Colestipol MCQs With Answer

Colestipol MCQs With Answer

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Colestipol MCQs With Answer is a focused review resource for B.Pharm students covering the pharmacology, mechanism, therapeutic uses, dosing, adverse effects, and drug interactions of colestipol — a bile acid sequestrant. This keyword-rich introduction emphasizes concepts such as bile acid binding, LDL lowering, anion-exchange resins, fat‑soluble vitamin malabsorption, hypertriglyceridemia risk, and clinical monitoring. Questions probe drug formulation, timing of administration, combinations with statins, and precautions in specific patient populations. Designed to deepen understanding beyond basics, these MCQs reinforce critical thinking needed for therapeutics and dispensing. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. What is the primary pharmacological mechanism of colestipol?

  • Inhibition of HMG-CoA reductase in the liver
  • Sequestration of bile acids in the intestine by anion-exchange resin
  • Activation of peroxisome proliferator-activated receptors (PPARs)
  • Competitive antagonism of LDL receptors

Correct Answer: Sequestration of bile acids in the intestine by anion-exchange resin

Q2. How does colestipol lower plasma LDL cholesterol?

  • Directly inhibits intestinal cholesterol absorption by micelle disruption
  • Prevents bile acid reabsorption leading to increased hepatic conversion of cholesterol to bile acids and upregulation of LDL receptors
  • Enhances lipoprotein lipase activity to clear LDL particles
  • Inhibits synthesis of apolipoprotein B in the liver

Correct Answer: Prevents bile acid reabsorption leading to increased hepatic conversion of cholesterol to bile acids and upregulation of LDL receptors

Q3. Which lipid parameter may increase with colestipol therapy and requires monitoring?

  • High-density lipoprotein (HDL)
  • Triglycerides (TG)
  • Lp(a)
  • Apolipoprotein A-I

Correct Answer: Triglycerides (TG)

Q4. Which of the following best describes the chemical nature of colestipol?

  • A small molecule HMG-CoA reductase inhibitor
  • An anion-exchange polymeric resin not systemically absorbed
  • A monoclonal antibody against PCSK9
  • A bile salt transporter inhibitor absorbed in the gut

Correct Answer: An anion-exchange polymeric resin not systemically absorbed

Q5. What is a common gastrointestinal adverse effect of colestipol?

  • Diarrhea with steatorrhea
  • Constipation and abdominal discomfort
  • Peptic ulceration
  • Pseudomembranous colitis

Correct Answer: Constipation and abdominal discomfort

Q6. Which fat‑soluble vitamins may have reduced absorption during chronic colestipol therapy?

  • Vitamin C and B12
  • Vitamin A, D, E, and K
  • Folate and niacin
  • Vitamin B6 and riboflavin

Correct Answer: Vitamin A, D, E, and K

Q7. How should oral drugs that interact with colestipol be scheduled to minimize binding?

  • Administer concurrently with colestipol to saturate binding
  • Give other oral medications at least 1 hour before or 4–6 hours after colestipol
  • Avoid all other oral drugs while on colestipol
  • Switch to intravenous administration of all interacting drugs

Correct Answer: Give other oral medications at least 1 hour before or 4–6 hours after colestipol

Q8. Which drug class is commonly combined with colestipol to achieve greater LDL reduction?

  • Beta-blockers
  • Statins (HMG-CoA reductase inhibitors)
  • Thiazide diuretics
  • ACE inhibitors

Correct Answer: Statins (HMG-CoA reductase inhibitors)

Q9. Colestipol is contraindicated or used with caution in which lipid disorder?

  • Familial hypercholesterolemia with low TG
  • Severe hypertriglyceridemia or TG > 400 mg/dL
  • Isolated low HDL syndrome
  • Mixed hyperlipidemia with normal TG

Correct Answer: Severe hypertriglyceridemia or TG > 400 mg/dL

Q10. Which laboratory parameter should be monitored before and during colestipol therapy?

