Amiodarone MCQs With Answer

Amiodarone MCQs With Answer is a focused question set designed for B. Pharm students to deepen understanding of this widely used antiarrhythmic. This introduction covers pharmacology, mechanism of action, pharmacokinetics, dosing, monitoring, adverse effects (pulmonary, thyroid, hepatic, ocular, dermatologic), and major drug interactions. These targeted multiple-choice questions emphasize clinical application, safe dispensing, and patient counselling — essential competencies for pharmacy graduates. Questions probe drug metabolism, CYP interactions, toxicity recognition, and management strategies to prepare you for exams and real-world pharmacy practice. The language is simple, yet the content goes deeper into core concepts to build confidence. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which Vaughan-Williams class does amiodarone primarily belong to?

• Class I (sodium channel blocker)
• Class II (beta blocker)
• Class III (potassium channel blocker)
• Class IV (calcium channel blocker)

Correct Answer: Class III (potassium channel blocker)

Q2. The principal ionic current blocked by amiodarone that prolongs repolarization is:

• Sodium current (INa)
• Calcium current (ICa)
• Potassium current (IK)
• Funny current (If)

Correct Answer: Potassium current (IK)

Q3. Amiodarone affects cardiac action potential by:

• Shortening action potential duration
• Prolonging action potential duration and refractory period
• Only decreasing conduction velocity without changing duration
• Increasing automaticity in pacemaker cells

Correct Answer: Prolonging action potential duration and refractory period

Q4. The most common thyroid abnormality associated with chronic amiodarone therapy is:

• Acute thyroiditis
• Hypothyroidism
• Graves’ disease
• Thyroid cancer

Correct Answer: Hypothyroidism

Q5. Which pulmonary complication is most feared with long-term amiodarone use?

• Bronchial asthma exacerbation
• Pulmonary fibrosis (interstitial pneumonitis)
• Pleural effusion due to heart failure
• Pulmonary embolism

Correct Answer: Pulmonary fibrosis (interstitial pneumonitis)

Q6. A common reversible ocular change seen with amiodarone therapy is:

• Retinal detachment
• Corneal microdeposits (vortex keratopathy)
• Glaucoma
• Macular degeneration

Correct Answer: Corneal microdeposits (vortex keratopathy)

Q7. A characteristic cutaneous adverse effect of amiodarone on prolonged exposure is:

• Psoriasis flare
• Lupus-like rash
• Blue-gray skin discoloration on sun-exposed areas
• Urticaria

Correct Answer: Blue-gray skin discoloration on sun-exposed areas

Q8. Co-administration of amiodarone with warfarin commonly leads to:

• Decreased INR and reduced anticoagulant effect
• No change in warfarin activity
• Increased INR and elevated bleeding risk
• Complete antagonism of warfarin

Correct Answer: Increased INR and elevated bleeding risk

Q9. Amiodarone interaction with digoxin typically results in:

• Decreased digoxin levels due to induction
• Increased digoxin levels due to P-glycoprotein inhibition
• No interaction
• Altered renal clearance with no plasma change

Correct Answer: Increased digoxin levels due to P-glycoprotein inhibition

Q10. The terminal elimination half-life of amiodarone is best described as:

• Hours (1–6 hours)
• 1–2 days
• Approximately 40–60 days (very long)
• Less than 24 hours

Correct Answer: Approximately 40–60 days (very long)

Q11. A commonly used oral loading dose strategy for amiodarone at the start of therapy is:

• 50–100 mg once daily for 1 week
• 800–1600 mg per day for 1–3 weeks then taper
• Single 10 mg dose only
• 5000 mg single loading dose

Correct Answer: 800–1600 mg per day for 1–3 weeks then taper

Q12. On ECG amiodarone typically causes which change?

• Marked ST-segment elevation
• Shortened QT interval
• Prolongation of QT interval
• Large U waves only

Correct Answer: Prolongation of QT interval

Q13. Amiodarone is often used to treat refractory cases of which arrhythmias?

• Atrial fibrillation and ventricular tachycardia
• Only sinus tachycardia
• Only first-degree AV block
• Only premature atrial complexes

Correct Answer: Atrial fibrillation and ventricular tachycardia

Q14. Amiodarone exhibits electrophysiologic properties of which Vaughan-Williams classes?

• Class I only
• Class II and IV only
• Class I, II, III and IV combined
• None of the Vaughan-Williams classes

Correct Answer: Class I, II, III and IV combined

Q15. Which laboratory tests should be monitored regularly during long-term amiodarone therapy?

