Expectorants: Ammonium chloride* MCQs With Answer

Expectorants: Ammonium chloride* MCQs With Answer
Ammonium chloride is a classic expectorant frequently discussed in B.Pharm pharmacology and formulation modules. This introduction covers its mechanism, chemical nature, clinical uses, pharmacokinetics, adverse effects, contraindications and formulation aspects — all key SEO terms for students: expectorants, ammonium chloride, B.Pharm, mechanism of action, dosage, adverse effects, urinary acidifier and respiratory therapy. Understanding how ammonium chloride increases bronchial secretions, causes urinary acidification and risks metabolic acidosis is essential for exams and practice. Clear grasp of interactions, quality control and patient counselling helps in both theory and pharmacy lab work. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. What is the primary accepted mechanism by which ammonium chloride acts as an expectorant?

• Irritation of gastric mucosa causing reflex bronchial gland secretion
• Direct enzymatic breakdown of mucus glycoproteins
• Inhibition of respiratory cough center in the medulla
• Anticholinergic blockade of airway secretions

Correct Answer: Irritation of gastric mucosa causing reflex bronchial gland secretion

Q2. What is the chemical formula of ammonium chloride?

• NH3Cl
• NH4Cl
• NH4CO3
• NH2Cl

Correct Answer: NH4Cl

Q3. Which of the following best describes ammonium chloride’s pharmacological classification?

• Mucolytic agent only
• Expectorant and urinary acidifier
• Antitussive and bronchodilator
• Antihistamine and decongestant

Correct Answer: Expectorant and urinary acidifier

Q4. Metabolism of ammonium chloride in the body contributes primarily to which acid-base change?

• Metabolic alkalosis due to bicarbonate formation
• Respiratory acidosis due to hypoventilation
• Metabolic acidosis due to generation of HCl and consumption of bicarbonate
• No significant acid-base effect

Correct Answer: Metabolic acidosis due to generation of HCl and consumption of bicarbonate

Q5. Which organ dysfunction is a direct contraindication for ammonium chloride use?

• Hypertension
• Hepatic coma
• Hyperthyroidism
• Osteoporosis

Correct Answer: Hepatic coma

Q6. Which of the following is a common adverse effect of ammonium chloride therapy?

• Hyperkalemia
• Metabolic acidosis
• Hypoglycemia
• Peripheral neuropathy

Correct Answer: Metabolic acidosis

Q7. Which interaction reduces the expectorant efficacy of ammonium chloride?

• Co-administration with guaifenesin
• Co-administration with sodium bicarbonate (alkalizing agents)
• Co-administration with vitamin C
• Co-administration with oral antibiotics

Correct Answer: Co-administration with sodium bicarbonate (alkalizing agents)

Q8. Which statement regarding ammonium chloride and mucus is correct?

• It enzymatically cleaves disulfide bonds in mucus
• It reduces sputum viscosity by breaking mucopolysaccharides
• It increases bronchial secretions but is not a true mucolytic
• It inhibits mucus production in the airways

Correct Answer: It increases bronchial secretions but is not a true mucolytic

Q9. Which of the following is the most likely presentation in acute ammonium chloride overdose?

• Hypertension and agitation
• Hyperammonemia, metabolic acidosis and respiratory depression
• Hypocalcemia and tetany
• Severe bradycardia with AV block

Correct Answer: Hyperammonemia, metabolic acidosis and respiratory depression

Q10. Typical adult oral dosing for ammonium chloride as an expectorant is best described as:

• 0.5–1 g three times daily (oral) as a traditional dosing range
• 10 mg once daily
• 50 g as a single dose
• Topical application only

Correct Answer: 0.5–1 g three times daily (oral) as a traditional dosing range

Q11. Which of the following describes the physical appearance of ammonium chloride?

• Yellow oily liquid
• White crystalline powder
• Dark brown resinous solid
• Colorless gas at room temperature

Correct Answer: White crystalline powder

Q12. The primary route of administration for ammonium chloride in expectorant therapy is:

• Intravenous infusion
• Oral
• Inhalational nebulization
• Topical dermal

Correct Answer: Oral

Q13. How does ammonium chloride acidify urine?

