Chlorprothixene MCQs With Answer

Chlorprothixene MCQs With Answer

Chlorprothixene MCQs With Answer provides B. Pharm students a concise, exam-focused review of this thioxanthene antipsychotic. This Student-friendly post covers pharmacology, mechanism of action, clinical uses, pharmacokinetics, adverse effects, drug interactions, monitoring parameters and management of side effects for chlorprothixene. The questions emphasize dopamine D2 antagonism, antihistaminic and alpha-adrenergic effects, extrapyramidal symptoms, QT monitoring, hepatic metabolism and safe dispensing considerations. Ideal for pharmacology revision, practical exams and clinical therapeutics, these targeted MCQs reinforce core concepts and clinical decision-making. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. What chemical class does chlorprothixene belong to?

• Phenothiazine
• Thioxanthene
• Butyrophenone
• Azapirone

Correct Answer: Thioxanthene

Q2. What is the primary pharmacological mechanism of chlorprothixene?

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

Correct Answer: Dopamine D2 receptor antagonism

Q3. Which clinical condition is chlorprothixene most commonly used to treat?

• Major depressive disorder
• Schizophrenia and acute psychosis
• Generalized anxiety disorder only
• Parkinson’s disease motor symptoms

Correct Answer: Schizophrenia and acute psychosis

Q4. Which receptor blockade contributes most to chlorprothixene’s sedative effects?

• Beta-adrenergic receptor blockade
• H1 histamine receptor blockade
• Mu-opioid receptor blockade
• Dopamine D1 receptor blockade

Correct Answer: H1 histamine receptor blockade

Q5. Which side effect is classically associated with typical antipsychotics like chlorprothixene?

• Extrapyramidal symptoms (EPS)
• Severe hypoglycemia
• Liver enzyme induction without symptoms
• Renal tubular acidosis

Correct Answer: Extrapyramidal symptoms (EPS)

Q6. Chlorprothixene is best described as which generation of antipsychotic?

• First-generation (typical) antipsychotic
• Second-generation (atypical) antipsychotic
• Third-generation partial agonist
• Non-antipsychotic mood stabilizer

Correct Answer: First-generation (typical) antipsychotic

Q7. Which adverse effect is related to alpha-1 adrenergic blockade by chlorprothixene?

• Orthostatic hypotension
• Hyperreflexia
• Bronchospasm
• Polyuria

Correct Answer: Orthostatic hypotension

Q8. Which metabolic organ is primarily responsible for chlorprothixene biotransformation?

• Kidney via glomerular filtration
• Liver via CYP450-mediated metabolism
• Lungs via pulmonary enzymes
• Skin via cutaneous metabolism

Correct Answer: Liver via CYP450-mediated metabolism

Q9. A common endocrine effect of D2 blockade by chlorprothixene is:

• Decreased cortisol production
• Hyperprolactinemia
• Increased thyroid hormone release
• Reduced insulin sensitivity only

Correct Answer: Hyperprolactinemia

Q10. Which monitoring parameter is recommended because chlorprothixene can affect cardiac conduction?

• Serum amylase
• Electrocardiogram (ECG) for QT interval
• Skin biopsy
• Ophthalmic tonometry

Correct Answer: Electrocardiogram (ECG) for QT interval

Q11. Which drug interaction increases the risk of severe sedation when given with chlorprothixene?

• SSRIs at therapeutic doses without sedative properties
• Benzodiazepines and other CNS depressants
• Topical nasal decongestants only
• Thyroid hormone replacement

Correct Answer: Benzodiazepines and other CNS depressants

Q12. Which management is appropriate for acute dystonic reaction due to chlorprothixene?

• Give a benzodiazepine or anticholinergic like benztropine
• Increase chlorprothixene dose immediately
• Prescribe a dopamine agonist like levodopa
• Initiate high-dose corticosteroids

Correct Answer: Give a benzodiazepine or anticholinergic like benztropine

Q13. Which long-term movement disorder is associated with chronic use of chlorprothixene?

• Tardive dyskinesia
• Essential tremor
• Restless legs syndrome exclusively
• Myasthenia gravis

Correct Answer: Tardive dyskinesia

Q14. Which of the following best describes chlorprothixene’s protein binding and distribution?

