Sympatholytics MCQs With Answer offer B. Pharm students a focused, exam-ready review of drugs that reduce sympathetic nervous system activity. This concise, keyword-rich introduction covers adrenergic blockers, alpha blockers, beta blockers, centrally acting agents, ganglionic blockers, mechanisms of action, pharmacology, clinical uses, adverse effects, contraindications, and drug interactions. Questions emphasize receptor selectivity, pharmacokinetics, therapeutic applications (hypertension, heart failure, pheochromocytoma), and emergency management, helping students build deep understanding rather than rote memorization. Each MCQ reinforces critical principles needed for prescriptions, patient safety, and rational drug choice. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which drug is an irreversible nonselective alpha antagonist commonly used preoperatively in pheochromocytoma?
- Phentolamine
- Prazosin
- Phenoxybenzamine
- Tamsulosin
Correct Answer: Phenoxybenzamine
Q2. Which sympatholytic acts by stimulating central alpha-2 adrenergic receptors to reduce sympathetic outflow?
- Clonidine
- Propranolol
- Prazosin
- Reserpine
Correct Answer: Clonidine
Q3. A beta-1 selective blocker preferred for patients with asthma to minimize bronchoconstriction is:
- Propranolol
- Metoprolol
- Carvedilol
- Pindolol
Correct Answer: Metoprolol
Q4. Which drug depletes norepinephrine from sympathetic nerve endings by inhibiting vesicular monoamine transporter (VMAT)?
- Guanethidine
- Reserpine
- Methyldopa
- Phentolamine
Correct Answer: Reserpine
Q5. Labetalol differs from pure beta-blockers because it also:
- Acts as a partial beta agonist
- Blocks alpha-1 receptors
- Stimulates alpha-2 receptors centrally
- Inhibits norepinephrine synthesis
Correct Answer: Blocks alpha-1 receptors
Q6. Which adverse effect is most closely associated with nonselective beta blockers like propranolol?
- Reflex tachycardia
- Bronchospasm in susceptible patients
- Significant miosis
- Urinary retention
Correct Answer: Bronchospasm in susceptible patients
Q7. Prazosin primarily lowers blood pressure by:
- Reducing heart rate via beta-1 blockade
- Inhibiting central sympathetic outflow
- Causing peripheral vasodilation via alpha-1 blockade
- Depleting norepinephrine stores
Correct Answer: Causing peripheral vasodilation via alpha-1 blockade
Q8. Which sympatholytic is a partial beta agonist with intrinsic sympathomimetic activity (ISA)?
- Atenolol
- Pindolol
- Propranolol
- Carvedilol
Correct Answer: Pindolol
Q9. Which drug is used to reverse extravasation of norepinephrine or dopamine by blocking alpha receptors?
- Phentolamine
- Metoprolol
- Clonidine
- Hexamethonium
Correct Answer: Phentolamine
Q10. Beta-blocker therapy can mask which important symptom of hypoglycemia in diabetic patients?
- Excessive sweating
- Tremor and palpitations
- Hunger
- Polyuria
Correct Answer: Tremor and palpitations
Q11. Which sympatholytic is most likely to cause orthostatic hypotension due to venous pooling from alpha-1 blockade?
- Phenoxybenzamine
- Methyldopa
- Propranolol
- Reserpine
Correct Answer: Phenoxybenzamine
Q12. Carvedilol’s cardioprotective effects in heart failure are due to combined:
- Alpha-2 agonism and beta-2 blockade
- Alpha-1 blockade and beta blockade
- VMAT inhibition and alpha blockade
- Ganglionic blockade and beta-1 selectivity
Correct Answer: Alpha-1 blockade and beta blockade
Q13. Which sympatholytic is a centrally acting prodrug converted to alpha-methylnorepinephrine in the CNS?
- Methyldopa
- Guanethidine
- Prazosin
- Hexamethonium
Correct Answer: Methyldopa
Q14. Which agent blocks nicotinic receptors at autonomic ganglia and is mainly of historical interest?
- Hexamethonium
- Clonidine
- Propranolol
- Phentolamine
Correct Answer: Hexamethonium
Q15. A major contraindication to nonselective beta-blockers is:
- Stable angina
- Asthma or COPD with bronchospasm
- Essential tremor
- Hyperthyroidism
Correct Answer: Asthma or COPD with bronchospasm
Q16. Which sympatholytic can cause drug-induced lupus-like syndrome as an adverse effect?
