Anti-inflammatory agents – Meclofenamate MCQs With Answer

Introduction

Anti-inflammatory agents play a central role in pain and inflammation management in pharmacotherapy. Meclofenamate, a fenamate-class NSAID, is widely studied for its mechanism of inhibiting prostaglandin synthesis and its clinical uses in rheumatoid arthritis, osteoarthritis and dysmenorrhea. B. Pharm students must understand meclofenamate’s pharmacodynamics, side effects, drug interactions, contraindications and monitoring parameters to ensure safe dispensing and therapeutic decisions. This concise, keyword-rich overview focuses on Meclofenamate MCQs to strengthen core pharmacology concepts, emphasize NSAID-specific cautions (GI, renal, bleeding risks), and test clinical application skills. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which chemical class does meclofenamate belong to?

• Salicylates
• Propionic acids
• Fenamates (anthranilic acid derivatives)
• Oxicams

Correct Answer: Fenamates (anthranilic acid derivatives)

Q2. The primary mechanism of action of meclofenamate is:

• Selective COX-2 inhibition
• Reversible inhibition of cyclooxygenase (COX-1 and COX-2)
• Inhibition of lipoxygenase pathway
• Stimulation of prostaglandin synthesis

Correct Answer: Reversible inhibition of cyclooxygenase (COX-1 and COX-2)

Q3. Which clinical indication is commonly treated with meclofenamate?

• Bacterial infections
• Rheumatoid arthritis and primary dysmenorrhea
• Type 1 diabetes mellitus
• Hypothyroidism

Correct Answer: Rheumatoid arthritis and primary dysmenorrhea

Q4. Meclofenamate’s antiplatelet effect is best described as:

• Irreversible inhibition of platelet COX
• No effect on platelets
• Reversible inhibition of platelet aggregation
• Activation of platelet aggregation

Correct Answer: Reversible inhibition of platelet aggregation

Q5. Which adverse effect is most commonly associated with meclofenamate?

• Gastrointestinal irritation and risk of bleeding
• Severe hypoglycemia
• Profound bradycardia
• Hyperkalemia

Correct Answer: Gastrointestinal irritation and risk of bleeding

Q6. Meclofenamate is contraindicated in which pregnancy trimester due to risk of premature ductus arteriosus closure?

• First trimester only
• Second trimester only
• Third trimester
• It is safe in all trimesters

Correct Answer: Third trimester

Q7. Which organ function should be monitored during prolonged meclofenamate therapy?

• Renal and hepatic function
• Thyroid function
• Pancreatic function only
• Adrenal function

Correct Answer: Renal and hepatic function

Q8. Meclofenamate’s classification as an NSAID implies it primarily reduces inflammation by:

• Blocking adrenergic receptors
• Inhibiting prostaglandin synthesis
• Increasing cytokine production
• Stimulating leukotriene formation

Correct Answer: Inhibiting prostaglandin synthesis

Q9. Which of the following drug interactions is clinically significant with meclofenamate?

• Reduced effect of warfarin
• Increased anticoagulant effect of warfarin
• Complete inactivation of insulin
• No interactions reported

Correct Answer: Increased anticoagulant effect of warfarin

Q10. Meclofenamate should be used cautiously in patients with:

• History of peptic ulcer disease
• History of seasonal allergies only
• Mild myopia
• Controlled hyperlipidemia

Correct Answer: History of peptic ulcer disease

Q11. The fenamate subclass, including meclofenamate, is derived from which parent structure?

• Benzodiazepine nucleus
• Anilide nucleus
• Anthranilic acid
• Thiazole ring

Correct Answer: Anthranilic acid

Q12. Which symptom suggests meclofenamate-induced renal impairment?

• Increased urine output and hypokalemia
• Oliguria, rising serum creatinine and edema
• Excessive salivation
• Improved glomerular filtration rate

Correct Answer: Oliguria, rising serum creatinine and edema

Q13. Which laboratory test is important to check before and during chronic meclofenamate therapy?

