Alkaloids – Reserpine MCQs With Answer

Alkaloids – Reserpine MCQs With Answer

Reserpine is a classical plant alkaloid from Rauwolfia species, important for B.Pharm students studying pharmacology and therapeutics. This focused introduction covers its chemistry, mechanism of action (VMAT2 inhibition causing monoamine depletion), pharmacokinetics, clinical uses (historical antihypertensive and antipsychotic roles), dose range, major adverse effects (depression, hypotension, diarrhea, nasal congestion), contraindications and key drug interactions. Emphasis is placed on assay methods, formulation considerations and clinical implications relevant to pharmacy practice and exams. Keywords: Alkaloids, Reserpine, Rauwolfia serpentina, VMAT2, monoamine depletion, antihypertensive, adverse effects, pharmacology, B.Pharm. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which plant is the primary natural source of reserpine?

• Atropa belladonna
• Digitalis purpurea
• Rauwolfia serpentina
• Hyoscyamus niger

Correct Answer: Rauwolfia serpentina

Q2. Reserpine belongs to which class of natural products?

• Steroidal glycosides
• Indole alkaloids
• Flavonoids
• Quinoline alkaloids

Correct Answer: Indole alkaloids

Q3. What is the primary molecular target of reserpine in neurons?

• Monoamine oxidase (MAO)
• Vesicular monoamine transporter 2 (VMAT2)
• Plasma membrane dopamine transporter (DAT)
• Tyrosine hydroxylase

Correct Answer: Vesicular monoamine transporter 2 (VMAT2)

Q4. Inhibition of VMAT2 by reserpine leads directly to:

• Increased vesicular storage of catecholamines
• Irreversible blockade of postsynaptic receptors
• Depletion of monoamines in synaptic vesicles
• Enhanced synthesis of norepinephrine

Correct Answer: Depletion of monoamines in synaptic vesicles

Q5. Which neurotransmitters are depleted by reserpine?

• Norepinephrine, dopamine and serotonin
• GABA and glutamate
• Adenosine and ATP
• Acetylcholine only

Correct Answer: Norepinephrine, dopamine and serotonin

Q6. Historically, reserpine was clinically used mainly as:

• An antihypertensive and antipsychotic agent
• An antidiabetic agent
• An antibiotic
• A bronchodilator

Correct Answer: An antihypertensive and antipsychotic agent

Q7. The most clinically significant central adverse effect associated with reserpine is:

• Mania
• Severe depression
• Psychomotor agitation
• Improved mood

Correct Answer: Severe depression

Q8. Which gastrointestinal adverse effect is commonly associated with reserpine?

• Constipation
• Nausea without altered motility
• Diarrhea
• Pancreatitis

Correct Answer: Diarrhea

Q9. Reserpine is contraindicated or should be used with extreme caution in patients with:

• A history of major depressive disorder
• Type 2 diabetes mellitus alone
• Chronic osteoarthritis
• Recurrent urinary tract infections

Correct Answer: A history of major depressive disorder

Q10. The onset of antihypertensive effect of reserpine is typically:

• Within minutes of a single dose
• Within hours
• Over several days to weeks
• After several months

Correct Answer: Over several days to weeks

Q11. Why does reserpine have a prolonged duration of action despite short plasma levels?

• Because it is stored in adipose tissue for months
• Because it irreversibly binds VMAT2 and recovery requires protein synthesis
• Because it forms active metabolites with long half-lives
• Because it accumulates in bone

Correct Answer: Because it irreversibly binds VMAT2 and recovery requires protein synthesis

Q12. Which clinical sign is expected due to reduced sympathetic tone from reserpine?

• Tachycardia
• Hypertension
• Bradycardia
• Mydriasis

Correct Answer: Bradycardia

Q13. Reserpine reduces the effectiveness of which class of drugs that require endogenous catecholamine stores to act?

• Direct-acting sympathomimetics (e.g., phenylephrine)
• Indirect-acting sympathomimetics (e.g., amphetamines)
• Beta-blockers
• Calcium channel blockers

Correct Answer: Indirect-acting sympathomimetics (e.g., amphetamines)

Q14. Which laboratory change is most likely after chronic reserpine therapy?

• Increased urinary catecholamines
• Decreased urinary catecholamines
• Marked leukocytosis
• Elevated fasting glucose only

Correct Answer: Decreased urinary catecholamines

Q15. Typical therapeutic oral dose range of reserpine used historically is approximately:

• 50–100 mg daily
• 0.05–0.25 mg daily
• 5–10 mg daily
• 1–2 g daily

Correct Answer: 0.05–0.25 mg daily

Q16. Which analytical method is commonly used for accurate assay of reserpine in formulations and biological samples?

