Chlorpromazine hydrochloride MCQs With Answer

Chlorpromazine hydrochloride MCQs With Answer provides B. Pharm students a focused, exam-ready review of chlorpromazine hydrochloride — a classic phenothiazine antipsychotic. This SEO-friendly introduction covers mechanism of action (D2 receptor blockade), pharmacokinetics, clinical uses (schizophrenia, acute psychosis, nausea, mania), common and serious adverse effects (EPS, sedation, hypotension, anticholinergic effects, photosensitivity), monitoring parameters, drug interactions, and dosage considerations. These targeted chlorpromazine MCQs emphasize clinical application, safety, and pharmacological principles to strengthen pharmacology and therapeutics understanding for B.Pharm exams and practical pharmacy practice. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. What is the primary mechanism of action of chlorpromazine?

• Selective serotonin reuptake inhibition
• GABA-A receptor agonism
• Dopamine D2 receptor antagonism
• NMDA receptor antagonism

Correct Answer: Dopamine D2 receptor antagonism

Q2. Chlorpromazine belongs to which chemical class of antipsychotics?

• Butyrophenones
• Phenothiazines
• Thioxanthenes
• Atypical antipsychotics

Correct Answer: Phenothiazines

Q3. Which of the following is a common acute extrapyramidal side effect of chlorpromazine?

• Tardive dyskinesia
• Akathisia
• Neutropenia
• Hypothyroidism

Correct Answer: Akathisia

Q4. Which adverse effect is characterized by involuntary, repetitive movements occurring after long-term use of chlorpromazine?

• Agranulocytosis
• Tardive dyskinesia
• Neuroleptic malignant syndrome
• Serotonin syndrome

Correct Answer: Tardive dyskinesia

Q5. Chlorpromazine may cause severe life-threatening rigidity, hyperthermia, and autonomic instability known as:

• Neuroleptic malignant syndrome
• Serotonin syndrome
• Acute dystonic reaction
• Anticholinergic crisis

Correct Answer: Neuroleptic malignant syndrome

Q6. Which cardiovascular adverse effect is commonly associated with chlorpromazine?

• Hypertension
• Orthostatic hypotension
• Bradycardia without hypotension
• Myocardial ischemia

Correct Answer: Orthostatic hypotension

Q7. Chlorpromazine has significant antagonism at which of the following receptor types leading to sedation?

• H1 histamine receptors
• Beta-1 adrenergic receptors
• NMDA receptors
• Glycine receptors

Correct Answer: H1 histamine receptors

Q8. Which of the following clinical uses is chlorpromazine NOT commonly indicated for?

• Schizophrenia and psychotic disorders
• Severe nausea and vomiting
• Parkinson’s disease treatment
• Acute manic agitation

Correct Answer: Parkinson’s disease treatment

Q9. Which metabolic effect can chlorpromazine produce that requires monitoring of metabolic parameters?

• Hypoglycemia
• Hyperprolactinemia and metabolic syndrome risk
• Hypolipidemia
• Increased thyroid function

Correct Answer: Hyperprolactinemia and metabolic syndrome risk

Q10. Chlorpromazine administration may lead to which ocular complication with long-term use?

• Corneal deposits and lens pigmentation
• Acute angle-closure glaucoma
• Optic neuritis
• Retinal detachment

Correct Answer: Corneal deposits and lens pigmentation

Q11. The route of administration available for chlorpromazine in emergencies for rapid tranquilization includes:

• Topical application
• Intramuscular injection
• Transdermal patch
• Inhalation

Correct Answer: Intramuscular injection

Q12. Which laboratory parameter should be periodically monitored in patients on long-term chlorpromazine therapy due to rare but serious hematologic effects?

• Serum amylase
• Complete blood count (CBC)
• Fasting triglycerides only
• Serum sodium

Correct Answer: Complete blood count (CBC)

Q13. Chlorpromazine’s antiemetic action is primarily due to blockade of which receptors in the chemoreceptor trigger zone?

