP involvement
• Because it has no sedative effects

Correct Answer: Because it is metabolized by phase II glucuronidation with minimal CYP involvement

Q8. Which of the following is a common adverse effect of oxazepam?

• Hyperactivity and increased appetite
• Drowsiness and impaired coordination
• Severe hypertension as the first-line effect
• Neutropenia in most patients

Correct Answer: Drowsiness and impaired coordination

Q9. Oxazepam has clinical utility in alcohol withdrawal because it:

• Stimulates glutamate receptors to reduce cravings
• Provides GABAergic sedation to lessen withdrawal symptoms and seizures
• Acts as an opioid receptor antagonist to reduce dependency
• Neutralizes acetaldehyde accumulation

Correct Answer: Provides GABAergic sedation to lessen withdrawal symptoms and seizures

Q10. Which is the most appropriate emergency antidote for benzodiazepine overdose including oxazepam?

• Naloxone
• Flumazenil
• Atropine
• Activated charcoal only

Correct Answer: Flumazenil

Q11. Which adverse outcome is a risk when oxazepam is combined with strong CNS depressants like opioids or alcohol?

• Reduced benzodiazepine efficacy without added risk
• Synergistic respiratory depression and sedation
• Increased hepatic enzyme induction leading to rapid clearance
• Antagonism of opioid analgesia

Correct Answer: Synergistic respiratory depression and sedation

Q12. Oxazepam’s onset of action after oral administration is typically:

• Immediate (within seconds)
• Rapid (minutes)
• Moderate (about 1–2 hours)
• Delayed (more than 24 hours)

Correct Answer: Moderate (about 1–2 hours)

Q13. Which feature distinguishes oxazepam from diazepam in clinical use?

• Oxazepam has longer active metabolites than diazepam
• Oxazepam is preferred in hepatic impairment due to direct conjugation
• Oxazepam is an enzyme inducer unlike diazepam
• Oxazepam has significant anticholinergic effects

Correct Answer: Oxazepam is preferred in hepatic impairment due to direct conjugation

Q14. Which of the following is a contraindication for oxazepam use?

• Acute narrow-angle glaucoma
• Controlled hypertension
• Mild seasonal allergies
• Stable hypothyroidism

Correct Answer: Acute narrow-angle glaucoma

Q15. How does chronic use of oxazepam affect GABA-A receptors over time?

• Upregulation of receptor sensitivity leading to increased responsiveness
• No change in receptor function with long-term use
• Downregulation and tolerance, reducing clinical effect over time
• Conversion of GABA-A receptors to glutamate receptors

Correct Answer: Downregulation and tolerance, reducing clinical effect over time

Q16. Which withdrawal symptom is commonly associated with abrupt discontinuation of oxazepam after prolonged use?

• Severe hyperglycemia
• Anxiety, insomnia, and possible seizures
• Permanent vision loss
• Immediate resolution of anxiety without rebound

Correct Answer: Anxiety, insomnia, and possible seizures

Q17. Oxazepam elimination primarily occurs via:

• Renal excretion of glucuronide conjugates
• Exhalation unchanged through lungs
• Fecal elimination of unchanged drug only
• Biliary secretion as active metabolite

Correct Answer: Renal excretion of glucuronide conjugates

Q18. Which property of oxazepam contributes to a lower risk of drug–drug interactions compared to many other benzodiazepines?

• High dependence on CYP450 2D6 for metabolism
• Primary metabolism by glucuronidation (phase II) rather than CYP450
• Requirement of CYP3A4 activation to an active metabolite
• Extensive enterohepatic recycling

Correct Answer: Primary metabolism by glucuronidation (phase II) rather than CYP450

Q19. In pregnancy, benzodiazepines like oxazepam are generally:

• Recommended as first-line therapy for anxiety
• Associated with potential teratogenic risk and generally avoided if possible
• Safe with no fetal risk documented
• Required to prevent preterm labor

Correct Answer: Associated with potential teratogenic risk and generally avoided if possible

Q20. Which laboratory monitoring is specifically required for routine oxazepam therapy?

• Frequent liver enzyme testing weekly
• No specific routine laboratory test; monitor clinical response and sedation
• Daily serum oxazepam levels mandatory
• Weekly CBC to assess bone marrow suppression

Correct Answer: No specific routine laboratory test; monitor clinical response and sedation

Q21. Oxazepam is most appropriately prescribed for which type of anxiety disorder?

• Long-term monotherapy for chronic generalized anxiety disorder without nonpharmacologic measures
• Short-term relief of acute anxiety and panic symptoms
• First-line maintenance for bipolar mania
• Primary treatment for obsessive-compulsive disorder

Correct Answer: Short-term relief of acute anxiety and panic symptoms

Q22. Which statement about oxazepam dosing in renal impairment is true?

• No dose adjustment is ever needed in renal impairment
• Dosing may require adjustment because glucuronide metabolites are renally excreted
• Oxazepam is dialyzable and therefore safe at high doses
• Renal impairment converts oxazepam to active toxic metabolites

Correct Answer: Dosing may require adjustment because glucuronide metabolites are renally excreted

Q23. Which pharmacodynamic effect is least associated with oxazepam?

