Chlorazepate MCQs With Answer

Chlorazepate MCQs With Answer offers B. Pharm students a focused, exam-ready review of chlorazepate pharmacology, mechanism, kinetics, clinical uses and safety. This concise, keyword-rich introduction emphasizes chlorazepate as a benzodiazepine prodrug, its conversion to nordiazepam (desmethyldiazepam), GABAA receptor modulation, pharmacokinetics, adverse effects, drug interactions and clinical applications such as anxiety, alcohol withdrawal and seizure adjunct therapy. Designed for pharmacy undergraduates, the material reinforces prescribing considerations, monitoring parameters and risk factors like dependence and respiratory depression. Use these targeted questions to strengthen therapeutic knowledge and practical decision-making in pharmaceutical care. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which statement best describes chlorazepate?

• A directly active short-acting benzodiazepine
• A prodrug that is converted to nordiazepam (desmethyldiazepam)
• An opioid receptor agonist used for pain
• A selective serotonin reuptake inhibitor

Correct Answer: A prodrug that is converted to nordiazepam (desmethyldiazepam)

Q2. Chlorazepate primarily acts by which mechanism at the receptor level?

• Blocking NMDA receptors
• Agonism at GABA-B receptors
• Enhancement of GABAA receptor-mediated chloride influx by increasing channel opening frequency
• Inhibition of monoamine oxidase

Correct Answer: Enhancement of GABAA receptor-mediated chloride influx by increasing channel opening frequency

Q3. The active metabolite predominantly formed from chlorazepate is:

• Diazepam
• Nordiazepam (desmethyldiazepam)
• Clonazepam
• Temazepam

Correct Answer: Nordiazepam (desmethyldiazepam)

Q4. Which clinical indication is chlorazepate commonly used for?

• Type 2 diabetes mellitus
• Anxiety disorders and alcohol withdrawal
• Bacterial infections
• Hyperthyroidism

Correct Answer: Anxiety disorders and alcohol withdrawal

Q5. Which of the following adverse effects is most characteristic of chlorazepate?

• Hypertension and tachycardia
• Renal failure
• Excessive sedation and ataxia
• Hyperglycemia

Correct Answer: Excessive sedation and ataxia

Q6. Chlorazepate should be used cautiously with which of the following drug classes due to additive respiratory depression?

• Beta-blockers
• Central nervous system depressants such as opioids and alcohol
• ACE inhibitors
• Antacids

Correct Answer: Central nervous system depressants such as opioids and alcohol

Q7. What is the primary route of elimination for chlorazepate metabolites?

• Fecal excretion unchanged
• Renal excretion of metabolites
• Exhaled via lungs
• Excreted in sweat

Correct Answer: Renal excretion of metabolites

Q8. Which patient population requires dosage reduction or special caution when prescribing chlorazepate?

• Young adults aged 20–30 without comorbidity
• Elderly patients due to increased sensitivity and fall risk
• Patients with uncomplicated seasonal allergies
• Patients with acute bacterial infections

Correct Answer: Elderly patients due to increased sensitivity and fall risk

Q9. Flumazenil is best described as:

• A benzodiazepine prodrug
• A benzodiazepine receptor antagonist used to reverse benzodiazepine effects
• An anticonvulsant unrelated to benzodiazepines
• An opioid antagonist

Correct Answer: A benzodiazepine receptor antagonist used to reverse benzodiazepine effects

Q10. Chlorazepate is commonly formulated as which salt for oral administration?

• Sodium chloride
• Dipotassium salt
• Calcium carbonate
• Magnesium sulfate

Correct Answer: Dipotassium salt

Q11. Which property explains the long duration of effect seen with chlorazepate therapy?

• Rapid renal clearance of the parent drug
• Formation of long-acting active metabolites (e.g., nordiazepam)
• High first-pass metabolism without active metabolites
• Short half-life and low protein binding

Correct Answer: Formation of long-acting active metabolites (e.g., nordiazepam)

Q12. A key counseling point for patients starting chlorazepate is:

• It enhances alertness while driving
• Avoid alcohol and other sedatives due to increased sedation and respiratory depression
• It has no potential for dependence
• It cures chronic insomnia permanently after one dose

Correct Answer: Avoid alcohol and other sedatives due to increased sedation and respiratory depression

Q13. In the context of epilepsy management, chlorazepate is primarily used as:

• A first-line monotherapy for absence seizures
• An adjunctive agent for partial seizures or as short-term control
• A primary therapy for bacterial meningitis
• An antipsychotic agent

Correct Answer: An adjunctive agent for partial seizures or as short-term control

Q14. Which laboratory or clinical monitoring is important during prolonged chlorazepate therapy?