• Muscarinic receptors
• Dopamine D2 receptors
• GABA receptors
• Opioid receptors

Correct Answer: Dopamine D2 receptors

Q14. Which drug interaction with chlorpromazine may increase the risk of central nervous system depression?

• Concurrent use of benzodiazepines
• Concurrent use of levodopa
• Concurrent use of metformin
• Concurrent use of vitamin supplements

Correct Answer: Concurrent use of benzodiazepines

Q15. Chlorpromazine can worsen which neurological condition due to dopamine blockade?

• Alzheimer’s disease
• Parkinson’s disease
• Migraine
• Myasthenia gravis

Correct Answer: Parkinson’s disease

Q16. The anticholinergic side effects of chlorpromazine include:

• Diarrhea and increased sweating
• Urinary retention and dry mouth
• Bradycardia and hyperreflexia
• Enhanced salivation and lacrimation

Correct Answer: Urinary retention and dry mouth

Q17. Which monitoring is recommended early after starting chlorpromazine due to the risk of orthostatic hypotension?

• Daily liver function tests
• Regular blood glucose measurements
• Supine and standing blood pressure monitoring
• Urine protein analysis

Correct Answer: Supine and standing blood pressure monitoring

Q18. Photosensitivity and skin pigmentation associated with chlorpromazine are due to:

• Direct antibacterial activity
• Drug-induced phototoxic and pigment deposition reactions
• Autoimmune skin reactions unrelated to the drug
• Increased melanin production via serotonin receptors

Correct Answer: Drug-induced phototoxic and pigment deposition reactions

Q19. Chlorpromazine may prolong which cardiac interval, requiring caution with other QT-prolonging drugs?

• PR interval
• QT interval
• RR interval
• ST segment only

Correct Answer: QT interval

Q20. Which patient counseling point is appropriate for someone starting chlorpromazine?

• Expect immediate relief of all symptoms within hours
• Avoid driving or operating heavy machinery until effects are known
• No need to report any muscle stiffness
• There are no interactions with other medications

Correct Answer: Avoid driving or operating heavy machinery until effects are known

Q21. In overdose, which complication is a major concern with chlorpromazine?

• Severe QT prolongation, hypotension, and CNS depression
• Profound hyperactivity and tremors only
• Acute renal failure as the primary issue
• Excessive bronchial secretions

Correct Answer: Severe QT prolongation, hypotension, and CNS depression

Q22. Which symptom differentiates neuroleptic malignant syndrome from serotonin syndrome?

• Hyperreflexia is more common in serotonin syndrome; severe lead-pipe rigidity is more typical of NMS
• Serotonin syndrome has severe bradykinesia, NMS does not
• NMS shows pronounced diarrhea while serotonin syndrome does not
• Only serotonin syndrome causes hyperthermia

Correct Answer: Hyperreflexia is more common in serotonin syndrome; severe lead-pipe rigidity is more typical of NMS

Q23. Chlorpromazine’s sedative effect is mainly attributed to blockade of which receptor?

• Alpha-2 adrenergic receptor
• H1 histamine receptor
• 5-HT3 receptor
• M1 muscarinic receptor

Correct Answer: H1 histamine receptor

Q24. Which population requires dose adjustment or extra caution when prescribing chlorpromazine?

• Young healthy adults with no comorbidities
• Elderly patients due to increased sensitivity to hypotension and EPS
• Patients with controlled hyperthyroidism only
• Those with high BMI only

Correct Answer: Elderly patients due to increased sensitivity to hypotension and EPS

Q25. Which effect of chlorpromazine is due to alpha-1 adrenergic blockade?

• Constipation
• Orthostatic hypotension
• Hyperprolactinemia
• Anticholinergic dry mouth

Correct Answer: Orthostatic hypotension

Q26. Which statement about chlorpromazine pharmacokinetics is correct?

