Rabeprazole MCQs With Answer

Rabeprazole MCQs With Answer

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Rabeprazole MCQs With Answer

This concise, student-focused introduction covers key aspects of rabeprazole relevant for B. Pharm courses: pharmacology, mechanism of action, pharmacokinetics, therapeutic uses, dosage, adverse effects, and drug interactions. Emphasis is placed on rabeprazole as a proton pump inhibitor (PPI), its prodrug activation in acidic parietal cell canaliculi, metabolism (including CYP2C19 involvement), role in H. pylori eradication and GERD management, and clinical considerations for safe dispensing and counselling. These MCQs are designed to reinforce core concepts, clinical reasoning, and exam preparedness for pharmacy undergraduates. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which class of drugs does rabeprazole belong to?

  • H2 receptor antagonists
  • Proton pump inhibitors
  • Anticholinergics
  • Antacids

Correct Answer: Proton pump inhibitors

Q2. Rabeprazole is best described as which of the following?

  • A direct inhibitor of gastric acid secreted as an active drug
  • An H+/K+ ATPase proton pump prodrug activated in acidic environment
  • An antacid that neutralizes gastric acid
  • A histamine analog that blocks H2 receptors

Correct Answer: An H+/K+ ATPase proton pump prodrug activated in acidic environment

Q3. Where is rabeprazole converted to its active form?

  • In the liver by CYP enzymes
  • In the alkaline lumen of the intestine
  • In the acidic canaliculi of gastric parietal cells
  • In the bloodstream by plasma esterases

Correct Answer: In the acidic canaliculi of gastric parietal cells

Q4. What is the primary molecular target of the active rabeprazole metabolite?

  • Histamine H2 receptor
  • Gastrin receptor
  • H+/K+ ATPase (proton pump)
  • Acetylcholine muscarinic receptor

Correct Answer: H+/K+ ATPase (proton pump)

Q5. Which of the following is a standard adult oral dose of rabeprazole for uncomplicated GERD?

  • 5 mg once daily
  • 10 mg four times daily
  • 20 mg once daily
  • 80 mg once daily

Correct Answer: 20 mg once daily

Q6. Compared with some other PPIs, rabeprazole is often noted for which pharmacokinetic characteristic?

  • Complete dependence on CYP2C19 for clearance
  • Very long plasma half-life of several days
  • Faster onset of acid suppression in many patients
  • Inability to suppress nocturnal acid secretion

Correct Answer: Faster onset of acid suppression in many patients

Q7. Which enzyme polymorphism most significantly affects rabeprazole metabolism?

  • CYP1A2 polymorphism
  • CYP2C19 polymorphism
  • CYP2D6 polymorphism
  • UGT1A1 polymorphism

Correct Answer: CYP2C19 polymorphism

Q8. Rabeprazole metabolism is unique because it is partly:

  • Excreted unchanged in feces
  • Metabolized non-enzymatically in addition to CYP-mediated pathways
  • Activated by pancreatic enzymes
  • Cleared exclusively by renal filtration

Correct Answer: Metabolized non-enzymatically in addition to CYP-mediated pathways

Q9. How should rabeprazole typically be administered for optimal efficacy?

  • With a high-fat meal
  • Immediately after dinner only
  • Before meals, preferably 30–60 minutes before breakfast
  • At bedtime on an empty stomach

Correct Answer: Before meals, preferably 30–60 minutes before breakfast

Q10. Which of the following is a common adverse effect reported with rabeprazole?

  • Severe hypoglycemia
  • Headache and diarrhea
  • Acute hemolytic anemia
  • Profound bradycardia

Correct Answer: Headache and diarrhea

Q11. Long-term PPI therapy, including rabeprazole, has been associated with which laboratory abnormality?

  • Hypomagnesemia
  • Hyperkalemia
  • Neutrophilia
  • Hypercalcemia

Correct Answer: Hypomagnesemia

Q12. Rabeprazole is commonly used as part of H. pylori eradication regimens. Which antibiotic combination is frequently paired with a PPI?

  • Vancomycin and gentamicin
  • Amoxicillin and clarithromycin
  • Amphotericin B and fluconazole
  • Doxycycline and linezolid

Correct Answer: Amoxicillin and clarithromycin

Q13. Which serious infection risk is associated with prolonged PPI use?

  • Clostridioides difficile infection
  • Opportunistic viral hepatitis
  • Tuberculosis reactivation
  • Invasive candidiasis of the brain

Correct Answer: Clostridioides difficile infection

Q14. The prolonged antisecretory effect of rabeprazole despite a short plasma half-life is best explained by:

  • High plasma protein binding that extends circulation time
  • Covalent irreversible inhibition of the proton pump
  • Active enterohepatic recycling
  • Slow renal excretion of the parent drug

Correct Answer: Covalent irreversible inhibition of the proton pump

Q15. Which of the following drugs may have reduced absorption when given with rabeprazole due to increased gastric pH?