• Frequent ECGs every day
• Monitoring for signs of tolerance, dependence, and withdrawal; assessment of sedation and respiratory status
• Daily serum potassium levels
• Routine liver biopsy

Correct Answer: Monitoring for signs of tolerance, dependence, and withdrawal; assessment of sedation and respiratory status

Q15. Withdrawal from long-term chlorazepate use may present with:

• Hyperactivity of the nervous system, anxiety, insomnia, and seizures
• Improved cognitive function
• Immediate full recovery without symptoms
• Only gastrointestinal cramps

Correct Answer: Hyperactivity of the nervous system, anxiety, insomnia, and seizures

Q16. Which statement about chlorazepate metabolism is correct?

• It is excreted unchanged in bile
• It undergoes hydrolysis to form an active benzodiazepine metabolite
• It is converted to dopamine
• It is metabolized exclusively to inactive conjugates

Correct Answer: It undergoes hydrolysis to form an active benzodiazepine metabolite

Q17. Which contraindication is most relevant for benzodiazepines like chlorazepate?

• Acute narrow-angle glaucoma and severe respiratory insufficiency
• Mild seasonal allergy
• Controlled hypertension
• Untreated vitamin D deficiency

Correct Answer: Acute narrow-angle glaucoma and severe respiratory insufficiency

Q18. The primary therapeutic effect of chlorazepate in anxiety is due to:

• Inhibition of monoamine oxidase
• Enhancement of inhibitory GABAergic neurotransmission
• Stimulation of adrenergic receptors
• Antagonism at histamine receptors exclusively

Correct Answer: Enhancement of inhibitory GABAergic neurotransmission

Q19. Which of the following is a paradoxical effect that can occur with benzodiazepines including chlorazepate?

• Increased sociability and calmness only
• Agitation, aggression or disinhibition
• Permanent immunity to infections
• Enhanced long-term memory

Correct Answer: Agitation, aggression or disinhibition

Q20. Which pharmacokinetic property best explains interpatient variability with chlorazepate?

• Identical clearance in all patients
• Differences in hepatic metabolism and formation of active metabolites
• No metabolism occurs
• Exclusive elimination via expired air

Correct Answer: Differences in hepatic metabolism and formation of active metabolites

Q21. Which drug interaction is most likely to increase chlorazepate effects?

• Concurrent use with rifampicin
• Concurrent use with enzyme inhibitors or additional CNS depressants like macrolides or fluoroquinolones that inhibit metabolism
• Taking multivitamins
• Topical antifungal cream

Correct Answer: Concurrent use with enzyme inhibitors or additional CNS depressants like macrolides or fluoroquinolones that inhibit metabolism

Q22. Which statement about chlorazepate pharmacology is accurate?

• It directly opens chloride channels without receptor binding
• It modulates the GABAA receptor complex as a positive allosteric modulator
• It acts primarily on dopamine D2 receptors
• It inhibits GABA release

Correct Answer: It modulates the GABAA receptor complex as a positive allosteric modulator

Q23. A B. Pharm student should recognize which risk associated with chronic benzodiazepine use?

• Complete resistance to bacterial infections
• Tolerance, dependence, cognitive impairment and risk of falls in elderly
• Guaranteed weight loss
• Improved athletic performance

Correct Answer: Tolerance, dependence, cognitive impairment and risk of falls in elderly

Q24. Which is an appropriate management step in suspected chlorazepate overdose with respiratory depression?

• Administer high-dose benzodiazepines
• Supportive respiratory care and consider flumazenil if indicated and no contraindications
• Give oral activated charcoal after 24 hours
• Immediate dialysis in all cases

Correct Answer: Supportive respiratory care and consider flumazenil if indicated and no contraindications

Q25. Compared to short-acting benzodiazepines, chlorazepate’s clinical profile typically shows:

• Very brief duration and no active metabolites
• Longer duration due to active metabolite(s) and prolonged effects
• Exclusive peripheral actions without CNS effects
• No potential for dependence

Correct Answer: Longer duration due to active metabolite(s) and prolonged effects

Q26. Which formulation is most commonly available for chlorazepate administration?

