Famotidine MCQs With Answer

Famotidine MCQs With Answer

This set of Famotidine MCQs with answers is designed for B.Pharm students to deepen understanding of famotidine’s pharmacology, mechanism of action, pharmacokinetics, therapeutic uses, adverse effects, dosage adjustments and drug interactions. The questions cover key concepts such as H2 receptor antagonism, renal excretion and dose modification, comparative features versus other acid-suppressing agents, clinical indications like peptic ulcer disease and GERD, and important safety considerations. Clear, focused items reinforce clinical pharmacology and therapeutics knowledge critical to pharmacy practice. The format helps prepare you for exams and practical decision-making. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which class of drug does famotidine belong to?

• Proton pump inhibitor
• H2 receptor antagonist
• Anticholinergic agent
• Gastric mucosal protective agent

Correct Answer: H2 receptor antagonist

Q2. What is the primary mechanism of action of famotidine?

• Irreversible inhibition of H+/K+ ATPase
• Competitive antagonism of H2 histamine receptors on gastric parietal cells
• Stimulation of mucous and bicarbonate secretion
• Activation of gastric motility via muscarinic receptors

Correct Answer: Competitive antagonism of H2 histamine receptors on gastric parietal cells

Q3. Famotidine most directly reduces which component of gastric secretion?

• Pepsinogen secretion
• Hydrochloric acid secretion
• Intrinsic factor production
• Mucus secretion

Correct Answer: Hydrochloric acid secretion

Q4. Which of the following is a primary clinical indication for famotidine?

• Acute myocardial infarction
• Peptic ulcer disease
• Type 2 diabetes mellitus
• Bronchial asthma

Correct Answer: Peptic ulcer disease

Q5. What is the approximate oral bioavailability of famotidine?

• Less than 5%
• Around 40–45%
• Over 90%
• Approximately 70–80%

Correct Answer: Around 40–45%

Q6. Famotidine is primarily eliminated by which route?

• Hepatic metabolism and biliary excretion
• Renal excretion of unchanged drug
• Fecal elimination after enterohepatic cycling
• Lung exhalation as volatile metabolites

Correct Answer: Renal excretion of unchanged drug

Q7. Which pharmacokinetic parameter of famotidine is most prolonged in patients with renal impairment?

• Volume of distribution
• Plasma protein binding
• Elimination half-life
• Oral absorption rate

Correct Answer: Elimination half-life

Q8. Compared with cimetidine, famotidine has which important clinical advantage?

• Stronger inhibition of CYP450 enzymes
• Greater anticholinergic side effects
• Minimal clinically significant CYP450 interactions
• Higher risk of gynecomastia

Correct Answer: Minimal clinically significant CYP450 interactions

Q9. Typical adult oral dosing for uncomplicated GERD using famotidine is most commonly:

• 20 mg once daily at bedtime or 20 mg twice daily
• 5 mg once daily
• 200 mg three times daily
• 1 g once daily

Correct Answer: 20 mg once daily at bedtime or 20 mg twice daily

Q10. Which adverse effect is most commonly associated with famotidine?

• Severe hepatocellular necrosis
• Headache and dizziness
• Profound hypotension in all patients
• Acute hemolytic anemia

Correct Answer: Headache and dizziness

Q11. Which rare hematological adverse event has been reported with H2 blockers like famotidine?

• Aplastic anemia
• Thrombocytopenia
• Polycythemia vera
• Chronic lymphocytic leukemia

Correct Answer: Thrombocytopenia

Q12. Famotidine is considered relatively safe in pregnancy and is commonly categorized as which risk category (historically)?

• Category X (contraindicated)
• Category B (no evidence of risk in humans)
• Category D (positive evidence of risk)
• Category A (controlled studies show no risk)

Correct Answer: Category B (no evidence of risk in humans)

Q13. Which statement about famotidine and proton pump inhibitors (PPIs) is correct?

• Famotidine produces a more prolonged and complete acid suppression than PPIs
• PPIs have a faster onset of action than famotidine
• Famotidine has a faster onset but shorter duration of acid suppression compared with PPIs
• PPIs act as competitive antagonists at H2 receptors

Correct Answer: Famotidine has a faster onset but shorter duration of acid suppression compared with PPIs

Q14. Which patient factor necessitates dose adjustment of famotidine?

• Severe hepatic impairment with normal renal function
• Pregnancy in first trimester
• Renal impairment with reduced creatinine clearance
• History of migraine

Correct Answer: Renal impairment with reduced creatinine clearance

Q15. Famotidine’s reduction of gastric acidity may reduce the absorption of which type of drug?

• Drugs requiring an acidic environment for optimal absorption (e.g., ketoconazole)
• All highly protein-bound drugs
• Drugs eliminated exclusively by hepatic glucuronidation
• Inhaled bronchodilators

Correct Answer: Drugs requiring an acidic environment for optimal absorption (e.g., ketoconazole)

Q16. Which formulation(s) is famotidine available in?

• Oral tablets only
• Intravenous and oral formulations
• Topical cream and oral liquid only
• Inhalation aerosol only

Correct Answer: Intravenous and oral formulations

Q17. Which laboratory monitoring may be indicated in long-term, high-dose famotidine therapy?

• Frequent blood glucose monitoring
• Periodic complete blood count to detect hematologic abnormalities
• Daily liver biopsy
• No monitoring ever required

Correct Answer: Periodic complete blood count to detect hematologic abnormalities

Q18. Which of the following best describes famotidine’s effect on basal and stimulated acid secretion?