• By directly secreting hydrochloric acid into urine
• By providing ammonium ions that are excreted and increasing net acid excretion
• By inhibiting kidney hydrogen ion secretion
• By increasing renal bicarbonate reabsorption

Correct Answer: By providing ammonium ions that are excreted and increasing net acid excretion

Q14. Which patient group requires caution or avoidance when prescribing ammonium chloride?

• Patients with urinary tract infections only
• Patients with renal impairment and metabolic acidosis
• Patients with seasonal allergic rhinitis only
• Patients receiving topical antifungals

Correct Answer: Patients with renal impairment and metabolic acidosis

Q15. Which of the following best characterizes ammonium chloride’s role in respiratory therapy?

• Bronchodilator that relaxes airway smooth muscle
• Expectorant that increases secretion volume via reflex mechanisms
• Antibiotic that treats respiratory infections
• Systemic steroid substitute

Correct Answer: Expectorant that increases secretion volume via reflex mechanisms

Q16. Ammonium chloride is synthesized industrially by which simple reaction?

• Reaction of ammonia with hydrochloric acid
• Neutralization of ammonia with sulfuric acid
• Oxidation of ammonium nitrate
• Hydrogenation of nitric acid

Correct Answer: Reaction of ammonia with hydrochloric acid

Q17. Which laboratory reagent is commonly used to detect the presence of ammonium ions?

• Nessler’s reagent (gives a colored complex)
• Ferric chloride test
• Sodium nitroprusside test
• Biuret test

Correct Answer: Nessler’s reagent (gives a colored complex)

Q18. Which electrolyte disturbance is most associated with ammonium chloride therapy?

• Hypochloremia
• Hyperchloremia with decreased bicarbonate
• Hyponatremia due to salt wasting
• Hypercalcemia

Correct Answer: Hyperchloremia with decreased bicarbonate

Q19. Which of the following statements about ammonium chloride and mucolytics is true?

• Ammonium chloride acts as a mucolytic by depolymerizing mucin
• Ammonium chloride is primarily an expectorant and not a mucolytic
• It selectively inhibits neutrophil elastase to reduce mucus viscosity
• It denatures airway proteins to dissolve mucus plugs

Correct Answer: Ammonium chloride is primarily an expectorant and not a mucolytic

Q20. Which pharmacokinetic property is true for ammonium chloride?

• Poorly absorbed from the gastrointestinal tract
• Readily absorbed from the gastrointestinal tract
• Not systemically absorbed and acts only locally in the stomach
• Only absorbed after parenteral administration

Correct Answer: Readily absorbed from the gastrointestinal tract

Q21. Which of the following clinical uses is NOT appropriate for ammonium chloride?

• Expectorant for productive cough
• Urinary acidification in certain metabolic conditions
• Treatment of peptic ulcer as a protective agent
• Short-term relief to increase bronchial secretions

Correct Answer: Treatment of peptic ulcer as a protective agent

Q22. Which formulation is commonly used for administering ammonium chloride in practice?

• Topical cream
• Oral syrup or effervescent powder
• Inhaled aerosol formulation
• Intramuscular depot injection

Correct Answer: Oral syrup or effervescent powder

Q23. Ammonium chloride’s effect on the respiratory system is mediated primarily via stimulation of which nerves or reflexes?

• Direct vagal efferent inhibition of bronchial glands
• Reflex stimulation of bronchial glands via gastric vagal afferents
• Sympathetic chain activation increasing mucus secretion
• Direct stimulation of pulmonary stretch receptors

Correct Answer: Reflex stimulation of bronchial glands via gastric vagal afferents

Q24. Which condition would make you avoid prescribing ammonium chloride?

• Renal failure with reduced ability to excrete ammonium
• Mild seasonal allergic rhinitis without infection
• Isolated insomnia
• Controlled hypothyroidism

Correct Answer: Renal failure with reduced ability to excrete ammonium

Q25. Which statement about ammonium chloride and pregnancy is most prudent for B.Pharm counselling?

• It is a proven safe agent in all trimesters
• Caution is advised and risk-benefit should be assessed due to limited data
• It is an FDA category A drug and recommended routinely
• It is absolutely contraindicated in pregnancy under all circumstances

Correct Answer: Caution is advised and risk-benefit should be assessed due to limited data

Q26. Which adverse gastrointestinal effect is commonly reported with ammonium chloride?