• Thin-layer chromatography only
• High-performance liquid chromatography (HPLC)
• Kjeldahl nitrogen estimation
• Gravimetric analysis

Correct Answer: High-performance liquid chromatography (HPLC)

Q17. Which of the following is a common peripheral adverse effect of reserpine?

• Reduced nasal congestion
• Nasal congestion
• Excessive sweating only
• Hyperreflexia

Correct Answer: Nasal congestion

Q18. Mechanistically, blood pressure reduction by reserpine is mainly due to:

• Increased cardiac output
• Reduced peripheral vascular resistance from lower sympathetic tone
• Direct vasoconstriction of arterioles
• Diuretic effect on the kidney

Correct Answer: Reduced peripheral vascular resistance from lower sympathetic tone

Q19. Which patient population is specifically advised to avoid reserpine because of teratogenic and fetal risk concerns?

• Pregnant women
• Elderly men only
• Adolescents under 12 without pregnancy
• Patients with controlled asthma

Correct Answer: Pregnant women

Q20. Recovery of neurotransmitter stores after stopping reserpine requires:

• Administration of MAO inhibitors
• De novo synthesis of vesicular transport proteins and neurotransmitters
• Sequestering reserpine with activated charcoal
• Dialysis to remove bound drug

Correct Answer: De novo synthesis of vesicular transport proteins and neurotransmitters

Q21. Which clinical measure is most appropriate when severe depression develops on reserpine?

• Continue the drug and observe
• Stop reserpine and initiate appropriate antidepressant/psychiatric treatment
• Increase the reserpine dose
• Switch to another alkaloid from Rauwolfia without evaluation

Correct Answer: Stop reserpine and initiate appropriate antidepressant/psychiatric treatment

Q22. How does reserpine affect response to indirect dietary sympathomimetics like tyramine?

• It potentiates tyramine effects causing hypertensive crisis
• It blocks tyramine effects due to depleted catecholamine stores
• It has no effect on tyramine action
• It converts tyramine to an inactive metabolite

Correct Answer: It blocks tyramine effects due to depleted catecholamine stores

Q23. Which of the following formulations was historically used for reserpine administration?

• Intravenous infusion only
• Oral tablets
• Inhaler aerosol
• Topical cream

Correct Answer: Oral tablets

Q24. Which monitoring parameter is most important during initiation of reserpine therapy?

• Serum creatinine only
• Blood pressure and mental status
• Fasting lipid profile
• Serum potassium only

Correct Answer: Blood pressure and mental status

Q25. Which of the following best describes reserpine’s binding to VMAT2?

• Reversible, rapidly reversible binding
• Irreversible binding that persists until transporter is resynthesized
• Covalent binding to DNA
• Competitive antagonism at postsynaptic receptors

Correct Answer: Irreversible binding that persists until transporter is resynthesized

Q26. A useful clinical laboratory finding in a patient taking reserpine would be:

• Elevated plasma norepinephrine concentration
• Low plasma and urinary catecholamine levels
• Marked eosinophilia
• Significant hypoglycemia

Correct Answer: Low plasma and urinary catecholamine levels

Q27. Which statement about drug interactions with reserpine is correct?

• Reserpine potentiates the pressor effect of indirect sympathomimetics
• Reserpine may increase the hypotensive effect when combined with other antihypertensives
• Reserpine has no interactions with psychotropic drugs
• Reserpine enhances catecholamine release from vesicles

Correct Answer: Reserpine may increase the hypotensive effect when combined with other antihypertensives

Q28. Which clinical sign would strongly suggest reserpine toxicity rather than simple antihypertensive effect?

• Mild dizziness on standing only
• New-onset severe depressive symptoms with suicidal ideation
• Transient flushing after meals
• Isolated cough without mood change

Correct Answer: New-onset severe depressive symptoms with suicidal ideation

Q29. For quality control of reserpine tablets, which test is essential?

• Assay of active ingredient content by HPLC
• Gram staining
• Blood agar culture test
• pH titration of excipients only

Correct Answer: Assay of active ingredient content by HPLC

Q30. Which alternative drug class is preferred today over reserpine for initial management of uncomplicated hypertension due to better safety?

• Tricyclic antidepressants
• ACE inhibitors or calcium channel blockers
• Monoamine oxidase inhibitors
• Phenothiazines

Correct Answer: ACE inhibitors or calcium channel blockers

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