Chlorpropamide MCQs With Answer

Chlorpropamide MCQs With Answer

Chlorpropamide is a first‑generation sulfonylurea used historically in type 2 diabetes management. This introduction and question set cover chlorpropamide’s mechanism of action, pharmacokinetics, dosing, adverse effects (including hypoglycemia and hyponatremia due to ADH potentiation), drug interactions (alcohol, beta‑blockers, warfarin), contraindications, and therapeutic considerations for B. Pharm students. Emphasis is placed on clinical pharmacology, metabolism, renal elimination, and patient safety—key topics for exams and practice. These focused MCQs will strengthen understanding of drug action, monitoring, and risk mitigation. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which class of antidiabetic drugs does chlorpropamide belong to?

• Biguanides
• First‑generation sulfonylureas
• Meglitinides
• Thiazolidinediones

Correct Answer: First‑generation sulfonylureas

Q2. What is the primary mechanism of action of chlorpropamide?

• Inhibition of hepatic gluconeogenesis
• Activation of insulin receptor tyrosine kinase
• Closure of pancreatic beta‑cell ATP‑sensitive K+ channels causing insulin release
• Delayed gastric glucose absorption

Correct Answer: Closure of pancreatic beta‑cell ATP‑sensitive K+ channels causing insulin release

Q3. Chlorpropamide is primarily indicated in which condition?

• Type 1 diabetes mellitus
• Type 2 diabetes mellitus with residual beta‑cell function
• Diabetic ketoacidosis
• Gestational diabetes

Correct Answer: Type 2 diabetes mellitus with residual beta‑cell function

Q4. A well‑known adverse effect of chlorpropamide related to antidiuretic hormone is:

• Polyuria
• Renal tubular acidosis
• SIADH leading to hyponatremia
• Hypernatremia

Correct Answer: SIADH leading to hyponatremia

Q5. Which interaction increases the risk of severe hypoglycemia when combined with chlorpropamide?

• Concomitant metformin therapy
• Concurrent beta‑blocker therapy masking hypoglycemic symptoms
• Concurrent thiazide diuretics causing hyperglycemia
• Co‑administration of bile acid sequestrants

Correct Answer: Concurrent beta‑blocker therapy masking hypoglycemic symptoms

Q6. Chlorpropamide can cause a disulfiram‑like reaction with which substance?

• Caffeine
• Alcohol (ethanol)
• Naproxen
• Vitamin C

Correct Answer: Alcohol (ethanol)

Q7. Which pharmacokinetic property best describes chlorpropamide?

• Short half‑life and rapid clearance
• Long half‑life with duration of action prone to accumulation
• Primarily excreted unchanged in bile
• Requires prodrug activation in the liver

Correct Answer: Long half‑life with duration of action prone to accumulation

Q8. Which patient population is at highest risk of prolonged hypoglycemia with chlorpropamide?

• Young adults with normal renal function
• Elderly patients with reduced renal function
• Patients on short‑acting insulin
• Patients with hyperthyroidism

Correct Answer: Elderly patients with reduced renal function

Q9. The metabolism and elimination of chlorpropamide primarily involve which organ?

• Lungs
• Liver metabolism and renal excretion
• Skin metabolism and fecal excretion
• Pancreas

Correct Answer: Liver metabolism and renal excretion

Q10. Which laboratory monitoring is particularly important after initiating chlorpropamide therapy?

• Liver function tests only
• Serum sodium and blood glucose
• Serum potassium only
• Coagulation profile only

Correct Answer: Serum sodium and blood glucose

Q11. Chlorpropamide should be avoided in which clinical scenario?

• Stable type 2 diabetes with good oral intake
• Pregnancy and lactation
• Postmenopausal women without diabetes
• Mild intermittent hyperglycemia

Correct Answer: Pregnancy and lactation

Q12. Which hematologic adverse effect is a rare but serious risk with sulfonylureas including chlorpropamide?

• Thrombocytosis
• Agranulocytosis
• Iron deficiency anemia
• Polycythemia vera

Correct Answer: Agranulocytosis

Q13. Which is a distinguishing clinical feature of first‑generation sulfonylureas like chlorpropamide compared to newer agents?

• Lower hypoglycemia risk
• Longer duration of action and higher hypoglycemia risk
• Direct insulin sensitization in peripheral tissues
• Primary action on incretin hormones

Correct Answer: Longer duration of action and higher hypoglycemia risk

Q14. Co‑administration of chlorpropamide with warfarin can lead to:

• Decreased anticoagulant effect due to enzyme induction
• Increased warfarin effect and elevated INR due to displacement or metabolism inhibition
• No interaction
• Immediate bleeding independent of INR changes

Correct Answer: Increased warfarin effect and elevated INR due to displacement or metabolism inhibition

Q15. Which adverse effect profile is classically associated with chlorpropamide?