  • Metformin
  • Ketoconazole
  • Amoxicillin
  • Azithromycin

Correct Answer: Ketoconazole

Q16. Regarding interactions with clopidogrel, rabeprazole is best described as:

  • Completely safe with no potential for interaction
  • Potentially inhibitory of CYP2C19 but generally less affecting clopidogrel activation than omeprazole
  • Known to enhance clopidogrel activation via CYP3A4 induction
  • Contraindicated because it irreversibly destroys clopidogrel

Correct Answer: Potentially inhibitory of CYP2C19 but generally less affecting clopidogrel activation than omeprazole

Q17. Which clinical condition often requires higher-than-standard doses of rabeprazole?

  • Irritable bowel syndrome
  • Zollinger–Ellison syndrome
  • Functional dyspepsia
  • Constipation-predominant disorders

Correct Answer: Zollinger–Ellison syndrome

Q18. Which monitoring parameter is most relevant during long-term rabeprazole therapy?

  • Serum magnesium and vitamin B12 levels
  • Serum amylase and lipase
  • Complete urine analysis weekly
  • Daily liver ultrasound

Correct Answer: Serum magnesium and vitamin B12 levels

Q19. Rabeprazole formulations are typically designed as:

  • Immediate-release chewable tablets only
  • Enteric-coated or delayed-release oral formulations
  • Topical gels for local stomach application
  • Inhalational aerosols

Correct Answer: Enteric-coated or delayed-release oral formulations

Q20. Which statement about rabeprazole and hepatic impairment is most appropriate?

  • No dose adjustment is ever needed in severe hepatic impairment
  • Use with caution and consider dose adjustment in severe hepatic impairment
  • It is contraindicated in any hepatic dysfunction
  • It is cleared exclusively by dialysis

Correct Answer: Use with caution and consider dose adjustment in severe hepatic impairment

Q21. Which of the following best explains why rabeprazole’s antisecretory effect accumulates over several days?

  • Daily accumulation of plasma levels causes rising concentrations
  • Progressive inactivation of newly synthesized proton pumps until steady-state inhibition is reached
  • The drug induces production of more parietal cells
  • It requires conversion to a long-lived circulating metabolite

Correct Answer: Progressive inactivation of newly synthesized proton pumps until steady-state inhibition is reached

Q22. A pharmacist counselling a patient about rabeprazole should advise:

  • Take the dose with a full meal to enhance absorption
  • Take the dose on an empty stomach, ideally before breakfast for best effect
  • Double the dose if symptoms persist after one day
  • Stop abruptly if mild gastrointestinal upset occurs

Correct Answer: Take the dose on an empty stomach, ideally before breakfast for best effect

Q23. Which adverse outcome has been associated with chronic PPI therapy and may require bone health assessment?

  • Increased risk of bone fractures due to decreased calcium absorption
  • Skeletal muscle hypertrophy
  • Progressive osteopetrosis
  • Calcification of soft tissues

Correct Answer: Increased risk of bone fractures due to decreased calcium absorption

Q24. Which of the following is a contraindication to rabeprazole therapy?

  • History of hypersensitivity to rabeprazole or substituted benzimidazoles
  • Mild transient dyspepsia
  • Controlled hypertension
  • Seasonal allergic rhinitis

Correct Answer: History of hypersensitivity to rabeprazole or substituted benzimidazoles

Q25. Which statement about rabeprazole’s effect on serum gastrin is correct?

  • It causes a decrease in gastrin levels with long-term use
  • It has no effect on gastrin secretion
  • It can cause an increase in serum gastrin due to decreased acid feedback
  • It blocks gastrin receptors directly

Correct Answer: It can cause an increase in serum gastrin due to decreased acid feedback

Q26. In the event of an acute rabeprazole overdose, the most appropriate immediate action is:

  • Perform gastric lavage and immediate hemodialysis in all cases
  • Supportive and symptomatic treatment; consider activated charcoal if ingestion recent
  • Administer intravenous naloxone
  • Give high-dose vitamin K

Correct Answer: Supportive and symptomatic treatment; consider activated charcoal if ingestion recent

Q27. Which of the following antibiotics used in H. pylori therapy poses a significant interaction risk with PPIs via CYP pathways?

  • Amoxicillin
  • Clarithromycin
  • Metronidazole
  • Doxycycline

Correct Answer: Clarithromycin

Q28. Which patient counseling point is correct for a patient starting rabeprazole?

  • Immediate relief of heartburn is guaranteed within minutes
  • Avoid abrupt discontinuation after long-term use due to possible rebound acid hypersecretion
  • It is safe to use with all antifungal azoles without interaction
  • It can be used to treat acute bacterial infections

Correct Answer: Avoid abrupt discontinuation after long-term use due to possible rebound acid hypersecretion

Q29. Which CYP isoenzyme primarily contributes to rabeprazole metabolism alongside non-enzymatic pathways?

  • CYP2C19
  • CYP2E1
  • CYP4A11
  • CYP2B6

Correct Answer: CYP2C19

Q30. Which clinical use is NOT an approved or common indication for rabeprazole?

  • Short-term treatment of active duodenal ulcer
  • Treatment of Zollinger–Ellison syndrome
  • Chronic active hepatitis C infection
  • Maintenance therapy for healed erosive esophagitis

Correct Answer: Chronic active hepatitis C infection

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