• Serum amylase only
• Complete blood count, liver and renal tests
• Fasting blood glucose only
• Serum magnesium only

Correct Answer: Complete blood count, liver and renal tests

Q14. Compared with aspirin, meclofenamate’s inhibition of cyclooxygenase is:

• Irreversible and longer lasting
• Reversible and generally shorter lasting
• More selective for COX-1 only
• Ineffective at inhibiting prostaglandins

Correct Answer: Reversible and generally shorter lasting

Q15. Which adverse reaction is a hypersensitivity risk with meclofenamate?

• Bronchospasm in aspirin-sensitive asthmatics
• Immediate hypoglycemia
• Panic attacks in all patients
• Peripheral neuropathy within minutes

Correct Answer: Bronchospasm in aspirin-sensitive asthmatics

Q16. Meclofenamate is primarily administered by which route for systemic anti-inflammatory effect?

• Intramuscular only
• Oral tablets (meclofenamate sodium)
• Topical eye drops
• Intrathecal injection

Correct Answer: Oral tablets (meclofenamate sodium)

Q17. Which patient group requires extra caution or avoidance when prescribing meclofenamate?

• Pregnant women in the third trimester
• Patients with well-controlled asthma and no NSAID sensitivity
• Young adult males with no comorbidities
• Patients taking only vitamin C supplements

Correct Answer: Pregnant women in the third trimester

Q18. Which effect on blood pressure may occur with NSAIDs like meclofenamate?

• Reduction in blood pressure in all patients
• No effect on blood pressure ever
• Potential to raise blood pressure and blunt antihypertensive therapy
• Causes orthostatic hypotension by vasodilation only

Correct Answer: Potential to raise blood pressure and blunt antihypertensive therapy

Q19. A pharmacist counseling a patient on meclofenamate should advise to avoid concurrent use of which OTC medicine without consultation?

• Acetaminophen for fever
• Topical emollient creams
• Aspirin or other NSAIDs because of additive GI and bleeding risk
• Oral rehydration solutions

Correct Answer: Aspirin or other NSAIDs because of additive GI and bleeding risk

Q20. Which metabolic process is most relevant to the elimination of meclofenamate?

• Extensive renal tubular secretion unchanged
• Hepatic metabolism followed by renal excretion of metabolites
• Exhaled unchanged via lungs
• Storage in adipose with no metabolism

Correct Answer: Hepatic metabolism followed by renal excretion of metabolites

Q21. Which statement about meclofenamate and platelet function is correct?

• It permanently disables platelet function for the platelet lifespan
• It has no effect on platelet aggregation
• It reversibly inhibits platelet aggregation, so platelet function recovers after washout
• It stimulates platelet aggregation

Correct Answer: It reversibly inhibits platelet aggregation, so platelet function recovers after washout

Q22. In a patient with heart failure, NSAIDs like meclofenamate can:

• Improve cardiac output by reducing inflammation
• Exacerbate fluid retention and worsen heart failure
• Have no hemodynamic effects
• Eliminate the need for diuretics

Correct Answer: Exacerbate fluid retention and worsen heart failure

Q23. Meclofenamate-induced liver injury is:

• Common and predictable in all patients
• Rare but possible; monitor liver enzymes during therapy
• Impossible because it is not metabolized hepatically
• Only seen with topical use

Correct Answer: Rare but possible; monitor liver enzymes during therapy

Q24. Which pharmacokinetic property increases the risk of drug displacement interactions for meclofenamate?

• High water solubility
• High plasma protein binding
• Complete inability to bind proteins
• Exclusive intracellular accumulation

Correct Answer: High plasma protein binding

Q25. Which monitoring parameter is least relevant during short-term meclofenamate use for acute pain?

• Signs of GI bleeding
• Serum creatinine in high-risk patients
• Daily ECG monitoring in all patients
• History of NSAID sensitivity

Correct Answer: Daily ECG monitoring in all patients

Q26. Which of the following best describes the onset of analgesic action for oral meclofenamate?

• Immediate within seconds
• Rapid within 30–60 minutes after oral dosing
• Requires weeks to begin effect like steroids
• No analgesic effect at therapeutic doses

Correct Answer: Rapid within 30–60 minutes after oral dosing

Q27. A known interaction: co-administration of meclofenamate with lithium may result in:

• Decreased lithium levels and loss of efficacy
• Increased lithium levels and lithium toxicity
• No interaction due to separate pathways
• Immediate urinary excretion of lithium

Correct Answer: Increased lithium levels and lithium toxicity

Q28. Which adverse CNS effect may be observed with meclofenamate?