• Gastric irritation and nausea
• Constipation due to reduced gut motility
• Pancreatitis
• Steatorrhea

Correct Answer: Gastric irritation and nausea

Q27. Storage recommendations for ammonium chloride powder in the pharmacy are:

• Store in a cool, dry place in an airtight container
• Store frozen at -20°C
• Store exposed to light on an open shelf
• Store in a humid environment to prevent caking

Correct Answer: Store in a cool, dry place in an airtight container

Q28. Which of the following effects on ventilation is expected after ammonium chloride–induced metabolic acidosis?

• Compensatory hyperventilation (increased respiratory rate)
• Compensatory hypoventilation
• No change in ventilation
• Immediate apnea

Correct Answer: Compensatory hyperventilation (increased respiratory rate)

Q29. Which laboratory parameter would most directly indicate ammonium chloride–induced acid load?

• Decreased serum chloride
• Decreased serum bicarbonate (HCO3–)
• Increased serum albumin
• Increased serum calcium

Correct Answer: Decreased serum bicarbonate (HCO3–)

Q30. In pharmaceutical analysis, ammonium chloride is categorized as which type of substance?

• Organic acid
• Inorganic ammonium salt
• Peptide-based compound
• Aliphatic alcohol

Correct Answer: Inorganic ammonium salt

Q31. Which of the following is an expected effect of ammonium chloride on urinary ammonium excretion?

• Decrease in urinary ammonium excretion
• No change in urinary ammonium excretion
• Increase in urinary ammonium excretion
• Complete inhibition of ammonium excretion

Correct Answer: Increase in urinary ammonium excretion

Q32. For quality control, which property is essential to check for pharmaceutical-grade ammonium chloride?

• Identity, purity and assay for chloride content
• Presence of aromatic impurities by smell only
• Protein content analysis
• Viscosity measurement

Correct Answer: Identity, purity and assay for chloride content

Q33. How does ammonium chloride affect urinary stone risk in some metabolic contexts?

• It alkalinizes urine and increases risk of calcium phosphate stones
• It acidifies urine and may reduce risk of some stone types but can increase uric acid stone risk
• It prevents all types of urinary stones
• It has no effect on urinary stone formation

Correct Answer: It acidifies urine and may reduce risk of some stone types but can increase uric acid stone risk

Q34. Which of the following patient histories would prompt extra caution before giving ammonium chloride?

• History of chronic liver disease and encephalopathy
• History of seasonal allergies only
• History of benign skin warts
• History of childhood asthma successfully resolved

Correct Answer: History of chronic liver disease and encephalopathy

Q35. Which of the following is true regarding ammonium chloride’s role in combination cough preparations?

• It is commonly combined with antitussives to suppress cough
• It may be combined with other expectorants like guaifenesin to enhance sputum clearance
• It is never formulated with other agents due to incompatibility
• It neutralizes the effect of all other cough medicines

Correct Answer: It may be combined with other expectorants like guaifenesin to enhance sputum clearance

Q36. Which statement about ammonium chloride’s solubility is correct?

• It is insoluble in water
• It is readily soluble in water
• It is only soluble in organic solvents
• Solubility is negligible at room temperature

Correct Answer: It is readily soluble in water

Q37. Which of the following is the most appropriate counselling point for a patient starting ammonium chloride?

• Expect decreased sputum production and dry cough
• Take with food or milk if gastric irritation occurs
• Avoid fluids as it increases fluid retention
• It has immediate bronchodilator effect, so use before exercise

Correct Answer: Take with food or milk if gastric irritation occurs

Q38. Which biochemical change would you monitor in a patient on prolonged high-dose ammonium chloride?

• Serum bicarbonate and acid-base status
• Serum TSH levels only
• Liver enzymes exclusively without electrolytes
• Serum amylase only

Correct Answer: Serum bicarbonate and acid-base status

Q39. Which of the following is NOT a correct statement about ammonium chloride?

• It can cause hyperchloremic metabolic acidosis
• It acts mainly by increasing respiratory secretions via reflex mechanisms
• It is a potent bronchodilator used in asthma maintenance therapy
• It acidifies urine and increases ammonium excretion

Correct Answer: It is a potent bronchodilator used in asthma maintenance therapy

Q40. Which organ plays a central role in converting ammonia from ammonium chloride metabolism into urea?

