Captopril MCQs With Answer

Captopril MCQs With Answer

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Captopril MCQs With Answer is a focused set of practice questions designed for B.Pharm students to master the pharmacology of captopril — the first orally active ACE inhibitor. This introduction and question set emphasize captopril’s mechanism of action, pharmacokinetics, clinical uses (hypertension, heart failure, diabetic nephropathy), adverse effects (cough, angioedema, hyperkalemia, neutropenia), contraindications (pregnancy, bilateral renal artery stenosis), and key drug interactions. The MCQs also reinforce dosing considerations, monitoring parameters, and patient counseling points. Each question aims to deepen conceptual understanding and exam readiness with clinically relevant scenarios and detailed options. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which of the following describes the primary mechanism of action of captopril?

  • Direct blockade of angiotensin II receptors
  • Inhibition of angiotensin-converting enzyme, reducing formation of angiotensin II
  • Activation of renin release from the juxtaglomerular cells
  • Inhibition of aldosterone receptors in the distal nephron

Correct Answer: Inhibition of angiotensin-converting enzyme, reducing formation of angiotensin II

Q2. Which structural feature distinguishes captopril from many other ACE inhibitors?

  • It is a prodrug needing hepatic activation
  • It contains a sulfhydryl (thiol) group
  • It has a phosphate ester moiety
  • It is a peptide analog of angiotensin II

Correct Answer: It contains a sulfhydryl (thiol) group

Q3. Which adverse effect is most directly related to increased bradykinin levels caused by captopril?

  • Hyperkalemia
  • Dry cough
  • Neutropenia
  • Hypoglycemia

Correct Answer: Dry cough

Q4. Which patient is captopril absolutely contraindicated in?

  • Pregnant woman in the second trimester
  • Patient with essential hypertension
  • Patient with type 2 diabetes and proteinuria
  • Patient with controlled heart failure

Correct Answer: Pregnant woman in the second trimester

Q5. How is captopril mainly eliminated from the body?

  • Extensive hepatic metabolism followed by biliary excretion
  • Renal excretion of unchanged drug and metabolites
  • Exhalation via the lungs
  • Primarily fecal elimination after gut hydrolysis

Correct Answer: Renal excretion of unchanged drug and metabolites

Q6. Which laboratory tests should be monitored after initiating captopril therapy?

  • Fasting blood glucose and HbA1c
  • Liver function tests and bilirubin
  • Serum creatinine and serum potassium
  • Serum calcium and magnesium

Correct Answer: Serum creatinine and serum potassium

Q7. A known serious but rare hematologic adverse effect of captopril is:

  • Thrombocytosis
  • Agranulocytosis or severe neutropenia
  • Polycythemia vera
  • Eosinophilia with organ dysfunction

Correct Answer: Agranulocytosis or severe neutropenia

Q8. Which drug interaction increases the risk of hyperkalemia when used with captopril?

  • Loop diuretics such as furosemide
  • Calcium channel blockers such as amlodipine
  • Potassium-sparing diuretics such as spironolactone
  • Beta blockers such as metoprolol

Correct Answer: Potassium-sparing diuretics such as spironolactone

Q9. Compared with enalapril and lisinopril, captopril is characterized by:

  • Longer half-life permitting once-daily dosing
  • Shorter half-life requiring more frequent dosing
  • Prodrug status requiring activation
  • Exclusive hepatic excretion

Correct Answer: Shorter half-life requiring more frequent dosing

Q10. Which clinical indication is captopril commonly used for?

  • Acute gout flare treatment
  • Essential hypertension and heart failure management
  • Acute bacterial infection
  • Seizure control in epilepsy

Correct Answer: Essential hypertension and heart failure management

Q11. The first-dose hypotension with captopril is most likely to occur in patients who:

  • Are on high-dose NSAIDs
  • Are volume depleted or on diuretics
  • Have well-controlled blood pressure off other agents
  • Are taking potassium supplements

Correct Answer: Are volume depleted or on diuretics

Q12. Which statement about captopril pharmacokinetics is correct?

  • It is an inactive prodrug converted to active metabolite in the liver
  • It has high oral bioavailability and is active in its administered form
  • It is primarily metabolized by cytochrome P450 enzymes
  • It is only effective when given intravenously

Correct Answer: It has high oral bioavailability and is active in its administered form

Q13. Which symptom suggests angioedema due to captopril?

  • Persistent dry cough
  • Sudden facial or tongue swelling and difficulty breathing
  • Gradual weight gain over weeks
  • Chronic constipation

Correct Answer: Sudden facial or tongue swelling and difficulty breathing

Q14. How does captopril affect aldosterone secretion?

  • Increases aldosterone through enhanced angiotensin II
  • Decreases aldosterone by lowering angiotensin II levels
  • No effect on aldosterone
  • Directly stimulates aldosterone receptors

Correct Answer: Decreases aldosterone by lowering angiotensin II levels

Q15. Which counseling point is important for patients starting captopril?

