Antihypertensive drugs MCQs With Answer

Introduction: Antihypertensive drugs MCQs With Answer provides B.Pharm students a focused review of pharmacology, mechanisms of action, clinical indications, adverse effects, and drug interactions of major antihypertensive classes. This resource emphasizes ACE inhibitors, angiotensin receptor blockers, beta‑blockers, calcium channel blockers, diuretics, and vasodilators, plus important concepts like pharmacokinetics, monitoring parameters, contraindications, and rational combination therapy. Designed to deepen understanding beyond memorization, these targeted MCQs reinforce critical thinking for prescription safety and patient counseling. Clear explanations and clinically relevant scenarios prepare students for exams and practice. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which class of antihypertensive drugs primarily reduces afterload by blocking angiotensin II receptors?

• ACE inhibitors
• Angiotensin receptor blockers (ARBs)
• Beta-blockers
• Thiazide diuretics

Correct Answer: Angiotensin receptor blockers (ARBs)

Q2. Which adverse effect is most commonly associated with ACE inhibitors?

• Dry cough
• Hypokalemia
• Peripheral edema
• Tachycardia

Correct Answer: Dry cough

Q3. Which antihypertensive is contraindicated in pregnancy due to teratogenicity?

• Hydralazine
• Labetalol
• ACE inhibitors (e.g., enalapril)
• Methyldopa

Correct Answer: ACE inhibitors (e.g., enalapril)

Q4. Which diuretic class is most effective for long-term hypertension control and causes hypokalemia?

• Loop diuretics
• Potassium-sparing diuretics
• Thiazide diuretics
• Carbonic anhydrase inhibitors

Correct Answer: Thiazide diuretics

Q5. Which beta-blocker is cardioselective and preferred in patients with asthma?

• Propranolol
• Metoprolol
• Nadolol
• Pindolol

Correct Answer: Metoprolol

Q6. Which calcium channel blocker primarily acts on vascular smooth muscle with minimal cardiac depression?

• Verapamil
• Diltiazem
• Amlodipine
• Digoxin

Correct Answer: Amlodipine

Q7. Which antihypertensive mechanism increases renal sodium and water excretion by inhibiting Na+/Cl− cotransport in distal tubule?

• Loop diuretic action
• Thiazide diuretic action
• ACE inhibition
• Beta-adrenergic blockade

Correct Answer: Thiazide diuretic action

Q8. Which drug is an alpha-1 blocker used to treat hypertension and may cause orthostatic hypotension?

• Prazosin
• Clonidine
• Methyldopa
• Hydrochlorothiazide

Correct Answer: Prazosin

Q9. Which antihypertensive is commonly associated with reflex tachycardia when used as a potent vasodilator?

• Nitroprusside
• Hydralazine
• Minoxidil
• All of the above

Correct Answer: All of the above

Q10. Which laboratory parameter should be monitored when a patient starts an ACE inhibitor or ARB?

• Serum potassium and creatinine
• Serum calcium and magnesium
• Serum phosphate
• Complete blood count only

Correct Answer: Serum potassium and creatinine

Q11. Which antihypertensive can cause hyperkalemia due to aldosterone antagonism?

• Spironolactone
• Furosemide
• Hydrochlorothiazide
• Verapamil

Correct Answer: Spironolactone

Q12. Which agent is used for hypertensive emergencies because it has a rapid onset and can be given IV?

• Oral enalapril
• Nitroprusside
• Oral amlodipine
• Oral spironolactone

Correct Answer: Nitroprusside

Q13. Which mechanism explains the antihypertensive effect of beta-blockers?

• Direct vasodilation via nitric oxide release
• Inhibition of renin release from juxtaglomerular cells
• Inhibition of Na+/K+ ATPase in vascular smooth muscle
• Antagonism of alpha-1 receptors

Correct Answer: Inhibition of renin release from juxtaglomerular cells

Q14. Which calcium channel blocker is most likely to cause constipation as a side effect?

• Amlodipine
• Nifedipine
• Verapamil
• Diltiazem

Correct Answer: Verapamil

Q15. Which antihypertensive combination is commonly used for synergistic blood pressure control and to reduce diuretic-induced hypokalemia?

