Bepridil hydrochloride MCQs With Answer

This set of Bepridil hydrochloride MCQs With Answer is crafted for B. Pharm students to strengthen knowledge of bepridil hydrochloride, a non‑selective calcium channel blocker with antiarrhythmic activity. Questions explore mechanism of action, pharmacokinetics, therapeutic uses in supraventricular and ventricular arrhythmias, dosing principles, adverse effects (notably QT prolongation and torsades), drug interactions, contraindications, and monitoring strategies. Focused clinical and pharmaceutical care points—formulation, patient counseling, and emergency management—are emphasized to support exam preparation and real‑world decision making. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which pharmacological class best describes bepridil hydrochloride?

• Beta‑adrenergic blocker
• Sodium channel blocker (Class I) only
• L‑type calcium channel blocker with antiarrhythmic properties
• ACE inhibitor

Correct Answer: L‑type calcium channel blocker with antiarrhythmic properties

Q2. What is the primary clinical indication for bepridil hydrochloride?

• Antihypertensive monotherapy
• Management of supraventricular and ventricular arrhythmias
• Chronic heart failure first‑line therapy
• Acute ischemic stroke treatment

Correct Answer: Management of supraventricular and ventricular arrhythmias

Q3. The main mechanism of action of bepridil involves blockade of which channel?

• Voltage‑gated sodium channels exclusively
• L‑type calcium channels reducing AV nodal conduction
• Renal sodium channels increasing diuresis
• H+/K+ ATPase in gastric mucosa

Correct Answer: L‑type calcium channels reducing AV nodal conduction

Q4. Which serious cardiac adverse effect is most associated with bepridil?

• Severe bradycardia without ECG changes
• QT interval prolongation leading to torsades de pointes
• Acute myocardial infarction
• Pulmonary embolism

Correct Answer: QT interval prolongation leading to torsades de pointes

Q5. Which organ plays the major role in the metabolism of bepridil hydrochloride?

• Kidney (renal excretion unchanged)
• Liver (hepatic metabolism)
• Lungs (pulmonary metabolism)
• Skin (cutaneous metabolism)

Correct Answer: Liver (hepatic metabolism)

Q6. Which monitoring parameter is essential when a patient is started on bepridil?

• Regular chest X‑rays
• Serial ECG monitoring for QT interval
• Daily fasting blood glucose only
• Urine protein testing

Correct Answer: Serial ECG monitoring for QT interval

Q7. Bepridil is contraindicated in which of the following conditions?

• Well‑controlled hypertension
• Congenital long QT syndrome
• Mild seasonal allergies
• Hyperthyroidism controlled with medication

Correct Answer: Congenital long QT syndrome

Q8. Concurrent use of bepridil with which drug class increases the risk of torsades de pointes?

• Selective serotonin reuptake inhibitors with QT liability
• Topical antifungals without systemic absorption
• Topical corticosteroids
• Oral probiotics

Correct Answer: Selective serotonin reuptake inhibitors with QT liability

Q9. In a patient developing torsades de pointes while on bepridil, the immediate management includes:

• Oral potassium supplements only
• Intravenous magnesium sulfate and electrical cardioversion if unstable
• Increasing the bepridil dose
• Oral antacids

Correct Answer: Intravenous magnesium sulfate and electrical cardioversion if unstable

Q10. Which hemodynamic effect is commonly observed with bepridil therapy?

• Marked increase in systemic vascular resistance
• Hypotension due to vasodilation
• Severe hypervolemia
• Immediate hypertensive crisis in all patients

Correct Answer: Hypotension due to vasodilation

Q11. Bepridil can exert which effect on myocardial contractility?

• Positive inotropic effect increasing contractility
• Negative inotropic effect potentially reducing contractility
• No effect on contractility ever
• Direct chronotropic stimulation only

Correct Answer: Negative inotropic effect potentially reducing contractility

Q12. The marketed pharmaceutical form is commonly the hydrochloride salt because it:

• Makes the drug lipophilic for topical use
• Improves solubility and stability for oral administration
• Eliminates the need for dosing adjustments
• Makes it inactive until metabolized

Correct Answer: Improves solubility and stability for oral administration

Q13. Which electrolyte disturbance most increases the risk of torsades with bepridil?

• Hypercalcemia
• Hypokalemia
• Hypernatremia
• Alkalosis without electrolyte change

Correct Answer: Hypokalemia

Q14. Co‑administration of bepridil with a strong inhibitor of which metabolic pathway is most likely to raise bepridil plasma levels?

