Glipizide MCQs With Answer provide B. Pharm students a concise, exam-focused review of this second‑generation sulfonylurea antidiabetic. This introduction and question set cover mechanism of action, pharmacokinetics, dosing (IR and ER), therapeutic uses, adverse effects, contraindications, monitoring parameters, drug interactions, and clinical decision‑making in renal/hepatic impairment. Emphasis is placed on rational prescribing, hypoglycemia recognition and management, and comparisons with other sulfonylureas to deepen clinical understanding. These targeted MCQs are designed to strengthen recall, analytical skills, and readiness for university exams and practical pharmacy practice. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. What is the primary mechanism of action of glipizide?
- Inhibition of dipeptidyl peptidase‑4 (DPP‑4)
- Closure of ATP‑sensitive K+ channels in pancreatic beta cells, increasing insulin release
- Activation of PPAR‑gamma to increase insulin sensitivity
- Delay of intestinal carbohydrate absorption
Correct Answer: Closure of ATP‑sensitive K+ channels in pancreatic beta cells, increasing insulin release
Q2. Glipizide belongs to which antidiabetic drug class?
- Biguanides
- Meglitinides
- Second‑generation sulfonylureas
- Thiazolidinediones
Correct Answer: Second‑generation sulfonylureas
Q3. Where is glipizide primarily metabolized?
- Kidney
- Liver
- Intestinal mucosa
- Plasma esterases
Correct Answer: Liver
Q4. What is the main route of elimination for glipizide metabolites?
- Exhaled air
- Feces unchanged
- Urine as metabolites
- Biliary excretion of unchanged drug
Correct Answer: Urine as metabolites
Q5. Which statement best describes glipizide’s plasma protein binding?
- Negligible protein binding (~10%)
- Moderate protein binding (~50%)
- Highly protein bound (~98–99%)
- Protein binding varies widely and is unpredictable
Correct Answer: Highly protein bound (~98–99%)
Q6. What is the typical onset and peak time for immediate‑release glipizide?
- Onset 24 hours, peak 48 hours
- Onset 30–60 minutes, peak 2–3 hours
- Onset 5 minutes, peak 15 minutes
- Onset 6–8 hours, peak 12 hours
Correct Answer: Onset 30–60 minutes, peak 2–3 hours
Q7. Which cytochrome P450 isoenzyme is primarily involved in glipizide metabolism?
- CYP3A4
- CYP2D6
- CYP2C9
- CYP1A2
Correct Answer: CYP2C9
Q8. The most clinically significant adverse effect of glipizide is:
- Hypoglycemia
- Hypertension
- Severe hyperkalemia
- Mydriasis
Correct Answer: Hypoglycemia
Q9. In which of the following conditions is glipizide contraindicated?
- Type 2 diabetes mellitus uncontrolled with lifestyle measures
- Type 1 diabetes mellitus
- Mild renal impairment
- Prediabetes
Correct Answer: Type 1 diabetes mellitus
Q10. What is a common initial adult dose for immediate‑release glipizide?
- 5 mg orally once daily before breakfast
- 50 mg once weekly
- 500 mg three times daily with meals
- 0.1 mg subcutaneously before meals
Correct Answer: 5 mg orally once daily before breakfast
Q11. What is the usual maximum recommended daily dose for glipizide extended‑release (XL) formulations?
- 20 mg once daily
- 5 mg once daily
- 80 mg once daily
- 40 mg twice daily
Correct Answer: 20 mg once daily
Q12. Which tests are most appropriate to monitor glycemic control during glipizide therapy?
- Serum creatinine and BUN only
- Fasting plasma glucose and HbA1c
- Serum amylase and lipase
- Liver ultrasound monthly
Correct Answer: Fasting plasma glucose and HbA1c
Q13. How do nonselective beta‑blockers interact clinically with glipizide?
- They enhance glipizide metabolism, reducing efficacy
- They mask adrenergic symptoms of hypoglycemia (tremor, tachycardia)
- They cause direct insulin release synergistically
- They increase glipizide protein binding and cause toxicity
Correct Answer: They mask adrenergic symptoms of hypoglycemia (tremor, tachycardia)
Q14. Which of the following medications can potentiate glipizide‑induced hypoglycemia?
- Rifampin
- Sulfonamide antibiotics (e.g., trimethoprim‑sulfamethoxazole)
- Carbamazepine
- Phenytoin
Correct Answer: Sulfonamide antibiotics (e.g., trimethoprim‑sulfamethoxazole)
Q15. Which drug is most likely to reduce glipizide plasma concentrations via enzyme induction?