• Low protein binding and confined to plasma only
• High protein binding with wide tissue distribution
• No plasma protein binding and rapid renal excretion
• Only distributes to cerebrospinal fluid

Correct Answer: High protein binding with wide tissue distribution

Q15. Which laboratory test may be elevated due to chlorprothixene-induced endocrine effects?

• Serum prolactin
• Serum creatinine kinase only after exercise
• Serum ceruloplasmin exclusively
• Serum vitamin D levels

Correct Answer: Serum prolactin

Q16. For which patient condition is chlorprothixene generally contraindicated?

• Acute psychosis with agitation
• Comatose state or severe CNS depression
• Chronic insomnia responsive to antihistamines
• Mild anxiety without psychotic features

Correct Answer: Comatose state or severe CNS depression

Q17. Which adverse metabolic effect is more commonly associated with atypical antipsychotics than with chlorprothixene?

• Significant weight gain and metabolic syndrome
• Extrapyramidal symptoms
• Orthostatic hypotension
• Sedation from H1 blockade

Correct Answer: Significant weight gain and metabolic syndrome

Q18. Which neurotransmitter receptor blockade contributes to anticholinergic-like side effects when present?

• Muscarinic acetylcholine receptor blockade
• NMDA receptor blockade
• GABA-B receptor blockade
• Histamine H2 receptor blockade

Correct Answer: Muscarinic acetylcholine receptor blockade

Q19. Which clinical sign suggests development of neuroleptic malignant syndrome (NMS) with chlorprothixene?

• Gradual hair loss over months
• Fever, severe rigidity and autonomic instability
• Mild transient headache after first dose
• Asymptomatic liver enzyme elevation only

Correct Answer: Fever, severe rigidity and autonomic instability

Q20. Which agent is appropriate to treat severe akathisia caused by chlorprothixene?

• Beta-blocker such as propranolol or a benzodiazepine
• High-dose aspirin
• Long-acting insulin
• Increased dietary calcium

Correct Answer: Beta-blocker such as propranolol or a benzodiazepine

Q21. Which statement about chlorprothixene onset and onset of antipsychotic effect is correct?

• Antipsychotic effects are immediate within minutes
• Some sedative effects occur quickly, but therapeutic antipsychotic benefits may take days to weeks
• Effects only occur after several months of therapy
• No clinical improvement is expected even after long-term use

Correct Answer: Some sedative effects occur quickly, but therapeutic antipsychotic benefits may take days to weeks

Q22. Which precaution is important when prescribing chlorprothixene to elderly patients?

• No special precautions required
• Use lower doses and monitor for orthostatic hypotension and anticholinergic effects
• Always combine with high-dose stimulants
• Prescribe without monitoring due to benign safety profile

Correct Answer: Use lower doses and monitor for orthostatic hypotension and anticholinergic effects

Q23. Which of the following is a likely pharmacokinetic property of chlorprothixene?

• Primarily excreted unchanged in urine
• Extensive hepatic metabolism with biliary and renal excretion of metabolites
• Eliminated exclusively via exhalation
• Not metabolized and stable in plasma indefinitely

Correct Answer: Extensive hepatic metabolism with biliary and renal excretion of metabolites

Q24. When counseling patients about chlorprothixene, which point is important regarding alcohol?

• Alcohol consumption is safe and enhances efficacy
• Avoid alcohol due to increased sedation and CNS depression
• Alcohol prevents extrapyramidal symptoms
• Only one alcoholic beverage per day is recommended

Correct Answer: Avoid alcohol due to increased sedation and CNS depression

Q25. Which adverse effect is directly linked to dopamine D2 blockade in the nigrostriatal pathway?

• Photosensitivity reactions
• Parkinsonism and other extrapyramidal symptoms
• Peripheral neuropathy only
• Hyperthyroidism

Correct Answer: Parkinsonism and other extrapyramidal symptoms

Q26. Which monitoring is recommended when initiating high-risk antipsychotics that can prolong QT, including chlorprothixene?

• Baseline and periodic ECG monitoring
• Daily MRI scans
• Routine bone marrow biopsy
• Weekly skin allergy testing

Correct Answer: Baseline and periodic ECG monitoring

Q27. In the event of severe orthostatic hypotension from chlorprothixene, which initial step is appropriate?

