Beta adrenergic blockers – Betazolol MCQs With Answer

Beta adrenergic blockers – Betazolol MCQs With Answer

Beta adrenergic blockers are essential in pharmacology and therapeutics for B. Pharm students. This introduction focuses on betazolol—a cardioselective beta-1 blocker—covering mechanism of action, pharmacokinetics, therapeutic uses (hypertension, angina, glaucoma), adverse effects, contraindications, and drug interactions. Understanding receptor selectivity, intrinsic sympathomimetic activity, metabolic pathways, and clinical considerations helps students apply pharmacological principles to patient care and exam scenarios. These MCQs emphasize clinical pharmacology, receptor pharmacodynamics, and safe prescribing practices specific to betazolol and related beta blockers. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. What is the primary receptor target of betazolol?

• Beta-2 adrenergic receptor
• Alpha-1 adrenergic receptor
• Beta-1 adrenergic receptor
• Muscarinic M2 receptor

Correct Answer: Beta-1 adrenergic receptor

Q2. Which best describes betazolol’s selectivity?

• Non-selective beta blocker
• Cardioselective (beta-1 selective) blocker
• Alpha and beta mixed blocker
• Pure alpha-1 blocker

Correct Answer: Cardioselective (beta-1 selective) blocker

Q3. Beta-1 receptor blockade primarily leads to which cardiac effect?

• Increased heart rate
• Decreased AV nodal conduction and heart rate
• Increased myocardial contractility
• Bronchoconstriction

Correct Answer: Decreased AV nodal conduction and heart rate

Q4. A key antihypertensive mechanism of beta blockers is suppression of:

• Renin release from juxtaglomerular cells
• Aldosterone synthase activity in adrenal cortex
• Direct vasodilation through nitric oxide
• ACE enzyme activity

Correct Answer: Renin release from juxtaglomerular cells

Q5. Which adverse effect is more likely with non-selective beta blockers than with beta-1 selective agents?

• Bradycardia
• Bronchospasm in asthmatic patients
• Fatigue
• Cold extremities

Correct Answer: Bronchospasm in asthmatic patients

Q6. Betazolol would most likely be relatively safer than a non-selective blocker in a patient with:

• Chronic obstructive pulmonary disease (COPD)
• Complete heart block
• Decompensated heart failure
• Severe bradycardia

Correct Answer: Chronic obstructive pulmonary disease (COPD)

Q7. Which property reduces central nervous system penetration of a beta blocker?

• High lipophilicity
• Low molecular weight
• High polarity and low lipophilicity
• High protein binding

Correct Answer: High polarity and low lipophilicity

Q8. Intrinsic sympathomimetic activity (ISA) in some beta blockers leads to:

• Pure antagonism with no agonist effects
• Partial agonist activity producing less resting bradycardia
• Enhanced vasoconstriction compared to other beta blockers
• Irreversible receptor blockade

Correct Answer: Partial agonist activity producing less resting bradycardia

Q9. Which clinical use is betazolol particularly suitable for due to beta-1 selectivity?

• Acute bronchospasm management
• Glaucoma and hypertension where cardioselectivity is preferred
• Peripheral vascular disease treatment
• Acute anaphylaxis

Correct Answer: Glaucoma and hypertension where cardioselectivity is preferred

Q10. Beta blockers can mask which important sign of hypoglycemia in diabetic patients?

• Excessive thirst
• Tremor and tachycardia
• Hyperphagia
• Polyuria

Correct Answer: Tremor and tachycardia

Q11. Which of the following is a potential metabolic effect of beta blockers?

• Increase in HDL cholesterol
• Reduction in glycogenolysis and potential hypoglycemia masking
• Activation of lipoprotein lipase increasing triglycerides
• Increase in gluconeogenesis causing hyperglycemia only

Correct Answer: Reduction in glycogenolysis and potential hypoglycemia masking

Q12. In managing acute supraventricular tachycardia, beta blockers act primarily by:

• Blocking sodium channels in the ventricles
• Slowing AV nodal conduction via beta-1 blockade
• Increasing sympathetic outflow
• Stimulating beta-2 receptors in the sinoatrial node

Correct Answer: Slowing AV nodal conduction via beta-1 blockade

Q13. Which interaction is clinically important with beta blockers and verapamil/diltiazem?