• Anxiolysis
• Muscle relaxation
• Anticoagulation
• Anticonvulsant activity at higher doses

Correct Answer: Anticoagulation

Q24. Oxazepam is sometimes chosen over longer-acting benzodiazepines because it:

• Has a quicker onset and longer residual sedation
• Has shorter to intermediate half-life reducing next-day sedation
• Is more likely to cause accumulation in adipose tissue
• Is more lipophilic and crosses blood-brain barrier faster than all others

Correct Answer: Has shorter to intermediate half-life reducing next-day sedation

Q25. Which of the following drug interactions is most concerning with oxazepam?

• Concomitant use with SSRIs increasing serotonin only
• Co-administration with strong opioid analgesics producing additive CNS depression
• Use with beta-blockers causing antihypertensive synergy only
• Use with metformin increasing hypoglycemia risk

Correct Answer: Co-administration with strong opioid analgesics producing additive CNS depression

Q26. Which pharmacological property explains oxazepam’s anxiolytic effect?

• Inhibition of monoamine oxidase A
• Enhancement of GABA-mediated inhibitory neurotransmission
• Selective blockade of adrenergic beta-receptors
• Stimulation of histamine H1 receptors

Correct Answer: Enhancement of GABA-mediated inhibitory neurotransmission

Q27. For a patient with chronic liver disease, which benzodiazepine is often safer due to predominant phase II metabolism?

• Diazepam
• Oxazepam
• Chlordiazepoxide
• Clonazepam

Correct Answer: Oxazepam

Q28. Which side effect is particularly concerning in elderly patients taking oxazepam?

• Weight gain without sedation
• Increased risk of falls, confusion, and cognitive impairment
• Improvements in memory function
• Acceleration of wound healing

Correct Answer: Increased risk of falls, confusion, and cognitive impairment

Q29. When comparing oxazepam with lorazepam and temazepam, what common pharmacokinetic trait do they share?

• All are 1,4-diazepine derivatives that require CYP3A4 activation
• All are 3-hydroxy benzodiazepines primarily metabolized by glucuronidation
• All produce long-acting active metabolites accumulating in elderly
• All are primarily excreted unchanged in bile

Correct Answer: All are 3-hydroxy benzodiazepines primarily metabolized by glucuronidation

Q30. Which adverse psychiatric reaction may paradoxically occur with benzodiazepines like oxazepam?

• Severe apathy only
• Paradoxical agitation, irritability, or aggression
• Immediate mood stabilization in all patients
• Permanent psychosis in all users

Correct Answer: Paradoxical agitation, irritability, or aggression

Q31. Which patient counseling point is most important for oxazepam therapy?

• It is safe to drink alcohol while taking oxazepam
• Avoid driving or operating heavy machinery until you know how oxazepam affects you
• You must double the dose if anxiety returns
• It cures anxiety permanently after one dose

Correct Answer: Avoid driving or operating heavy machinery until you know how oxazepam affects you

Q32. Oxazepam’s common formulation for oral use is:

• Intravenous solution only
• Oral tablets or capsules
• Transdermal patch exclusively
• Inhalation aerosol

Correct Answer: Oral tablets or capsules

Q33. In which schedule do benzodiazepines like oxazepam typically fall in many countries due to abuse potential?

• Uncontrolled over-the-counter (OTC)
• Controlled substance (prescription only) due to dependence potential
• Classified as a stimulant
• Herbal supplement category

Correct Answer: Controlled substance (prescription only) due to dependence potential

Q34. Which clinical scenario would most likely require tapering rather than abrupt discontinuation of oxazepam?

• Single low-dose use for one night’s insomnia
• Prolonged high-dose therapy for months with physiologic dependence
• Use discontinued after a single dose due to rash
• Switching to an SSRI the same day

Correct Answer: Prolonged high-dose therapy for months with physiologic dependence

Q35. Which pharmacokinetic parameter is least likely to vary significantly with oxazepam compared to lipophilic benzodiazepines?

• Rate of redistribution into adipose tissue
• Dependency on glucuronidation for clearance
• Absence of active long-lived metabolites
• Reduced accumulation in the elderly compared with diazepam

Correct Answer: Rate of redistribution into adipose tissue

Q36. Which laboratory or clinical sign suggests benzodiazepine overdose such as with oxazepam?

• Marked hypertension with tachycardia only
• Excessive sedation, respiratory depression, and reduced reflexes
• Hyperreflexia and agitation exclusively
• Profound hypokalemia

Correct Answer: Excessive sedation, respiratory depression, and reduced reflexes

Q37. Which therapeutic advantage does oxazepam have in comparison to very short-acting benzodiazepines for sleep maintenance?

• It provides intermediate duration of action helpful for both sleep onset and maintenance
• It guarantees no next-day sedation
• It has stimulant properties to prevent daytime drowsiness
• It is ineffective for sleep maintenance

Correct Answer: It provides intermediate duration of action helpful for both sleep onset and maintenance

Q38. Which receptor subunit composition is most associated with benzodiazepine sensitivity relevant to oxazepam’s effects?