• CYP3A4 inhibitors such as ketoconazole
• Renal organic anion transporter inhibitors only
• Topical enzyme inhibitors
• Monoamine oxidase inhibitors without hepatic effects

Correct Answer: CYP3A4 inhibitors such as ketoconazole

Q15. A common noncardiac adverse effect seen with many calcium channel blockers that may occur with bepridil is:

• Severe pruritus as the most common effect
• Constipation
• Profuse rhinorrhea in all patients
• Hyperglycemia in all cases

Correct Answer: Constipation

Q16. When combining bepridil with other antiarrhythmics, the safest monitoring approach is:

• No monitoring needed if initial ECG is normal
• Frequent ECG and serum electrolyte monitoring
• Only monitor blood pressure at monthly visits
• Rely solely on patient symptom reports

Correct Answer: Frequent ECG and serum electrolyte monitoring

Q17. Why has clinical use of bepridil become limited in many settings?

• Because it is universally ineffective
• Due to risk of severe QT prolongation and torsades de pointes
• Because it causes permanent hair loss
• Because it is prohibitively expensive compared with placebo

Correct Answer: Due to risk of severe QT prolongation and torsades de pointes

Q18. Bepridil’s effect on atrioventricular conduction is most likely to produce which ECG change?

• Marked shortening of PR interval
• Prolongation of PR interval due to slowed AV nodal conduction
• Immediate disappearance of the QRS complex
• Pathognomonic U waves in all patients

Correct Answer: Prolongation of PR interval due to slowed AV nodal conduction

Q19. Patients taking bepridil should be advised to seek immediate care if they experience:

• Mild dry skin that improves with lotion
• Syncope, palpitations or sudden fainting
• Typical seasonal sneezing
• Minor bruising after a bump

Correct Answer: Syncope, palpitations or sudden fainting

Q20. For pharmaceutical handling and storage, bepridil hydrochloride tablets are generally stored:

• Frozen at −20°C
• At controlled room temperature, protected from moisture
• Exposed to direct sunlight to increase potency
• In open containers to allow aeration

Correct Answer: At controlled room temperature, protected from moisture

Q21. Extra caution is required when prescribing bepridil to patients with which cardiac condition?

• Isolated asymptomatic mitral valve prolapse only
• Severe left ventricular systolic dysfunction (heart failure)
• Stable fixed pulmonary stenosis
• Mild, well‑controlled essential tremor

Correct Answer: Severe left ventricular systolic dysfunction (heart failure)

Q22. Which class of antiarrhythmics should generally be avoided with bepridil because of additive QT prolongation?

• Class II beta blockers
• Class IA and Class III antiarrhythmics
• Short‑acting nitrates
• Loop diuretics without QT effects

Correct Answer: Class IA and Class III antiarrhythmics

Q23. Besides ECG monitoring, which laboratory tests are important when a patient is on bepridil?

• Serum electrolytes, especially potassium and magnesium
• Only liver biopsy is required
• Daily complete urine microscopy
• Serum vitamin D levels only

Correct Answer: Serum electrolytes, especially potassium and magnesium

Q24. At the cellular level, bepridil tends to have which effect on cardiac action potentials?

• Shortens action potential duration significantly
• Prolongs action potential duration and repolarization
• Eliminates phase 4 depolarization completely
• Has no effect on action potentials

Correct Answer: Prolongs action potential duration and repolarization

Q25. Which life‑threatening arrhythmia is most directly linked to bepridil toxicity?

• Sinus tachycardia only
• Torsades de pointes (polymorphic ventricular tachycardia)
• Atrial premature complexes that are always benign
• Asymptomatic first‑degree AV block without progression

Correct Answer: Torsades de pointes (polymorphic ventricular tachycardia)

Q26. Part of bepridil’s pharmacological profile includes peripheral vasodilation. This contributes to which clinical effect?

• Worsening angina in all patients
• Reduction in systemic vascular resistance and anti‑anginal benefit
• Increased platelet aggregation
• Direct anticoagulant action

Correct Answer: Reduction in systemic vascular resistance and anti‑anginal benefit

Q27. Bepridil is contraindicated in patients with which degree of AV block unless a pacemaker is present?

• First‑degree AV block only
• Second‑ or third‑degree AV block without a pacemaker
• Bundle branch block without symptoms
• Sinus arrhythmia

Correct Answer: Second‑ or third‑degree AV block without a pacemaker

Q28. Which common dietary interaction may increase bepridil plasma concentrations?

• High‑fiber diet reducing absorption
• Grapefruit juice inhibiting intestinal CYP3A4
• Green leafy vegetables high in vitamin K
• Bananas providing extra potassium

Correct Answer: Grapefruit juice inhibiting intestinal CYP3A4

Q29. Bepridil’s pharmacodynamic profile is most similar to which of the following agents?

• Non‑dihydropyridine calcium channel blockers such as verapamil
• Thiazide diuretics like hydrochlorothiazide
• Direct renin inhibitors only
• Short‑acting insulin analogs

Correct Answer: Non‑dihydropyridine calcium channel blockers such as verapamil

Q30. Before initiating bepridil therapy, which baseline assessments are recommended?

• Baseline ECG and serum electrolytes (K+, Mg2+)
• Only a dermatology consult
• MRI of the brain in all patients
• No baseline tests are necessary

Correct Answer: Baseline ECG and serum electrolytes (K+, Mg2+)

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