• Enhanced renal clearance of beta blocker
• Risk of severe bradycardia and AV block when combined
• Increased bronchodilation
• Mutual antagonism leading to reduced efficacy of both

Correct Answer: Risk of severe bradycardia and AV block when combined

Q14. Withdrawal of long-term beta blocker therapy may cause:

• Tachycardia and potential angina due to receptor upregulation
• Permanent receptor blockade
• Immediate improvement in exercise tolerance
• No physiological effects

Correct Answer: Tachycardia and potential angina due to receptor upregulation

Q15. Betazolol’s antihypertensive effect is partly due to:

• Direct alpha-1 mediated vasodilation
• Decreased cardiac output and reduced renin secretion
• Activation of RAAS increasing sodium retention
• Inhibition of acetylcholinesterase

Correct Answer: Decreased cardiac output and reduced renin secretion

Q16. Which beta blocker property makes it useful topically in glaucoma?

• High systemic lipophilicity causing CNS effects
• Ability to reduce aqueous humor production by ciliary epithelium
• Strong alpha-2 agonism
• Increasing outflow through trabecular meshwork

Correct Answer: Ability to reduce aqueous humor production by ciliary epithelium

Q17. Which ECG change is commonly associated with beta blocker therapy?

• Shortened PR interval
• Prolongation of PR interval
• Marked QRS widening
• New ST elevation

Correct Answer: Prolongation of PR interval

Q18. Which condition is an absolute contraindication for initiating beta blocker therapy?

• Mild controlled asthma
• Second- or third-degree AV block without a pacemaker
• Well-controlled hypertension
• Stable chronic angina

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

Q19. Which beta blocker characteristic correlates with more central nervous system side effects like vivid dreams?

• High water solubility
• High lipophilicity and blood–brain barrier penetration
• High molecular weight
• High protein binding only

Correct Answer: High lipophilicity and blood–brain barrier penetration

Q20. Compared to non-selective beta blockers, beta-1 selective agents are less likely to:

• Lower heart rate
• Cause peripheral vasoconstriction via beta-2 blockade
• Reduce renin secretion
• Cause fatigue

Correct Answer: Cause peripheral vasoconstriction via beta-2 blockade

Q21. Which of the following is true about betazolol and exercise tolerance?

• It increases peak exercise heart rate due to beta-2 agonism
• It may reduce maximal exercise capacity by limiting heart rate and contractility
• It has no effect on exercise tolerance
• It increases oxygen demand of myocardium

Correct Answer: It may reduce maximal exercise capacity by limiting heart rate and contractility

Q22. Which statement about beta blockers and heart failure is correct?

• All beta blockers worsen heart failure and are contraindicated
• Certain beta blockers (e.g., carvedilol, metoprolol succinate) improve morbidity and mortality when titrated carefully
• Beta blockers are first-line for acute decompensated heart failure without stabilization
• Beta blockers increase renin secretion worsening heart failure

Correct Answer: Certain beta blockers (e.g., carvedilol, metoprolol succinate) improve morbidity and mortality when titrated carefully

Q23. Which lab effect may be seen with non-selective beta blockers but less so with beta-1 selective agents?

• Elevation of HDL cholesterol
• Increased triglycerides and lowered HDL
• Significant renal dysfunction markers
• Marked leukocytosis

Correct Answer: Increased triglycerides and lowered HDL

Q24. The pharmacodynamic term for a drug that reduces constitutive receptor activity is:

• Partial agonist
• Inverse agonist
• Neutral antagonist
• Allosteric agonist

Correct Answer: Inverse agonist

Q25. Which monitoring parameter is most important when initiating betazolol therapy?