• Immediately double the dose
• Place patient supine, monitor vitals and consider dose reduction
• Administer a stimulant medication
• Start high-dose antibiotics

Correct Answer: Place patient supine, monitor vitals and consider dose reduction

Q28. Which pharmacodynamic property differentiates typical antipsychotics like chlorprothixene from many atypicals?

• Higher D2 receptor affinity leading to greater EPS risk
• Exclusive serotonin reuptake inhibition
• Complete absence of any antihistaminic effects
• Only peripheral action without central effects

Correct Answer: Higher D2 receptor affinity leading to greater EPS risk

Q29. Which of the following medications may potentiate anticholinergic and sedative effects when combined with chlorprothixene?

• Anticholinergic agents and other sedatives
• Topical fluoride rinses
• Oral vitamin C supplements only
• Topical emollients applied to skin

Correct Answer: Anticholinergic agents and other sedatives

Q30. Which statement about chlorprothixene and pregnancy is most appropriate for counseling?

• It is completely safe and requires no monitoring in pregnancy
• Use with caution; antipsychotics can cross the placenta and may require specialist advice
• It is a recommended first-line treatment for all pregnant women
• It causes guaranteed congenital malformations

Correct Answer: Use with caution; antipsychotics can cross the placenta and may require specialist advice

Q31. Which adverse dermatologic reaction is reported with some typical antipsychotics and should be monitored?

• Photosensitivity and skin reactions
• Immediate hair regrowth
• Permanent skin hardening in all patients
• Universal acne resolution

Correct Answer: Photosensitivity and skin reactions

Q32. Which is the most appropriate action if a patient develops signs of tardive dyskinesia?

• Continue the same dose indefinitely
• Reassess therapy, consider dose reduction or switching and consult for VMAT2 inhibitors
• Prescribe daily stimulants to suppress symptoms
• Ignore the symptoms as they always resolve spontaneously

Correct Answer: Reassess therapy, consider dose reduction or switching and consult for VMAT2 inhibitors

Q33. Which neurotransmitter blockade by chlorprothixene can contribute to weight gain and metabolic changes?

• H1 histamine and possibly serotonin receptor blockade
• Exclusive blockade of sodium channels
• Pure cholinesterase inhibition only
• Selective activation of beta-3 adrenergic receptors

Correct Answer: H1 histamine and possibly serotonin receptor blockade

Q34. Which administration consideration is important when dispensing chlorprothixene to outpatients?

• Advise caution with activities requiring alertness due to sedation
• Encourage heavy alcohol intake to improve sleep
• No counseling about side effects is necessary
• Recommend combining with over-the-counter stimulants routinely

Correct Answer: Advise caution with activities requiring alertness due to sedation

Q35. Which pharmacological strategy reduces antipsychotic-induced acute dystonia?

• Co-administration of anticholinergic agents or benzodiazepines
• Adding high-dose dopamine antagonists
• Stopping all medications without replacement
• Adding loop diuretics immediately

Correct Answer: Co-administration of anticholinergic agents or benzodiazepines

Q36. Which lab abnormality might require attention when a patient is treated with antipsychotics, including chlorprothixene?

• Elevated prolactin levels and metabolic parameters
• Consistent hypokalemia unrelated to other drugs
• Marked hypercalcemia in every case
• Reduced serum hemoglobin exclusively

Correct Answer: Elevated prolactin levels and metabolic parameters

Q37. Which factor increases the risk of extrapyramidal side effects with chlorprothixene?

• High potency D2 antagonism and higher doses
• Concomitant vitamin supplementation
• Low affinity for dopamine receptors
• Exclusive peripheral action without CNS penetration

Correct Answer: High potency D2 antagonism and higher doses

Q38. Which statement about chlorprothixene’s role in antiemetic therapy is correct?

• It has established widespread use as a first-line antiemetic for chemotherapy
• It may have antiemetic effects due to dopamine blockade but is primarily an antipsychotic
• It is only used as a prokinetic agent
• It is a selective 5-HT3 antagonist used solely for nausea

Correct Answer: It may have antiemetic effects due to dopamine blockade but is primarily an antipsychotic

Q39. What is an appropriate counseling point regarding missed doses of chlorprothixene?