• It is primarily excreted unchanged in urine without hepatic metabolism
• It undergoes extensive hepatic metabolism and has active metabolites
• It has negligible first-pass metabolism
• It is not protein bound in plasma

Correct Answer: It undergoes extensive hepatic metabolism and has active metabolites

Q27. Which adverse effect requires immediate discontinuation of chlorpromazine and urgent medical evaluation?

• Mild sedation on the first day of therapy
• Sudden high fever with muscle rigidity and autonomic instability
• Transient mild headache
• Dry mouth manageable with fluids

Correct Answer: Sudden high fever with muscle rigidity and autonomic instability

Q28. Use of chlorpromazine during pregnancy is associated with which consideration?

• It is absolutely contraindicated in all trimesters
• Risk-benefit assessment is required; neonatal extrapyramidal symptoms may occur if used near delivery
• It enhances fetal growth and is recommended
• No monitoring is needed for neonates after exposure

Correct Answer: Risk-benefit assessment is required; neonatal extrapyramidal symptoms may occur if used near delivery

Q29. Which symptom suggests an acute dystonic reaction from chlorpromazine requiring immediate treatment?

• Gradual weight gain over months
• Sudden involuntary neck twisting and facial grimacing
• Slow-onset dry eyes
• Mild transient dizziness

Correct Answer: Sudden involuntary neck twisting and facial grimacing

Q30. Which agent is often used to treat acute extrapyramidal symptoms caused by chlorpromazine?

• Propranolol
• Benztropine or trihexyphenidyl (anticholinergic)
• SSRIs
• Metformin

Correct Answer: Benztropine or trihexyphenidyl (anticholinergic)

Q31. Chlorpromazine increases prolactin levels by blocking dopamine in which region?

• Hypothalamic tuberoinfundibular pathway
• Mesocortical pathway
• Spinal cord motor neurons
• Peripheral adrenal cortex

Correct Answer: Hypothalamic tuberoinfundibular pathway

Q32. Which metabolic adverse effect is commonly associated with many antipsychotics including chlorpromazine?

• Weight loss and hypoglycemia
• Weight gain, dyslipidemia, and hyperglycemia
• Hypolipidemia and low blood pressure
• Improved insulin sensitivity

Correct Answer: Weight gain, dyslipidemia, and hyperglycemia

Q33. Combining chlorpromazine with lithium can increase the risk of:

• Improved renal clearance of lithium
• Neurotoxicity and enhanced adverse central effects
• Reduced therapeutic effect of both agents without side effects
• Hyperthyroidism

Correct Answer: Neurotoxicity and enhanced adverse central effects

Q34. Which of the following is a contraindication or strong caution for chlorpromazine use?

• History of severe CNS depression or comatose state
• Mild seasonal allergies
• Controlled hypertension only
• History of treated peptic ulcer disease

Correct Answer: History of severe CNS depression or comatose state

Q35. For antiemetic use, chlorpromazine acts centrally at:

• The area postrema/chemoreceptor trigger zone
• The enteric nervous system exclusively
• The spinal cord dorsal horn only
• The neuromuscular junction

Correct Answer: The area postrema/chemoreceptor trigger zone

Q36. Which laboratory test is particularly relevant when chlorpromazine is suspected to cause hepatic dysfunction?

• Serum amylase only
• Liver function tests (ALT, AST, bilirubin)
• Serum calcium level
• Urinalysis for ketones

Correct Answer: Liver function tests (ALT, AST, bilirubin)

Q37. Chlorpromazine may lower the seizure threshold; caution is needed in patients with:

• A history of epilepsy or seizure disorder
• Migraine without aura only
• Controlled diabetes only
• Asymptomatic gallstones

Correct Answer: A history of epilepsy or seizure disorder

Q38. Which physical sign is characteristic of parkinsonian side effects from chlorpromazine?

• Hyperreflexia with clonus
• Resting tremor, bradykinesia, and rigidity
• Muscle hypertrophy
• Painless joint swelling

Correct Answer: Resting tremor, bradykinesia, and rigidity

Q39. Which statement about chlorpromazine dosing strategy is appropriate for initiating therapy in psychosis?