• Hallucinations in all patients
• Dizziness, headache and occasionally drowsiness
• Permanent paralysis
• Complete loss of taste only

Correct Answer: Dizziness, headache and occasionally drowsiness

Q29. For B. Pharm students reviewing pharmacology, why is knowledge of meclofenamate important?

• It has no clinical relevance
• It exemplifies NSAID pharmacology, adverse effects, and drug interactions important for safe dispensing
• Because it cures infections better than antibiotics
• Only for historical interest with no modern application

Correct Answer: It exemplifies NSAID pharmacology, adverse effects, and drug interactions important for safe dispensing

Q30. Which precaution is important when dispensing meclofenamate to an elderly patient?

• No precautions required specific to age
• Use lowest effective dose, monitor renal function and GI bleeding risk
• Advise increased sodium intake to prevent renal effects
• Recommend concurrent high-dose corticosteroids

Correct Answer: Use lowest effective dose, monitor renal function and GI bleeding risk

Q31. Meclofenamate’s effect on prostaglandins in the kidney primarily leads to:

• Enhanced renal blood flow in hypovolemia
• Reduced synthesis of vasodilatory prostaglandins, potentially decreasing renal perfusion
• Complete protection against nephrotoxicity
• Increased production of erythropoietin

Correct Answer: Reduced synthesis of vasodilatory prostaglandins, potentially decreasing renal perfusion

Q32. Which symptom would warrant immediate discontinuation of meclofenamate and urgent medical evaluation?

• Mild transient headache
• Signs of anaphylaxis: difficulty breathing, swelling of face or throat
• Occasional mild thirst
• Temporary mild increase in appetite

Correct Answer: Signs of anaphylaxis: difficulty breathing, swelling of face or throat

Q33. When counseling about GI risk, which co-therapy increases risk of GI bleeding with meclofenamate?

• Proton pump inhibitors
• Antiplatelet agents or anticoagulants (e.g., warfarin)
• Folic acid supplements
• Topical moisturizers

Correct Answer: Antiplatelet agents or anticoagulants (e.g., warfarin)

Q34. Which statement about the COX selectivity of meclofenamate is accurate?

• Highly selective COX-2 inhibitor like celecoxib
• Non-selective COX inhibitor affecting both COX-1 and COX-2
• Only inhibits COX-3
• Does not inhibit any COX enzymes

Correct Answer: Non-selective COX inhibitor affecting both COX-1 and COX-2

Q35. Which condition is a relative contraindication for initiating meclofenamate therapy?

• Uncontrolled hypertension and active peptic ulcer disease
• Seasonal allergic rhinitis well controlled
• Mild acne vulgaris
• Recent uncomplicated minor head trauma only

Correct Answer: Uncontrolled hypertension and active peptic ulcer disease

Q36. Which adjunct therapy can reduce gastrointestinal risk when NSAIDs like meclofenamate are necessary?

• Proton pump inhibitor co-therapy
• High-dose aspirin added
• St. John’s wort supplement
• Topical antifungal

Correct Answer: Proton pump inhibitor co-therapy

Q37. Overdose management of meclofenamate primarily involves:

• Specific antidote administration
• Supportive care and symptomatic treatment, possibly activated charcoal early
• Immediate dialysis in all cases
• No treatment required as it is harmless

Correct Answer: Supportive care and symptomatic treatment, possibly activated charcoal early

Q38. Which of the following is a reason to prefer an alternative NSAID over meclofenamate?

• Patient with previous severe NSAID hypersensitivity
• Need for short-term analgesia in otherwise healthy person
• Desire to treat a minor headache
• None—meclofenamate is superior in all cases

Correct Answer: Patient with previous severe NSAID hypersensitivity

Q39. Which metabolic interaction can occur with methotrexate when co-administered with NSAIDs like meclofenamate?