• Hypoglycemia, weight gain, and hyponatremia
• Weight loss, palpitations, and hypotension
• Severe hyperglycemia and ketoacidosis
• Renal stones and hypercalcemia

Correct Answer: Hypoglycemia, weight gain, and hyponatremia

Q16. The risk of hypoglycemia with chlorpropamide is increased by which of the following?

• Missed doses of chlorpropamide
• Reduced caloric intake or fasting
• Concurrent corticosteroid therapy
• High carbohydrate meals

Correct Answer: Reduced caloric intake or fasting

Q17. Which statement regarding chlorpropamide’s effect on insulin is correct?

• It increases insulin sensitivity without affecting insulin secretion
• It directly stimulates insulin release from pancreatic beta cells
• It inhibits insulin secretion
• It degrades circulating insulin

Correct Answer: It directly stimulates insulin release from pancreatic beta cells

Q18. In a patient with severe renal impairment, chlorpropamide use is:

• Preferred due to renal excretion advantage
• Contraindicated or requires dose reduction because of prolonged half‑life
• Unaffected by renal function
• Recommended at higher doses

Correct Answer: Contraindicated or requires dose reduction because of prolonged half‑life

Q19. Which of the following is an appropriate counseling point for patients starting chlorpropamide?

• Consume alcohol freely to enhance efficacy
• Report symptoms of confusion or persistent nausea which may indicate hyponatremia
• Avoid monitoring blood glucose since risks are minimal
• There is no risk of hypoglycemia, so snacking is unnecessary

Correct Answer: Report symptoms of confusion or persistent nausea which may indicate hyponatremia

Q20. Which monitoring frequency is reasonable soon after initiating chlorpropamide?

• No monitoring required
• Frequent blood glucose checks and periodic sodium assessment
• Only annual monitoring
• Only monitor liver enzymes daily

Correct Answer: Frequent blood glucose checks and periodic sodium assessment

Q21. Which drug class would most likely blunt adrenergic warning signs of hypoglycemia when combined with chlorpropamide?

• ACE inhibitors
• Beta‑blockers
• Calcium channel blockers
• Statins

Correct Answer: Beta‑blockers

Q22. Chlorpropamide’s propensity to cause photosensitivity is best classified as:

• Common and dose‑dependent
• Rare but reported adverse effect
• Not associated with sulfonylureas
• Only occurs with topical use

Correct Answer: Rare but reported adverse effect

Q23. Compared to second‑generation sulfonylureas, chlorpropamide generally has:

• Greater potency and shorter half‑life
• Lower potency and longer half‑life
• Identical pharmacokinetic profile
• No risk of hypoglycemia

Correct Answer: Lower potency and longer half‑life

Q24. The biochemical target on beta cells that sulfonylureas bind to is known as:

• GLUT2 transporter
• KATP (ATP‑sensitive potassium) channel SUR subunit
• Voltage‑gated calcium channel alpha1 subunit
• Insulin receptor substrate‑1

Correct Answer: KATP (ATP‑sensitive potassium) channel SUR subunit

Q25. Which of the following adverse effects may present with confusion, seizures, or coma in a patient on chlorpropamide?

• Hyponatremia due to SIADH
• Hyperkalemia
• Hypocalcemia
• Hypermagnesemia

Correct Answer: Hyponatremia due to SIADH

Q26. Which pharmacodynamic property explains weight gain associated with chlorpropamide?

• Increased lipolysis
• Enhanced insulin secretion leading to anabolic effects
• Appetite suppression
• Increased basal metabolic rate

Correct Answer: Enhanced insulin secretion leading to anabolic effects

Q27. In case of severe chlorpropamide‑induced hypoglycemia, the immediate treatment is:

• Oral glucose if conscious; IV dextrose or glucagon if unconscious
• Immediate insulin administration
• Administer metformin
• Give a high‑fat meal only

Correct Answer: Oral glucose if conscious; IV dextrose or glucagon if unconscious

Q28. Which adverse hepatic effect has been reported, albeit rarely, with chlorpropamide?

• Cholestatic jaundice
• Acute fatty liver of pregnancy
• Hepatocellular carcinoma
• Wilson’s disease

Correct Answer: Cholestatic jaundice

Q29. Which statement about chlorpropamide dosing is correct?

• Single daily dosing is often sufficient due to its long duration
• Requires multiple daily dosing every 2–3 hours
• Must be given intravenously
• Dosage is fixed at 500 mg for all adults

Correct Answer: Single daily dosing is often sufficient due to its long duration

Q30. A student pharmacist counseling a patient on chlorpropamide should advise which precaution?

• Avoid alcohol to prevent disulfiram‑like reactions
• Increase sun exposure without protection
• Double the dose if a dose is missed
• Stop monitoring blood glucose after one month

Correct Answer: Avoid alcohol to prevent disulfiram‑like reactions

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