• Intravenous infusion only
• Oral tablets (dipotassium salt)
• Transdermal patch
• Nasal spray

Correct Answer: Oral tablets (dipotassium salt)

Q27. In pregnancy, benzodiazepines like chlorazepate are best described as:

• Completely safe with no fetal effects
• Used with caution due to potential neonatal sedation, floppy infant syndrome and withdrawal
• Recommended to enhance fetal development
• Always indicated for morning sickness

Correct Answer: Used with caution due to potential neonatal sedation, floppy infant syndrome and withdrawal

Q28. Which adverse cognitive effect may occur with long-term chlorazepate therapy?

• Enhanced problem-solving skills
• Impaired memory and psychomotor slowing
• Superhuman concentration
• Permanent language improvement

Correct Answer: Impaired memory and psychomotor slowing

Q29. Which concept best describes why gradual tapering is recommended when stopping long-term chlorazepate?

• To induce rapid detoxification
• To reduce risk of withdrawal symptoms including anxiety, insomnia and seizures
• Because abrupt stop increases drug potency
• Because tapering increases bioavailability

Correct Answer: To reduce risk of withdrawal symptoms including anxiety, insomnia and seizures

Q30. Chlorazepate’s onset of action is influenced by which factor?

• Whether it is administered as an injectable solution only
• Rate of conversion of the prodrug to its active metabolite and absorption from GI tract
• Its ability to bind to opioid receptors
• Its poor oral absorption making onset negligible

Correct Answer: Rate of conversion of the prodrug to its active metabolite and absorption from GI tract

Q31. Which monitoring parameter is least relevant for routine chlorazepate therapy?

• Assessment of sedation and respiratory status
• Evaluation for signs of dependence and withdrawal
• Regular complete blood counts for all patients
• Medication review for interacting CNS depressants

Correct Answer: Regular complete blood counts for all patients

Q32. Which of the following describes a pharmacodynamic interaction relevant to chlorazepate?

• Enzyme induction by rifampicin lowering chlorazepate levels
• Additive CNS depression when combined with opioids or alcohol
• Formation of inactive conjugates in the liver
• Metabolic competition at renal transporters only

Correct Answer: Additive CNS depression when combined with opioids or alcohol

Q33. Which benzodiazepine receptor binding effect differentiates benzodiazepines from barbiturates?

• Benzodiazepines increase duration of chloride channel opening while barbiturates increase frequency
• Benzodiazepines increase frequency of chloride channel opening; barbiturates increase duration
• Both have identical mechanisms with no differences
• Neither affects GABAergic neurotransmission

Correct Answer: Benzodiazepines increase frequency of chloride channel opening; barbiturates increase duration

Q34. Which symptom would most likely prompt immediate medical review in a patient taking chlorazepate?

• Mild temporary dry mouth
• Marked daytime drowsiness, confusion, or respiratory difficulty
• Transient improvement in sleep
• Mild transient dizziness on first dose

Correct Answer: Marked daytime drowsiness, confusion, or respiratory difficulty

Q35. Concomitant use of chlorazepate with which medication class can significantly impair psychomotor performance?

• Topical corticosteroids
• Other CNS depressants such as antihistamines, antipsychotics or opioids
• Proton pump inhibitors
• Oral contraceptives

Correct Answer: Other CNS depressants such as antihistamines, antipsychotics or opioids

Q36. Which factor is most important when selecting benzodiazepine therapy for an elderly patient?

• Prefer long-acting agents to reduce dosing frequency without considering fall risk
• Use lower doses and prefer shorter-acting agents where possible due to fall and cognitive risk
• Always use the highest available dose to ensure efficacy
• Ignore comorbidities when selecting an agent

Correct Answer: Use lower doses and prefer shorter-acting agents where possible due to fall and cognitive risk

Q37. A pharmacology exam question: which receptor subunit selectivity is most associated with benzodiazepine anxiolytic effects?

• GABAA receptors containing alpha-1 subunits only
• GABAA receptors; anxiolysis is linked to alpha-2 and alpha-3 subunits
• NMDA subunit selectivity
• Serotonin 5-HT2 receptor selectivity

Correct Answer: GABAA receptors; anxiolysis is linked to alpha-2 and alpha-3 subunits

Q38. Which regulatory consideration is important when dispensing chlorazepate?

• It is an over-the-counter vitamin
• It is a controlled medication in many jurisdictions due to dependence potential
• It requires no labeling or counseling
• It is banned worldwide

Correct Answer: It is a controlled medication in many jurisdictions due to dependence potential

Q39. For which of the following conditions is chlorazepate least appropriate?