  • It is safe to use during pregnancy
  • A persistent dry cough may develop and should be reported
  • No need to monitor potassium during therapy
  • Concurrent NSAID use enhances blood pressure lowering

Correct Answer: A persistent dry cough may develop and should be reported

Q16. Which renal condition requires caution or avoidance of captopril?

  • Bilateral renal artery stenosis
  • Simple cyst in one kidney
  • History of renal stones without obstruction
  • Mild asymptomatic proteinuria

Correct Answer: Bilateral renal artery stenosis

Q17. Which effect of captopril contributes to its renoprotective benefit in diabetic nephropathy?

  • Increase in intraglomerular pressure
  • Reduction in glomerular capillary pressure and proteinuria
  • Direct stimulation of insulin secretion
  • Promotion of sodium retention to preserve GFR

Correct Answer: Reduction in glomerular capillary pressure and proteinuria

Q18. Co-administration of NSAIDs with captopril may result in:

  • Enhanced antihypertensive effect leading to severe hypotension
  • Reduced antihypertensive effect and potential renal dysfunction
  • Marked potassium wasting and hypokalemia
  • Increased ACE inhibition via synergistic enzyme blockade

Correct Answer: Reduced antihypertensive effect and potential renal dysfunction

Q19. Which dose-related adverse effect is more common with captopril than with non-thiol ACE inhibitors?

  • Hyperkalemia
  • Rash and taste disturbances (dysgeusia)
  • Angioedema
  • Dry cough

Correct Answer: Rash and taste disturbances (dysgeusia)

Q20. Which monitoring sign suggests a clinically significant decline in renal function after starting captopril?

  • Serum creatinine rise by 5% from baseline
  • Serum creatinine rise by >30% from baseline
  • Decrease in blood urea nitrogen only with stable creatinine
  • Minor transient orthostatic dizziness

Correct Answer: Serum creatinine rise by >30% from baseline

Q21. Which statement about captopril dosing frequency is true?

  • Once daily dosing is typically adequate for all patients
  • Multiple daily dosing may be required due to short half-life
  • It must be administered intravenously every 6 hours
  • Dosing frequency is unrelated to its half-life

Correct Answer: Multiple daily dosing may be required due to short half-life

Q22. Which electrolyte abnormality is commonly monitored because of captopril therapy?

  • Hypokalemia due to potassium wasting
  • Hyperkalemia due to reduced aldosterone
  • Hyponatremia due to sodium overload
  • Hypocalcemia due to chelation

Correct Answer: Hyperkalemia due to reduced aldosterone

Q23. Which clinical scenario requires immediate discontinuation of captopril?

  • Development of a mild headache on therapy
  • Onset of angioedema with airway compromise
  • Transient rise in blood creatinine by 10%
  • Improvement in blood pressure control

Correct Answer: Onset of angioedema with airway compromise

Q24. Which statement about captopril and pregnancy risk is correct?

  • Captopril is safe in the first trimester but not later
  • ACE inhibitors are teratogenic and contraindicated in pregnancy
  • Captopril prevents congenital anomalies and is recommended
  • Pregnancy has no impact on ACE inhibitor safety profile

Correct Answer: ACE inhibitors are teratogenic and contraindicated in pregnancy

Q25. Which pharmacodynamic effect explains captopril’s antihypertensive action?

  • Direct vasoconstriction of arterioles
  • Decreased angiotensin II leading to vasodilation and reduced peripheral resistance
  • Enhanced sympathetic outflow from the brainstem
  • Increased cardiac contractility via beta-adrenergic stimulation

Correct Answer: Decreased angiotensin II leading to vasodilation and reduced peripheral resistance

Q26. Which medication when combined with captopril increases the risk of lithium toxicity?

  • Spironolactone
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Loop diuretics
  • None — captopril reduces lithium levels

Correct Answer: Nonsteroidal anti-inflammatory drugs (NSAIDs)

Q27. Which formulation/route is captopril commonly administered?

  • Oral tablets
  • Transdermal patch
  • Intramuscular depot injection
  • Inhalation aerosol

Correct Answer: Oral tablets

Q28. In a patient with heart failure, how does captopril improve outcomes?

  • By increasing preload through sodium retention
  • By reducing afterload and limiting remodeling via angiotensin II inhibition
  • By direct positive inotropic effect increasing contractility
  • By acting as a diuretic to mobilize large fluid volumes

Correct Answer: By reducing afterload and limiting remodeling via angiotensin II inhibition

Q29. Which adverse reaction is specifically linked to the sulfhydryl group of captopril?

  • Bronchospasm
  • Taste disturbance and rash
  • Pancreatitis
  • Hyperglycemia

Correct Answer: Taste disturbance and rash

Q30. Which of the following is the best initial step before starting captopril in a hypertensive patient?

  • Begin high-dose captopril without baseline labs
  • Check baseline renal function and serum potassium
  • Recommend pregnancy as a reason to start captopril
  • Stop monitoring once blood pressure decreases

Correct Answer: Check baseline renal function and serum potassium

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