• Double the next dose immediately to compensate
• Take the missed dose as soon as remembered unless close to the next dose
• Stop therapy permanently without consulting prescriber
• Skip all remaining doses for that week

Correct Answer: Take the missed dose as soon as remembered unless close to the next dose

Q40. Which adverse cardiac event may be potentiated by combining chlorprothixene with other QT-prolonging drugs?

• Torsades de pointes
• Mitral valve prolapse
• Benign positional palpitations always
• Left ventricular hypertrophy immediately

Correct Answer: Torsades de pointes

Q41. Which patient education point should be emphasized for orthostatic hypotension prevention?

• Rise slowly from sitting or lying positions and stay hydrated
• Always stand up quickly to strengthen circulation
• Avoid fluid intake throughout day
• Perform intense exercise immediately after dosing

Correct Answer: Rise slowly from sitting or lying positions and stay hydrated

Q42. Which enzyme system is most commonly involved in chlorprothixene metabolism and potential drug interactions?

• CYP450 enzyme system
• Renal dehydrogenase exclusively
• Salivary amylase
• Cutaneous lipase only

Correct Answer: CYP450 enzyme system

Q43. Which clinical effect may indicate excessive anticholinergic action from chlorprothixene?

• Excessive drooling and lacrimation
• Dry mouth, blurred vision and urinary retention
• Excessive sweating and rhinorrhea
• Improved bowel motility with diarrhea

Correct Answer: Dry mouth, blurred vision and urinary retention

Q44. Which management is correct if a patient on chlorprothixene reports persistent sedation affecting daily function?

• Assess timing and dose, consider dose reduction or switching antipsychotic
• Recommend drinking alcohol to counteract sedation
• Double the dose to overcome sedation
• Stop all monitoring and continue same regimen

Correct Answer: Assess timing and dose, consider dose reduction or switching antipsychotic

Q45. Which of the following best describes therapeutic drug monitoring for typical antipsychotics like chlorprothixene?

• Routine plasma level monitoring has limited routine use; monitor clinically and for side effects
• Daily plasma levels are mandatory for all patients
• No clinical monitoring ever required after initiation
• Only urine color indicates therapeutic level

Correct Answer: Routine plasma level monitoring has limited routine use; monitor clinically and for side effects

Q46. Which of the following patient histories would prompt extra caution before prescribing chlorprothixene?

• History of orthostatic hypotension, cardiac arrhythmias or prolonged QT
• History of seasonal allergies only
• History of broken bones many years ago
• History of mild myopia without systemic disease

Correct Answer: History of orthostatic hypotension, cardiac arrhythmias or prolonged QT

Q47. Which is an appropriate pharmacy responsibility when dispensing chlorprothixene?

• Provide counseling on side effects, interactions, adherence and monitoring advice
• Dispense without informing patient of risks
• Recommend stopping other prescribed medications arbitrarily
• Encourage combining with herbal stimulants for efficacy

Correct Answer: Provide counseling on side effects, interactions, adherence and monitoring advice

Q48. Which adverse effect is more urgent and requires immediate medical attention in a patient on chlorprothixene?

• Severe muscle rigidity, high fever and altered mental status
• Mild transient dry mouth
• Occasional mild sedation
• Temporary mild headache after dosing

Correct Answer: Severe muscle rigidity, high fever and altered mental status

Q49. Which strategy can help minimize extrapyramidal symptoms when initiating typical antipsychotics?

• Start with the lowest effective dose and titrate cautiously
• Begin with very high doses to desensitize receptors
• Avoid patient education and monitoring
• Use concurrent high-dose stimulants

Correct Answer: Start with the lowest effective dose and titrate cautiously

Q50. Which statement summarizes the pharmacist’s role regarding chlorprothixene therapy?

• Ensure appropriate use by assessing drug interactions, counseling on adverse effects and monitoring needs
• Automatically stop therapy when prescribed without discussion
• Recommend unsupervised combination with OTC sedatives routinely
• Ignore patient questions about side effects

Correct Answer: Ensure appropriate use by assessing drug interactions, counseling on adverse effects and monitoring needs

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