• Enhanced renal clearance of methotrexate reducing its efficacy
• Reduced renal clearance of methotrexate increasing toxicity risk
• Methotrexate completely inactivates meclofenamate
• No documented interaction

Correct Answer: Reduced renal clearance of methotrexate increasing toxicity risk

Q40. Which monitoring advice is appropriate when a patient starts meclofenamate and an ACE inhibitor?

• No monitoring required because they act on separate systems
• Monitor renal function and blood pressure because NSAIDs may reduce ACE inhibitor efficacy and impair renal function
• Stop ACE inhibitor immediately when starting NSAID
• Double the ACE inhibitor dose to compensate

Correct Answer: Monitor renal function and blood pressure because NSAIDs may reduce ACE inhibitor efficacy and impair renal function

Q41. Which adverse dermatological reaction has been associated with NSAIDs including fenamates?

• Severe cutaneous adverse reactions (e.g., Stevens–Johnson syndrome) though rare
• Guaranteed hair growth stimulation
• Painless skin whitening only
• No skin reactions reported ever

Correct Answer: Severe cutaneous adverse reactions (e.g., Stevens–Johnson syndrome) though rare

Q42. Which dosing principle is recommended when initiating an NSAID like meclofenamate?

• Start with the highest tolerated dose for immediate effect
• Start with the lowest effective dose for the shortest duration necessary
• Dosing frequency is irrelevant
• Alternate daily with antibiotics

Correct Answer: Start with the lowest effective dose for the shortest duration necessary

Q43. Which symptom profile is most consistent with an NSAID-associated upper GI bleed?

• Sudden severe abdominal pain, melena or hematemesis, dizziness
• Gradual hair loss only
• Isolated itchy scalp without systemic signs
• Immediate relief of abdominal pain

Correct Answer: Sudden severe abdominal pain, melena or hematemesis, dizziness

Q44. Which statement about switching from another NSAID to meclofenamate is correct?

• Switching requires no consideration of washout period if previous NSAID caused bleeding
• Consider individual patient response, prior adverse effects, and allow appropriate washout or monitoring as needed
• It is impossible to switch between NSAIDs safely
• Switching guarantees elimination of all previous adverse effects

Correct Answer: Consider individual patient response, prior adverse effects, and allow appropriate washout or monitoring as needed

Q45. Which patient education point is essential when dispensing meclofenamate?

• It is safe to take with any herbal or prescription drug without consulting a clinician
• Take with food or milk to minimize GI upset and report signs of GI bleeding
• It should be taken on an empty stomach for best effect
• It causes no interactions and requires no monitoring

Correct Answer: Take with food or milk to minimize GI upset and report signs of GI bleeding

Q46. Which OTC medication class increases bleeding risk when combined with meclofenamate?

• Antacids
• Non-selective NSAIDs and aspirin
• Topical antihistamines
• Oral probiotics

Correct Answer: Non-selective NSAIDs and aspirin

Q47. Which physiologic mediator’s synthesis is directly reduced by meclofenamate leading to analgesia?

• Insulin
• Prostaglandins
• Glucagon
• Insulin-like growth factor

Correct Answer: Prostaglandins

Q48. Which statement reflects appropriate pharmacy documentation when dispensing meclofenamate?

• Documentation of allergies, current anticoagulant use, and counseling provided about GI/renal risks
• No documentation is required for NSAID dispensing
• Only document the sale price and nothing about patient history
• Record the patient’s favorite color

Correct Answer: Documentation of allergies, current anticoagulant use, and counseling provided about GI/renal risks

Q49. Compared to selective COX-2 inhibitors, non-selective NSAIDs like meclofenamate have:

• Lower risk of GI injury and no cardiovascular risk
• Higher potential for GI mucosal injury due to COX-1 inhibition
• Exclusive renal protective effects
• No effect on prostaglandin synthesis

Correct Answer: Higher potential for GI mucosal injury due to COX-1 inhibition

Q50. Which clinical scenario would most strongly prompt avoiding meclofenamate?

• Young adult with acute musculoskeletal strain and no comorbidities
• Patient with active peptic ulcer bleeding and current warfarin therapy
• Patient needing short-term topical analgesia only
• Patient who tolerates acetaminophen poorly due to taste

Correct Answer: Patient with active peptic ulcer bleeding and current warfarin therapy

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