- Reserpine
- Hydralazine
- Propranolol
- Methyldopa
Correct Answer: Hydralazine
Q17. The mechanism by which guanethidine lowers blood pressure is primarily:
- Alpha-1 receptor antagonism
- Beta-1 receptor blockade
- Inhibition of norepinephrine release from nerve endings
- Central alpha-2 agonism
Correct Answer: Inhibition of norepinephrine release from nerve endings
Q18. Which beta-blocker has significant lipid-soluble properties and high CNS penetration, increasing risk of sleep disturbances?
- Atenolol
- Metoprolol
- Propranolol
- Nadolol
Correct Answer: Propranolol
Q19. In the presence of alpha blockade, administration of epinephrine causes which response (epinephrine reversal)?
- Enhanced vasoconstriction
- Marked bradycardia only
- Net vasodilation and hypotension
- No change in blood pressure
Correct Answer: Net vasodilation and hypotension
Q20. Which sympatholytic is most appropriate for treating benign prostatic hyperplasia by relaxing smooth muscle in the prostate?
- Prazosin
- Tamsulosin
- Propranolol
- Clonidine
Correct Answer: Tamsulosin
Q21. Which lab abnormality can occur with nonselective beta-blockers due to inhibited lipolysis?
- Hyperkalemia
- Elevated LDL cholesterol
- Hypoglycemia unawareness and impaired recovery
- Increased HDL
Correct Answer: Hypoglycemia unawareness and impaired recovery
Q22. Abrupt withdrawal of beta-blockers can precipitate which complication?
- Hypotension and bradycardia
- Rebound tachycardia and angina
- Persistent bronchospasm relief
- Enhanced insulin sensitivity
Correct Answer: Rebound tachycardia and angina
Q23. Which sympatholytic is useful for hypertensive emergencies in pregnancy due to safe profile?
- Methyldopa
- Propranolol
- Reserpine
- Phenoxybenzamine
Correct Answer: Methyldopa
Q24. Which statement about alpha-2 agonists like clonidine is true?
- They increase sympathetic outflow
- They cause peripheral alpha-1 mediated vasoconstriction exclusively
- They reduce norepinephrine release via presynaptic receptors
- They irreversibly block alpha receptors
Correct Answer: They reduce norepinephrine release via presynaptic receptors
Q25. Which agent is contraindicated in patients with pheochromocytoma unless alpha blockade is established first?
- Beta-blocker alone
- Phenoxybenzamine
- Phentolamine
- Clonidine
Correct Answer: Beta-blocker alone
Q26. Which pharmacodynamic property explains why atenolol is less likely to cause CNS side effects than propranolol?
- Greater intrinsic sympathomimetic activity
- Lower lipid solubility and less blood-brain barrier penetration
- Irreversible receptor binding
- Stronger alpha-1 antagonism
Correct Answer: Lower lipid solubility and less blood-brain barrier penetration
Q27. Which sympatholytic is preferred for treating hypertensive patients with concomitant benign prostatic hyperplasia because it improves urinary flow?
- Prazosin
- Propranolol
- Methyldopa
- Reserpine
Correct Answer: Prazosin
Q28. Which agent is an alpha-1 selective antagonist with minimal effect on ejaculation compared to nonselective agents?
- Tamsulosin
- Phenoxybenzamine
- Phentolamine
- Clonidine
Correct Answer: Tamsulosin
Q29. Which statement best describes pindolol’s clinical implication?
- Its ISA makes it ideal for acute myocardial infarction management
- ISA may reduce the degree of bradycardia in resting patients
- ISA causes irreversible beta blockade
- ISA enhances bronchoconstriction dramatically
Correct Answer: ISA may reduce the degree of bradycardia in resting patients
Q30. Which drug interaction is important to monitor when a patient on sympatholytics receives epinephrine during surgery?
- Alpha blockade may enhance vasoconstrictive response to epinephrine
- Beta blockade may blunt tachycardia but unmask alpha-mediated hypertension
- Central alpha-2 agonists potentiate epinephrine action
- VMAT inhibitors increase epinephrine synthesis
Correct Answer: Beta blockade may blunt tachycardia but unmask alpha-mediated hypertension
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