• NMDA receptor subunits NR1/NR2
• GABA-A receptor containing alpha and gamma subunits
• Dopamine D1/D2 heteromers
• Serotonin 5-HT3 ligand-gated channels only

Correct Answer: GABA-A receptor containing alpha and gamma subunits

Q39. Which of the following is a monitoring concern when initiating oxazepam in a patient on multiple psychotropic medications?

• Monitoring for additive sedation and potential pharmacodynamic interactions
• Expecting no interactions due to oxazepam’s inert nature
• Need for immediate discontinuation of all other drugs
• Requirement to add hepatic enzyme inducers concurrently

Correct Answer: Monitoring for additive sedation and potential pharmacodynamic interactions

Q40. Which patient population should be prescribed oxazepam with extra caution due to increased sensitivity?

• Healthy young adults with no comorbidities
• Elderly, pregnant women, and those with respiratory insufficiency
• Patients with controlled myopia
• Individuals taking vitamin supplements only

Correct Answer: Elderly, pregnant women, and those with respiratory insufficiency

Q41. Which therapeutic use of oxazepam is supported by clinical practice guidelines?

• First-line chronic therapy for generalized anxiety disorder for years without reassessment
• Short-term management of severe acute anxiety and alcohol withdrawal symptoms
• Treatment of bacterial meningitis
• Primary drug for Parkinson’s disease motor symptoms

Correct Answer: Short-term management of severe acute anxiety and alcohol withdrawal symptoms

Q42. What is a common reason to switch a patient from diazepam to oxazepam?

• To increase drug accumulation in adipose tissue
• To avoid active metabolites and reduce hepatic CYP interactions
• To induce hepatic enzymes for faster clearance of other drugs
• To increase anticholinergic side effects

Correct Answer: To avoid active metabolites and reduce hepatic CYP interactions

Q43. Which formulation consideration is important when preparing oxazepam for oral administration in the pharmacy?

• Oxazepam tablets are hygroscopic and must be stored in airtight containers
• Oxazepam is light-sensitive and must be stored under amber glass only
• Oxazepam requires refrigeration at all times
• Oxazepam is administered only by intravenous infusion in hospital settings

Correct Answer: Oxazepam tablets are hygroscopic and must be stored in airtight containers

Q44. Which safety advice is important when combining oxazepam with elderly patient therapy plans?

• Increase dose gradually to achieve rapid tolerance
• Use the lowest effective dose for the shortest duration and reassess frequently
• Prescribe concurrently with multiple CNS depressants to ensure efficacy
• Discontinue other fall-preventing strategies when benzodiazepines are used

Correct Answer: Use the lowest effective dose for the shortest duration and reassess frequently

Q45. Which of the following best describes the development of misuse potential with oxazepam?

• No potential for misuse or dependence
• Risk of tolerance, physical dependence, and misuse with long-term or high-dose use
• Dependence only occurs if combined with antibiotics
• Dependence develops instantly after a single dose

Correct Answer: Risk of tolerance, physical dependence, and misuse with long-term or high-dose use

Q46. Which clinical test would be most helpful to distinguish benzodiazepine-induced sedation from opioid-induced sedation?

• Serum benzodiazepine assay and clinical assessment of pupil size
• Complete blood count differentiating drug classes
• X-ray imaging of the chest
• ECG changes specific to benzodiazepines

Correct Answer: Serum benzodiazepine assay and clinical assessment of pupil size

Q47. Which statement about oxazepam’s protein binding is correct?

• Oxazepam is completely unbound in plasma
• Oxazepam is moderately to highly protein bound which can be displaced by other drugs
• Protein binding is irrelevant to its pharmacokinetics
• Oxazepam irreversibly binds to albumin

Correct Answer: Oxazepam is moderately to highly protein bound which can be displaced by other drugs

Q48. Which patient scenario indicates immediate medical attention when on oxazepam?

• Occasional mild drowsiness after the first dose
• Development of severe respiratory depression and loss of consciousness
• Mild dry mouth manageable with fluids
• Transient headache that resolves in hours

Correct Answer: Development of severe respiratory depression and loss of consciousness

Q49. Which dosing strategy reduces risk of benzodiazepine withdrawal when discontinuing oxazepam?

• Abrupt cessation after long-term use
• Gradual tapering of dose over weeks to months depending on duration of use
• Switching abruptly to a stimulant medication
• Doubling the dose for one day then stopping

Correct Answer: Gradual tapering of dose over weeks to months depending on duration of use

Q50. Which educational point should a B.Pharm student emphasize when counseling about oxazepam adherence?

• Take higher doses if anxiety returns the next day
• Follow prescribed dose, avoid alcohol, report excessive sedation, and do not stop abruptly after long-term use
• Share medication with family members for convenience
• Only take the medication when feeling well-rested

Correct Answer: Follow prescribed dose, avoid alcohol, report excessive sedation, and do not stop abruptly after long-term use

G S Sachin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.

Mail- Sachin@pharmacyfreak.com