• Kidney
• Liver
• Pancreas
• Bone marrow

Correct Answer: Liver

Q41. In compatibility testing, which class of drugs would most likely reduce ammonium chloride’s effect?

• Acidifying agents like ascorbic acid
• Systemic alkalizers such as sodium bicarbonate
• Other expectorants like guaifenesin
• Topical anesthetics

Correct Answer: Systemic alkalizers such as sodium bicarbonate

Q42. What is the expected effect of ammonium chloride on serum sodium concentration in most patients?

• Marked hypernatremia due to sodium load
• No direct predictable major change in serum sodium in normal dosing
• Immediate severe hyponatremia
• Complete loss of serum sodium

Correct Answer: No direct predictable major change in serum sodium in normal dosing

Q43. Which physical property of ammonium chloride is relevant for its packaging to prevent degradation?

• Strong oxidizing character requiring metal containers
• Hygroscopic tendency requiring airtight, moisture-proof packaging
• High volatility requiring pressurized containers
• Photosensitivity requiring transparent containers

Correct Answer: Hygroscopic tendency requiring airtight, moisture-proof packaging

Q44. Which of the following is an important safety point when ammonium chloride is used in patients with chronic lung disease?

• It should be used long-term without monitoring
• Monitor for worsening acidosis and respiratory compensation because acidosis can worsen respiratory status
• It is the preferred long-term mucolytic in COPD
• No special precautions are needed in COPD or chronic lung disease

Correct Answer: Monitor for worsening acidosis and respiratory compensation because acidosis can worsen respiratory status

Q45. The melting/sublimation behavior of ammonium chloride is characterized by:

• Low melting point around 50°C and immediate decomposition
• Decomposes or sublimes at relatively high temperatures (around 340°C)
• Boils at room temperature
• Exists as a liquid crystal at ambient conditions

Correct Answer: Decomposes or sublimes at relatively high temperatures (around 340°C)

Q46. Which statement is correct regarding ammonium chloride and pediatric use?

• It is universally safe for neonates without dose adjustment
• Use caution in infants and young children due to risk of metabolic disturbances; follow pediatric dosing guidelines
• It is the first-line agent for pediatric asthma maintenance
• It should be given intravenously to children only

Correct Answer: Use caution in infants and young children due to risk of metabolic disturbances; follow pediatric dosing guidelines

Q47. Which of the following best summarizes ammonium chloride’s relevance in the B.Pharm curriculum?

• Only important in medicinal chemistry with no clinical relevance
• Important across pharmacology, pharmaceutics, toxicology and clinical pharmacy sections
• Irrelevant to modern pharmacy education
• Only a forensic poison with no therapeutic use

Correct Answer: Important across pharmacology, pharmaceutics, toxicology and clinical pharmacy sections

Q48. Which monitoring parameter would you prioritize after administering ammonium chloride to a patient with borderline renal function?

• Serum bicarbonate and chloride levels, and renal function tests
• Only blood glucose
• Only lipid profile
• Only serum uric acid once yearly

Correct Answer: Serum bicarbonate and chloride levels, and renal function tests

Q49. Which statement about ammonium chloride’s role in cough preparations is correct from a formulation perspective?

• It is frequently used as a humectant in topical cough syrups
• It may be included as an expectorant agent in oral cough syrups or effervescent granules
• It cannot be formulated with sweeteners or flavoring agents
• It must be sterilized by autoclaving in final syrup formulations

Correct Answer: It may be included as an expectorant agent in oral cough syrups or effervescent granules

Q50. Which of the following best describes a practical exam question for B.Pharm students about ammonium chloride?

• Design a sterile parenteral formulation of ammonium chloride for inhalation
• Explain mechanism of expectorant action, major adverse effects (metabolic acidosis), contraindications and quality control tests
• Discuss its role as the primary bronchodilator in asthma management
• Describe how ammonium chloride is used to treat chronic hypertension

Correct Answer: Explain mechanism of expectorant action, major adverse effects (metabolic acidosis), contraindications and quality control tests

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