  • Serum creatinine only
  • Liver enzymes, lipid profile including LDL and TG, and fat‑soluble vitamin levels when clinically indicated
  • Complete blood count only
  • Serum amylase and lipase routinely

Correct Answer: Liver enzymes, lipid profile including LDL and TG, and fat‑soluble vitamin levels when clinically indicated

Q11. What is the onset of maximal LDL-lowering effect after initiating colestipol therapy?

  • Within 1–2 hours
  • 2–4 days
  • Approximately 2–4 weeks
  • After 6 months only

Correct Answer: Approximately 2–4 weeks

Q12. Which of the following drugs is most likely to have reduced oral absorption when coadministered with colestipol?

  • Warfarin
  • Metformin (immediate-release)
  • Insulin (subcutaneous)
  • Amoxicillin (parenteral)

Correct Answer: Warfarin

Q13. Mechanistically, colestipol increases hepatic LDL receptor expression primarily because:

  • It donates cholesterol to hepatocytes
  • Loss of bile acids stimulates cholesterol conversion to bile acids, depleting hepatic cholesterol and upregulating LDL receptors
  • It directly binds transcription factors that encode LDL receptors
  • It inhibits PCSK9 expression in hepatocytes

Correct Answer: Loss of bile acids stimulates cholesterol conversion to bile acids, depleting hepatic cholesterol and upregulating LDL receptors

Q14. Which patient counseling point is appropriate for a patient starting colestipol powder?

  • Mix the powder with at least 200 mL of water or fluid before ingestion
  • It should be taken on an empty stomach with no fluids
  • Always refrigerate the suspension after preparation
  • Crush tablets and dissolve in alcohol for better taste

Correct Answer: Mix the powder with at least 200 mL of water or fluid before ingestion

Q15. Compared to cholestyramine, colestipol is best described as:

  • A bile acid sequestrant with similar mechanism but different resin composition and dosing options
  • A systemic lipid-lowering agent with significant oral absorption
  • A fibrate derivative with PPARα agonist activity
  • An intravenous-only lipid-lowering agent

Correct Answer: A bile acid sequestrant with similar mechanism but different resin composition and dosing options

Q16. Which therapeutic use besides hypercholesterolemia can colestipol serve?

  • Treatment of acute bacterial infections in the gut
  • Adjunctive therapy to relieve pruritus in cholestatic liver disease by removing bile acids in the gut
  • Primary therapy for nephrotic syndrome
  • Rapid LDL reduction in acute coronary syndrome

Correct Answer: Adjunctive therapy to relieve pruritus in cholestatic liver disease by removing bile acids in the gut

Q17. Which statement about systemic absorption of colestipol is correct?

  • Colestipol is well absorbed and undergoes hepatic metabolism
  • Colestipol is minimally or not systemically absorbed and acts within the gastrointestinal tract
  • Colestipol is absorbed and excreted unchanged by the kidneys
  • Colestipol crosses the blood-brain barrier to lower central cholesterol

Correct Answer: Colestipol is minimally or not systemically absorbed and acts within the gastrointestinal tract

Q18. What is the recommended approach if a patient requires levothyroxine and colestipol concurrently?

  • Discontinue levothyroxine while on colestipol
  • Administer levothyroxine at least 4 hours before colestipol to avoid binding
  • Double the dose of levothyroxine when starting colestipol
  • Give levothyroxine and colestipol together to improve adherence

Correct Answer: Administer levothyroxine at least 4 hours before colestipol to avoid binding

Q19. Which adverse laboratory effect might result from long-term colestipol therapy if vitamins are not supplemented?

  • Hypocalcemia due to vitamin D malabsorption leading to decreased bone density
  • Hyperkalemia from potassium retention
  • Macrocytic anemia from folate deficiency
  • Hypoglycemia due to vitamin B12 loss

Correct Answer: Hypocalcemia due to vitamin D malabsorption leading to decreased bone density

Q20. Which patient population requires careful use or dose adjustment when prescribing colestipol?

  • Patients with severe constipation or bowel obstruction
  • Patients with well-controlled hypertension
  • Patients using topical dermatologic steroids
  • Patients receiving inhaled bronchodilators

Correct Answer: Patients with severe constipation or bowel obstruction

Q21. Which effect on LDL receptor-mediated clearance is expected when colestipol is administered?