• Thyroid function tests, liver function tests and chest imaging as indicated
• Only renal function tests
• Only blood glucose
• Only lipid profile

Correct Answer: Thyroid function tests, liver function tests and chest imaging as indicated

Q16. Before initiating amiodarone, baseline assessments commonly include:

• Thyroid function tests, liver enzymes, chest X-ray and ophthalmic exam
• No baseline tests are necessary
• Only EEG and colonoscopy
• Only pregnancy test in elderly men

Correct Answer: Thyroid function tests, liver enzymes, chest X-ray and ophthalmic exam

Q17. Which clinical condition is a relative contraindication to starting amiodarone without precautions?

• Severe sinus node dysfunction without pacemaker
• Controlled hypertension on monotherapy
• Mild seasonal allergic rhinitis
• Well-managed hyperlipidaemia

Correct Answer: Severe sinus node dysfunction without pacemaker

Q18. Amiodarone is available in which pharmaceutical formulations?

• Oral tablets only
• Intravenous infusion only
• Both oral tablets and intravenous formulations
• Topical cream formulation

Correct Answer: Both oral tablets and intravenous formulations

Q19. Which of the following is NOT a typical cardiac electrophysiologic effect of amiodarone?

• Prolongation of PR interval
• Widening of QRS complex at high doses
• Marked increase in heart rate (sinus tachycardia)
• Prolongation of QT interval

Correct Answer: Marked increase in heart rate (sinus tachycardia)

Q20. The most common gastrointestinal adverse effects reported with amiodarone include:

• Nausea, vomiting and constipation
• Massive GI bleeding
• Pancreatitis as the usual effect
• Intestinal obstruction

Correct Answer: Nausea, vomiting and constipation

Q21. Which medication is most likely to decrease amiodarone plasma concentrations due to enzyme induction?

• Ketoconazole
• Rifampicin (rifampin)
• Amiodarone itself
• Verapamil

Correct Answer: Rifampicin (rifampin)

Q22. Amiodarone-induced hyperthyroidism can occur by which mechanism?

• Iodine-induced increased thyroid hormone synthesis (type I) or destructive thyroiditis (type II)
• Autoimmune Graves’ disease only
• Primary hypothyroidism leading to rebound hyperthyroidism
• Excess dietary iodine unrelated to drug

Correct Answer: Iodine-induced increased thyroid hormone synthesis (type I) or destructive thyroiditis (type II)

Q23. Which rare ocular adverse event associated with amiodarone can lead to permanent visual impairment?

• Corneal microdeposits that always resolve
• Optic neuropathy (optic neuritis)
• Cataract formation within days
• Transient night blindness only

Correct Answer: Optic neuropathy (optic neuritis)

Q24. The recommended immediate management when amiodarone-induced pulmonary toxicity is suspected includes:

• Continue drug and observe for months
• Stop amiodarone and consider corticosteroid therapy
• Increase the dose to overcome toxicity
• Switch to another iodine-containing drug

Correct Answer: Stop amiodarone and consider corticosteroid therapy

Q25. Because of amiodarone’s very long half-life, drug effects and tissue accumulation typically persist for:

• Hours after stopping
• Days only
• Months to years
• A few minutes

Correct Answer: Months to years

Q26. Concomitant use of amiodarone increases the risk of statin-induced myopathy most notably with which statin?

• Pravastatin (no interaction)
• Fluvastatin only
• Simvastatin (CYP3A4 substrate)
• Dietary fish oil supplements

Correct Answer: Simvastatin (CYP3A4 substrate)

Q27. The FDA pregnancy category most often assigned to amiodarone is:

• Category A (safe)
• Category B
• Category C
• Category D (evidence of risk)

Correct Answer: Category D (evidence of risk)

Q28. Which element within the amiodarone molecule contributes directly to its thyroid effects?

• Chlorine
• Iodine
• Fluorine
• Sulfur

Correct Answer: Iodine

Q29. Which electrolyte disturbance increases the risk of proarrhythmia (e.g., torsades) when using amiodarone?

• Hyperkalemia
• Hypokalemia
• Hypernatremia
• Hypercalcemia

Correct Answer: Hypokalemia

Q30. After initiating amiodarone, how frequently are thyroid function tests commonly recommended during stable long-term therapy?

• Weekly
• Monthly
• Every 6 months
• Every 5 years

Correct Answer: Every 6 months

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