• It increases both basal and stimulated secretion
• It reduces basal secretion but increases stimulated secretion
• It reduces both basal and stimulated acid secretion by blocking H2 receptors
• It only blocks gastrin-induced acid secretion

Correct Answer: It reduces both basal and stimulated acid secretion by blocking H2 receptors

Q19. When comparing famotidine with ranitidine (before ranitidine withdrawal), a noted advantage of famotidine was:

• Higher risk of CYP450-mediated drug interactions
• Greater potency and longer duration of action with lower CYP inhibition
• Extensive first-pass hepatic metabolism
• More severe endocrine side effects

Correct Answer: Greater potency and longer duration of action with lower CYP inhibition

Q20. Which clinical use is famotidine commonly employed for in hospitalized patients?

• Prophylaxis of stress-related mucosal bleeding in critically ill patients
• Treatment of acute ischemic stroke
• Primary therapy for bacterial pneumonia
• Long-term therapy for schizophrenia

Correct Answer: Prophylaxis of stress-related mucosal bleeding in critically ill patients

Q21. Famotidine interaction potential with warfarin is generally:

• High—famotidine strongly increases INR by CYP induction
• High—famotidine significantly decreases warfarin levels via CYP induction
• Low—famotidine has minimal effect on CYP enzymes and clinically significant interaction is unlikely
• Absolute contraindication to co-administration

Correct Answer: Low—famotidine has minimal effect on CYP enzymes and clinically significant interaction is unlikely

Q22. Which adverse central nervous system effect may occur, especially in elderly or renally impaired patients taking famotidine?

• Seizures in all patients
• Hallucinations, confusion or agitation
• Permanent cognitive decline within 24 hours
• Major depressive disorder induction

Correct Answer: Hallucinations, confusion or agitation

Q23. Which statement about famotidine metabolism is correct?

• Famotidine is extensively metabolized by CYP3A4 to active metabolites
• Famotidine undergoes minimal hepatic metabolism and is largely excreted unchanged
• Famotidine is converted into an active sulfone metabolite responsible for most effects
• Famotidine is prodrug activated in the stomach acid

Correct Answer: Famotidine undergoes minimal hepatic metabolism and is largely excreted unchanged

Q24. In an overdose of famotidine in a patient with normal renal function, which initial management step is most appropriate in an acute care setting?

• Immediate hemodialysis for all patients
• Supportive care and symptomatic treatment; consider activated charcoal if early presentation
• Administer large doses of antacids to neutralize famotidine
• Give high-dose vitamin K

Correct Answer: Supportive care and symptomatic treatment; consider activated charcoal if early presentation

Q25. Which of the following is a contraindication or caution specific to IV administration of famotidine?

• Avoid rapid IV bolus in patients with severe renal insufficiency due to potential CNS effects
• IV famotidine is contraindicated in all pregnant women
• IV famotidine must always be given with a loop diuretic
• IV administration causes irreversible renal damage in healthy adults

Correct Answer: Avoid rapid IV bolus in patients with severe renal insufficiency due to potential CNS effects

Q26. Which statement about tolerance (tachyphylaxis) to H2 blockers like famotidine is true?

• Tachyphylaxis does not occur; effect increases indefinitely
• Tolerance to acid suppression may develop with continuous H2 antagonist therapy over days to weeks
• Immediate hypersensitivity reactions cause tolerance
• Tolerance only occurs when combined with PPIs

Correct Answer: Tolerance to acid suppression may develop with continuous H2 antagonist therapy over days to weeks

Q27. Which of the following best explains why dose adjustment of famotidine is crucial in renal impairment?

• Because famotidine is extensively protein bound and displaced by uremic toxins
• Because famotidine is primarily cleared unchanged by kidneys, reduced clearance increases exposure
• Because hepatic metabolism increases proportionally in renal failure
• Because famotidine is activated by renal enzymes

Correct Answer: Because famotidine is primarily cleared unchanged by kidneys, reduced clearance increases exposure

Q28. Which pharmacodynamic effect distinguishes famotidine from antacids?

• Famotidine neutralizes existing gastric acid instantly
• Famotidine reduces acid secretion by blocking H2 receptors, offering longer-lasting reduction
• Famotidine acts as a surfactant to protect mucosa physically
• Famotidine primarily chelates dietary ions to reduce acidity

Correct Answer: Famotidine reduces acid secretion by blocking H2 receptors, offering longer-lasting reduction

Q29. Which monitoring parameter should be considered when famotidine is used in patients with severe renal dysfunction receiving dialysis?

• No monitoring is required because famotidine is not dialyzable
• Adjust dose and consider supplemental dosing after dialysis because famotidine is at least partially dialyzable
• Always stop famotidine permanently when dialysis begins
• Switch to oral antacid only

Correct Answer: Adjust dose and consider supplemental dosing after dialysis because famotidine is at least partially dialyzable

Q30. Which of the following best summarizes famotidine’s clinical utility for B.Pharm students to remember?

• Famotidine is a first-line contraceptive agent
• Famotidine is an H2 receptor antagonist; useful for acid-related disorders, requires renal dose adjustment, has fewer CYP interactions than cimetidine, and may cause CNS effects in susceptible patients
• Famotidine is primarily used as an antihypertensive drug
• Famotidine must be co-administered with rifampicin to be effective

Correct Answer: Famotidine is an H2 receptor antagonist; useful for acid-related disorders, requires renal dose adjustment, has fewer CYP interactions than cimetidine, and may cause CNS effects in susceptible patients

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