  • Decreased LDL receptor expression and reduced clearance
  • Increased LDL receptor expression and enhanced clearance of LDL
  • No effect on LDL receptor expression
  • Inhibition of LDL receptor recycling without affecting clearance

Correct Answer: Increased LDL receptor expression and enhanced clearance of LDL

Q22. Which formulation is colestipol most commonly available as?

  • Oral sustained-release tablets absorbed systemically
  • Granules or powder for oral suspension and tablets that act locally in GI tract
  • Intravenous solution for acute use
  • Transdermal patch for continuous delivery

Correct Answer: Granules or powder for oral suspension and tablets that act locally in GI tract

Q23. Which of the following is the best explanation for colestipol’s low systemic side-effect profile?

  • It is rapidly metabolized to inactive metabolites
  • It is not absorbed from the gastrointestinal tract and acts locally
  • It selectively targets hepatic enzymes without affecting other tissues
  • It is administered in very low doses that are pharmacologically inert

Correct Answer: It is not absorbed from the gastrointestinal tract and acts locally

Q24. Which monitoring parameter is most important when colestipol is added to warfarin therapy?

  • Serum potassium
  • International Normalized Ratio (INR)
  • Fasting blood glucose
  • Serum magnesium

Correct Answer: International Normalized Ratio (INR)

Q25. Why might colestipol reduce absorption of certain statins if coadministered improperly?

  • It enhances hepatic uptake of statins reducing plasma levels
  • Colestipol may physically bind or sequester certain drugs in the gut, decreasing their bioavailability
  • It induces CYP3A4 metabolism causing rapid statin degradation
  • It competes at the LDL receptor site with statins

Correct Answer: Colestipol may physically bind or sequester certain drugs in the gut, decreasing their bioavailability

Q26. Which clinical advice is appropriate regarding dietary fat when initiating colestipol therapy?

  • Strictly eliminate all dietary fat immediately
  • Avoid very high-fat meals if hypertriglyceridemia is present; maintain balanced diet and monitor lipids
  • Increase dietary fat to enhance bile acid secretion
  • No dietary considerations are necessary with colestipol

Correct Answer: Avoid very high-fat meals if hypertriglyceridemia is present; maintain balanced diet and monitor lipids

Q27. Which clinical scenario would most strongly favor using a bile acid sequestrant like colestipol?

  • Pregnant patient with markedly elevated LDL where statins are contraindicated
  • Patient requiring rapid LDL reduction within hours
  • Patient with severe hypertriglyceridemia alone
  • Patient with acute pancreatitis due to gallstones

Correct Answer: Pregnant patient with markedly elevated LDL where statins are contraindicated

Q28. Which feature distinguishes colestipol from newer agents like PCSK9 inhibitors?

  • Colestipol acts systemically to degrade LDL particles
  • Colestipol is an oral, non-absorbed resin acting in the gut; PCSK9 inhibitors are injected monoclonal antibodies targeting hepatic LDL receptor degradation
  • Colestipol increases PCSK9 expression while inhibitors decrease it
  • Colestipol directly blocks intestinal cholesterol synthesis enzymes

Correct Answer: Colestipol is an oral, non-absorbed resin acting in the gut; PCSK9 inhibitors are injected monoclonal antibodies targeting hepatic LDL receptor degradation

Q29. Which adverse event would prompt immediate re-evaluation and possible discontinuation of colestipol?

  • Mild transient bloating after first dose
  • Progressive severe constipation with abdominal distension suggesting bowel obstruction
  • Stable mild elevation of LDL after therapy
  • Intermittent mild headache

Correct Answer: Progressive severe constipation with abdominal distension suggesting bowel obstruction

Q30. For pharmacy practice, which counseling point is essential when dispensing colestipol with other medications?

  • Advise patients that all medications should be taken together to maximize effect
  • Explain the potential for drug binding and recommend separating administration times for oral drugs to avoid interaction
  • Tell patients colestipol will increase absorption of all oral drugs
  • No counseling is needed because colestipol has no drug interactions

Correct Answer: Explain the potential for drug binding and recommend separating administration times for oral drugs to avoid interaction

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