- Fluconazole
- Rifampin
- Ketoconazole
- Fluvoxamine
Correct Answer: Rifampin
Q16. How should glipizide dosing be approached in patients with significant hepatic impairment?
- No adjustment needed; safe at full dose
- Use with caution and consider lower initial dose or alternative therapy
- Increase dose due to rapid hepatic clearance
- Switch to intramuscular administration
Correct Answer: Use with caution and consider lower initial dose or alternative therapy
Q17. What is an important consideration when prescribing glipizide to a patient with advanced renal impairment?
- Renal impairment eliminates hypoglycemia risk
- There is increased risk of prolonged hypoglycemia; dose reduction or avoidance may be necessary
- Glipizide is contraindicated only if GFR >90 mL/min
- No monitoring is required beyond routine blood pressure checks
Correct Answer: There is increased risk of prolonged hypoglycemia; dose reduction or avoidance may be necessary
Q18. For women with gestational diabetes, which therapy is generally preferred over glipizide?
- Insulin therapy
- Glipizide at high dose
- Glibenclamide (glyburide) as first choice
- Uncontrolled carbohydrate restriction only
Correct Answer: Insulin therapy
Q19. Glipizide exerts its effect by binding to which specific subunit of the beta‑cell KATP channel?
- SUR1 subunit of the KATP channel
- Kir6.1 pore subunit only
- Voltage‑gated calcium channel alpha subunit
- GLUT2 transporter
Correct Answer: SUR1 subunit of the KATP channel
Q20. Compared with glyburide (glibenclamide), what is a clinical advantage of glipizide?
- Longer half‑life leading to once‑weekly dosing
- Lower risk of prolonged hypoglycemia due to shorter duration of action
- Greater risk of hematologic toxicity
- Higher incidence of severe cholestatic liver injury
Correct Answer: Lower risk of prolonged hypoglycemia due to shorter duration of action
Q21. Management of severe glipizide‑induced hypoglycemia that is refractory to oral glucose includes:
- Oral metformin administration
- Intravenous dextrose and consideration of subcutaneous or IV octreotide
- Immediate hemodialysis
- Activated charcoal only
Correct Answer: Intravenous dextrose and consideration of subcutaneous or IV octreotide
Q22. Which laboratory parameter best reflects long‑term glycemic control in a patient on glipizide?
- Serum insulin concentration
- HbA1c
- Random serum glucose at midnight only
- Serum C‑peptide once monthly
Correct Answer: HbA1c
Q23. Co‑administration of which agent is most likely to decrease glipizide effectiveness by inducing hepatic metabolism?
- Rifampin
- Fluconazole
- Amiodarone
- Fluvoxamine
Correct Answer: Rifampin
Q24. Which patient is at highest risk of glipizide‑induced hypoglycemia?
- A young adult with regular meals and normal renal function
- An elderly patient with inconsistent oral intake and reduced renal function
- An athlete consuming high‑carbohydrate meals regularly
- A patient on stable metformin monotherapy
Correct Answer: An elderly patient with inconsistent oral intake and reduced renal function
Q25. Which metabolic side effect is commonly associated with sulfonylureas including glipizide?
- Weight gain
- Weight loss
- Severe hyperthermia
- Hypokalemia
Correct Answer: Weight gain
Q26. Are glipizide metabolites pharmacologically active?
- Yes, they are more potent than parent drug
- Yes, they cause prolonged hyperglycemia
- No, most metabolites are inactive and excreted renally
- They are converted to active insulin analogues
Correct Answer: No, most metabolites are inactive and excreted renally
Q27. When is the optimal timing to take immediate‑release glipizide for glucose control?
- With or immediately after the largest meal of the day
- 30 minutes before breakfast
- Only at bedtime
- Every 8 hours regardless of meals
Correct Answer: 30 minutes before breakfast
Q28. Which laboratory tests should be considered periodically to detect hepatic adverse effects of glipizide?
- Serum electrolytes only
- Liver function tests (ALT, AST, bilirubin)
- Urinalysis for ketones only
- Serum troponin levels
Correct Answer: Liver function tests (ALT, AST, bilirubin)
Q29. Which oral antidiabetic is commonly combined with glipizide for complementary mechanisms?
- Metformin
- Warfarin
- Loop diuretics
- ACE inhibitors
Correct Answer: Metformin
Q30. Which counseling point is most important for patients starting glipizide?
- Avoid carrying simple sugars because hypoglycemia cannot occur with glipizide
- Be aware of hypoglycemia signs, carry a quick source of glucose, and wear medical identification
- Stop all other medications immediately when starting glipizide
- Take glipizide only when fasting for best effect
Correct Answer: Be aware of hypoglycemia signs, carry a quick source of glucose, and wear medical identification
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.
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