• Start at high dose and abruptly stop after a week
• Begin with a low to moderate dose and titrate based on response and tolerability
• Use a single one-time dose for chronic management
• Avoid titration and maintain the same dose regardless of response

Correct Answer: Begin with a low to moderate dose and titrate based on response and tolerability

Q40. Which neurotransmitter receptor blockade by chlorpromazine contributes to antimuscarinic side effects?

• M3 muscarinic receptor blockade
• D1 dopamine receptor blockade only
• NMDA receptor blockade
• GABA-B receptor blockade

Correct Answer: M3 muscarinic receptor blockade

Q41. Chlorpromazine’s bitter taste and high first-pass effect most influence which aspect of therapy?

• Choice of formulation and route (oral vs parenteral)
• Ability to treat peripheral infections
• Need for dietary calcium supplements
• Requirement for renal dose adjustment

Correct Answer: Choice of formulation and route (oral vs parenteral)

Q42. Which adverse endocrine effect may occur with chronic chlorpromazine therapy?

• Decreased cortisol production
• Hyperprolactinemia leading to galactorrhea and menstrual disturbances
• Suppressed parathyroid hormone levels
• Increased growth hormone only

Correct Answer: Hyperprolactinemia leading to galactorrhea and menstrual disturbances

Q43. A pharmacy student should advise a patient starting chlorpromazine to avoid which activity until they know how the drug affects them?

• Reading books
• Driving and operating heavy machinery
• Walking short distances
• Taking vitamin supplements

Correct Answer: Driving and operating heavy machinery

Q44. Concomitant use of drugs that inhibit hepatic metabolism may lead to what change in chlorpromazine therapy?

• Reduced therapeutic effect due to induction
• Increased plasma levels and potential toxicity
• Complete blockade of drug absorption
• No change in effect

Correct Answer: Increased plasma levels and potential toxicity

Q45. Which symptom is least likely to be caused by the anticholinergic effects of chlorpromazine?

• Constipation
• Dry mouth
• Hypersalivation
• Blurred vision

Correct Answer: Hypersalivation

Q46. Which special precaution is necessary when administering IV chlorpromazine?

• It can be given as a rapid IV push without monitoring
• Use slow IV administration with monitoring for hypotension and arrhythmias
• Mix with epinephrine to enhance effect
• No precautions are needed compared to oral dosing

Correct Answer: Use slow IV administration with monitoring for hypotension and arrhythmias

Q47. Which of the following is a pharmacodynamic effect of chlorpromazine that can be therapeutically useful in severe hiccups?

• Stimulation of dopamine receptors in the GI tract
• Dopamine antagonism in the brainstem hiccup center
• Serotonin reuptake inhibition in the spinal cord
• Direct skeletal muscle relaxation only

Correct Answer: Dopamine antagonism in the brainstem hiccup center

Q48. Chlorpromazine may produce which dermatologic adverse effect that requires sun avoidance counseling?

• Photosensitivity reactions
• Psoriasis cure
• Immediate permanent tattooing
• Alopecia universalis

Correct Answer: Photosensitivity reactions

Q49. When switching a patient from chlorpromazine to an atypical antipsychotic, what consideration is important?

• No washout or monitoring required
• Monitor for withdrawal dyskinesia, relapse, and overlapping side effects during cross-titration
• Chlorpromazine must be doubled the day before switch
• Immediate discontinuation without follow-up

Correct Answer: Monitor for withdrawal dyskinesia, relapse, and overlapping side effects during cross-titration

Q50. In pharmacology exams, which characteristic best distinguishes typical antipsychotics like chlorpromazine from atypical agents?

• Greater serotonergic antagonism relative to dopamine antagonism
• Higher propensity for extrapyramidal side effects due to stronger D2 antagonism
• Complete absence of metabolic side effects
• Exclusive action on GABA receptors

Correct Answer: Higher propensity for extrapyramidal side effects due to stronger D2 antagonism

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