• ACE inhibitor plus beta-blocker
• Thiazide diuretic plus ACE inhibitor
• Calcium channel blocker plus nitrates
• Loop diuretic plus ARB

Correct Answer: Thiazide diuretic plus ACE inhibitor

Q16. Which drug blocks peripheral alpha-2 receptors and can cause fluid retention and edema?

• Methyldopa
• Prazosin
• Minoxidil
• Clonidine

Correct Answer: Minoxidil

Q17. Which statement about thiazide diuretics is correct?

• They are ineffective at low glomerular filtration rates (severe renal failure).
• They primarily inhibit Na-K-2Cl transporter in the loop of Henle.
• They cause metabolic acidosis.
• They increase urinary calcium excretion.

Correct Answer: They are ineffective at low glomerular filtration rates (severe renal failure).

Q18. Which antihypertensive drug is associated with lupus-like syndrome as a notable adverse effect?

• Hydralazine
• Lisinopril
• Atenolol
• Hydrochlorothiazide

Correct Answer: Hydralazine

Q19. Which property of ACE inhibitors enhances bradykinin levels and contributes to vasodilation?

• Inhibition of angiotensinogen synthesis
• Prevention of angiotensin II breakdown
• Inhibition of kininase II (ACE) leading to decreased bradykinin degradation
• Activation of renin release

Correct Answer: Inhibition of kininase II (ACE) leading to decreased bradykinin degradation

Q20. Which of the following is a nonselective beta-blocker that can exacerbate bronchospasm in asthmatic patients?

• Metoprolol
• Atenolol
• Propranolol
• Nebivolol

Correct Answer: Propranolol

Q21. Which antihypertensive agent acts as a direct arteriolar vasodilator and can cause hirsutism?

• Hydralazine
• Minoxidil
• Sodium nitroprusside
• Enalapril

Correct Answer: Minoxidil

Q22. Which drug class may cause rebound hypertension if abruptly discontinued due to upregulation of receptors?

• ACE inhibitors
• Beta-blockers
• Diuretics
• Calcium channel blockers

Correct Answer: Beta-blockers

Q23. Which antihypertensive is preferred in patients with benign prostatic hyperplasia (BPH) due to improvement in urinary symptoms?

• Prazosin
• Verapamil
• Hydrochlorothiazide
• Enalapril

Correct Answer: Prazosin

Q24. Which monitoring is most important when starting a patient on spironolactone?

• Blood glucose levels
• Serum potassium
• Liver function tests only
• Coagulation profile

Correct Answer: Serum potassium

Q25. Which antihypertensive mechanism directly reduces sympathetic outflow from the CNS?

• Alpha-2 agonists like clonidine
• ACE inhibitors
• Calcium channel blockers
• Loop diuretics

Correct Answer: Alpha-2 agonists like clonidine

Q26. In a patient with diabetes and microalbuminuria, which antihypertensive class is often preferred to provide renal protection?

• Beta-blockers
• ACE inhibitors
• Calcium channel blockers
• Alpha-blockers

Correct Answer: ACE inhibitors

Q27. Which adverse effect is characteristic of dihydropyridine calcium channel blockers like nifedipine?

• Bradycardia
• Peripheral edema
• Hyperkalemia
• Priapism

Correct Answer: Peripheral edema

Q28. Which interaction is important to consider with ACE inhibitors and potassium supplements?

• They lower blood glucose when combined
• They increase the risk of hyperkalemia
• They cause severe hyponatremia
• They reduce ACE inhibitor absorption

Correct Answer: They increase the risk of hyperkalemia

Q29. Which antihypertensive is a prodrug converted to an active ACE inhibitor after hepatic metabolism?

• Lisinopril
• Enalapril
• Captopril
• Losartan

Correct Answer: Enalapril

Q30. Which statement best describes the rationale for combination therapy in hypertension?

• Combining drugs from same class increases efficacy without added side effects
• Combining low doses of agents with complementary mechanisms enhances control and reduces adverse effects
• Combination therapy is only used when monotherapy causes cough
• Combination therapy always prevents target organ damage regardless of BP level

Correct Answer: Combining low doses of agents with complementary mechanisms enhances control and reduces adverse effects

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