• Serum potassium weekly
• Heart rate and blood pressure
• Pulmonary function tests daily
• Serum creatinine hourly

Correct Answer: Heart rate and blood pressure

Q26. Beta blockers reduce mortality after myocardial infarction mainly by:

• Increasing myocardial oxygen demand
• Reducing arrhythmias and myocardial workload
• Enhancing platelet aggregation
• Stimulating renin release

Correct Answer: Reducing arrhythmias and myocardial workload

Q27. Which adverse effect is commonly reported with beta blocker use and may affect patient adherence?

• Increased libido
• Sexual dysfunction (erectile dysfunction)
• Enhanced hair growth
• Excessive sweating

Correct Answer: Sexual dysfunction (erectile dysfunction)

Q28. When co-prescribed with insulin, beta blockers can:

• Exaggerate hyperglycemia warning symptoms
• Mask adrenergic symptoms of hypoglycemia while prolonging hypoglycemia
• Enhance insulin secretion from pancreas
• Neutralize insulin action completely

Correct Answer: Mask adrenergic symptoms of hypoglycemia while prolonging hypoglycemia

Q29. In an overdose of beta blockers, which antidotal therapy is commonly used?

• Naloxone
• Glucagon to increase intracellular cAMP independent of beta receptors
• Flumazenil
• Atropine followed by adrenaline only

Correct Answer: Glucagon to increase intracellular cAMP independent of beta receptors

Q30. Betazolol’s duration of action is most influenced by:

• Its route of elimination and half-life
• Its ability to chelate calcium
• Renal reabsorption of unchanged drug only
• Immediate irreversible receptor binding

Correct Answer: Its route of elimination and half-life

Q31. Which pharmacokinetic parameter affects dosing frequency of beta blockers like betazolol?

• Volume of distribution only
• Elimination half-life
• Color of tablet coating
• Onset of action in minutes exclusively

Correct Answer: Elimination half-life

Q32. Concomitant use of NSAIDs with beta blockers may cause which effect?

• Synergistic antihypertensive effect
• Reduced antihypertensive efficacy of beta blockers
• Enhanced beta-1 selectivity
• Increased beta blocker renal clearance

Correct Answer: Reduced antihypertensive efficacy of beta blockers

Q33. Which statement is correct about stereochemistry of many beta blockers?

• They are always achiral molecules
• Many have chiral centers; enantiomers may differ in activity
• Only the R-enantiomer is pharmacologically active for all agents
• Stereochemistry does not affect pharmacokinetics

Correct Answer: Many have chiral centers; enantiomers may differ in activity

Q34. Beta blockers are classified pharmacologically based on all EXCEPT:

• Beta receptor selectivity
• Intrinsic sympathomimetic activity
• Ability to block calcium channels directly
• Lipophilicity and pharmacokinetic profile

Correct Answer: Ability to block calcium channels directly

Q35. Which therapeutic effect is NOT typically associated with beta-1 selective blockers?

• Reduction in heart rate
• Decrease in myocardial contractility
• Potent bronchodilation via beta-2 agonism
• Lowering of blood pressure

Correct Answer: Potent bronchodilation via beta-2 agonism

Q36. Which clinical scenario requires caution or dose adjustment for betazolol?

• Controlled hyperthyroidism without symptoms
• Patients with severe hepatic impairment if drug is hepatically metabolized
• Patients with well-controlled hypertension switching from ACE inhibitor
• Young healthy athletes

Correct Answer: Patients with severe hepatic impairment if drug is hepatically metabolized

Q37. Which statement about topical ophthalmic beta blockers (e.g., betaxolol family) is true?

• They have no systemic absorption and no systemic effects
• They can be systemically absorbed and may cause bradycardia or bronchospasm
• They increase intraocular pressure
• They are contraindicated in all elderly patients

Correct Answer: They can be systemically absorbed and may cause bradycardia or bronchospasm

Q38. Mechanistically, beta-1 receptor blockade reduces myocardial oxygen demand by:

• Increasing heart rate and contractility
• Reducing heart rate, contractility, and blood pressure
• Vasodilating coronary arteries directly without affecting heart rate
• Increasing catecholamine release to the heart

Correct Answer: Reducing heart rate, contractility, and blood pressure

Q39. Which is a relative contraindication to beta blocker therapy?