• Acute alcohol withdrawal under supervision
• Generalized anxiety disorder short-term therapy
• Chronic long-term insomnia without re-evaluation
• Adjunctive therapy for partial seizures

Correct Answer: Chronic long-term insomnia without re-evaluation

Q40. Which metabolic organ is primarily responsible for converting chlorazepate to its active metabolite?

• Kidney
• Liver
• Pancreas
• Spleen

Correct Answer: Liver

Q41. Which statement accurately describes the use of chlorazepate in alcohol withdrawal?

• It is ineffective for preventing withdrawal seizures
• It can be used to reduce anxiety, agitation and risk of withdrawal seizures under supervision
• It should be combined with alcohol to reduce symptoms
• It is contraindicated in alcohol withdrawal

Correct Answer: It can be used to reduce anxiety, agitation and risk of withdrawal seizures under supervision

Q42. Which counseling advice should be given about driving while taking chlorazepate?

• Driving is always safe regardless of dose
• Avoid driving or operating machinery until you know how the drug affects you
• Driving improves with the medication
• Only avoid driving during the first five minutes after a dose

Correct Answer: Avoid driving or operating machinery until you know how the drug affects you

Q43. Which clinical feature differentiates benzodiazepine dependence from appropriate short-term therapeutic use?

• Short-term relief of anxiety
• Craving, inability to stop drug use, and withdrawal symptoms on cessation
• Improved sleep for one or two nights
• Use under direct medical supervision for a defined period

Correct Answer: Craving, inability to stop drug use, and withdrawal symptoms on cessation

Q44. Which statement about dosing frequency for chlorazepate is typically correct?

• It is given once and provides lifetime cure
• Dosage should be individualized; long-acting metabolites may allow once or twice daily dosing but require careful titration
• It must be administered hourly
• Dosing is irrelevant for therapeutic effect

Correct Answer: Dosage should be individualized; long-acting metabolites may allow once or twice daily dosing but require careful titration

Q45. Which laboratory test is directly diagnostic of chlorazepate activity?

• Serum benzodiazepine assays can detect presence but clinical correlation is required
• Blood glucose levels are diagnostic
• Urine pregnancy test measures chlorazepate
• Serum sodium directly reflects drug activity

Correct Answer: Serum benzodiazepine assays can detect presence but clinical correlation is required

Q46. Which of the following best summarizes patient education for long-term benzodiazepine therapy?

• No need for follow-up once symptoms improve
• Discuss risks of tolerance, dependence, avoid alcohol, review other medications, and plan for tapering when discontinuing
• Encourage self-increasing doses for better effect
• Stop the drug abruptly whenever desired

Correct Answer: Discuss risks of tolerance, dependence, avoid alcohol, review other medications, and plan for tapering when discontinuing

Q47. Which pharmacological class does chlorazepate belong to?

• Benzodiazepines
• Opioids
• SSRIs
• Beta-lactam antibiotics

Correct Answer: Benzodiazepines

Q48. In patients with hepatic impairment, what is the likely impact on chlorazepate therapy?

• Decreased formation of active metabolite leading to lower effects without risk
• Altered metabolism may increase levels of parent drug and metabolites; dose adjustment and caution are necessary
• No change because the drug is not metabolized
• Immediate requirement for dialysis

Correct Answer: Altered metabolism may increase levels of parent drug and metabolites; dose adjustment and caution are necessary

Q49. Which of the following is an appropriate pharmacy intervention when a patient on chlorazepate is prescribed an opioid?

• No intervention needed
• Advise prescriber and patient about additive sedation and respiratory depression; consider dose adjustments and monitoring
• Recommend doubling the chlorazepate dose
• Stop both medications immediately without consultation

Correct Answer: Advise prescriber and patient about additive sedation and respiratory depression; consider dose adjustments and monitoring

Q50. Which statement best represents the educational focus for B. Pharm students studying chlorazepate?

• Only memorizing brand names is important
• Understand pharmacology, metabolism to active metabolites, clinical uses, risks of dependence, interactions and safe dispensing practices
• Assume all patients respond identically and ignore monitoring
• Focus solely on manufacturing techniques without clinical context

Correct Answer: Understand pharmacology, metabolism to active metabolites, clinical uses, risks of dependence, interactions and safe dispensing practices

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