• Controlled hypertension on monotherapy
• Reactive airway disease with recent severe exacerbation
• Stable angina
• Post-MI patient on evidence-based therapy

Correct Answer: Reactive airway disease with recent severe exacerbation

Q40. Beta blockers exert antiarrhythmic effects mainly by:

• Blocking Na/K ATPase in myocardial cells
• Reducing sympathetic-mediated automaticity and AV conduction
• Directly blocking potassium channels exclusively
• Increasing intracellular calcium in pacemaker cells

Correct Answer: Reducing sympathetic-mediated automaticity and AV conduction

Q41. Which drug interaction increases risk of bradycardia when combined with betazolol?

• Loop diuretics
• Digitalis (digoxin)
• Nitrates
• Thiazide diuretics

Correct Answer: Digitalis (digoxin)

Q42. In pharmacology exams, which lab parameter is most useful to monitor beta blocker toxicity?

• Serum sodium
• Electrocardiogram (ECG) for bradyarrhythmias
• Liver enzymes only
• Complete blood count daily

Correct Answer: Electrocardiogram (ECG) for bradyarrhythmias

Q43. Which patient population requires extra caution with beta-1 selective blockers due to altered pharmacokinetics?

• Healthy young adults
• Elderly patients with reduced hepatic or renal function
• Premenopausal women on oral contraceptives only
• Patients with acute allergic rhinitis

Correct Answer: Elderly patients with reduced hepatic or renal function

Q44. Which of the following is TRUE about combining beta blockers with alpha-blockers like prazosin?

• Combination always causes severe hypertension
• Combined therapy may be useful for resistant hypertension due to complementary mechanisms
• They are pharmacologically identical and redundant
• Beta blockers block alpha receptors, so combination is ineffective

Correct Answer: Combined therapy may be useful for resistant hypertension due to complementary mechanisms

Q45. Which cardiovascular condition is a recognized indication for chronic beta blocker therapy?

• Uncontrolled acute decompensated heart failure requiring inotropes
• Chronic stable angina
• Isolated peripheral neuropathy
• Active asthma exacerbation

Correct Answer: Chronic stable angina

Q46. Beta blockers affect which intracellular second messenger system most directly in cardiac tissue?

• cAMP reduction via inhibition of adenylate cyclase
• Activation of guanylate cyclase increasing cGMP
• Increased IP3 and DAG production
• Direct increase of intracellular calcium via L-type channels

Correct Answer: cAMP reduction via inhibition of adenylate cyclase

Q47. When educating a patient about betazolol, which counsel is most appropriate?

• Stop the drug suddenly if you feel dizzy
• Do not abruptly discontinue therapy; consult physician before stopping
• Always double the dose if one dose is missed
• It cures asthma and can be used as needed

Correct Answer: Do not abruptly discontinue therapy; consult physician before stopping

Q48. Which adverse effect can be dose-limiting for many beta blockers and may require dose reduction?

• Hypertension and tachycardia
• Severe bradycardia or symptomatic hypotension
• Excessive weight gain within hours
• Immediate hepatic necrosis in all patients

Correct Answer: Severe bradycardia or symptomatic hypotension

Q49. For ophthalmic beta blockers used in glaucoma, systemic side effects are minimized by which measure?

• Applying pressure to the nasolacrimal duct after instillation
• Applying large volumes to the eye
• Using oral supplementation to reduce absorption
• Avoiding blinking after administration

Correct Answer: Applying pressure to the nasolacrimal duct after instillation

Q50. Which statement about betazolol compared with a highly lipophilic beta blocker is likely true?

• Betazolol is more likely to cause central nervous system side effects
• Betazolol, if less lipophilic, may have fewer CNS adverse effects and less blood–brain barrier penetration
• Betazolol always has a shorter half-life than lipophilic agents
• Betazolol has intrinsic sympathomimetic activity whereas lipophilic agents never do

Correct Answer: Betazolol, if less lipophilic, may have fewer CNS adverse effects and less blood–brain barrier penetration

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