Felodipine MCQs With Answer

Felodipine MCQs With Answer

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Felodipine MCQs With Answer: This concise set of 30 MCQs is crafted for B. Pharm students to deepen understanding of felodipine — a dihydropyridine calcium channel blocker widely used for hypertension. Topics include pharmacodynamics, pharmacokinetics (absorption, low oral bioavailability, first‑pass metabolism), CYP3A4‑mediated drug interactions (e.g., grapefruit juice), clinical uses, adverse effects (peripheral edema, flushing, reflex tachycardia), dosing and extended‑release formulations, contraindications, monitoring, and overdose management. Questions focus on applied therapeutics, mechanism of action, patient counseling, and formulation issues to prepare you for exams and practical pharmacy care. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which class of drug does felodipine belong to?

  • Dihydropyridine calcium channel blocker
  • Non‑dihydropyridine calcium channel blocker
  • Beta‑adrenergic blocker
  • ACE inhibitor

Correct Answer: Dihydropyridine calcium channel blocker

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

  • Inhibition of angiotensin converting enzyme
  • Blockade of L‑type calcium channels in vascular smooth muscle reducing Ca2+ influx
  • Beta‑1 receptor antagonism in the heart
  • Stimulation of nitric oxide release from endothelium

Correct Answer: Blockade of L‑type calcium channels in vascular smooth muscle reducing Ca2+ influx

Q3. What is the main clinical indication for felodipine?

  • Type 2 diabetes mellitus
  • Hypertension
  • Hyperlipidemia
  • Epilepsy

Correct Answer: Hypertension

Q4. Which cardiovascular effect is commonly associated with felodipine due to peripheral vasodilation?

  • Bradycardia without reflex changes
  • Reflex tachycardia
  • Increased AV nodal conduction causing heart block
  • Marked decrease in cardiac contractility in all patients

Correct Answer: Reflex tachycardia

Q5. Which adverse effect is most characteristic of dihydropyridine calcium channel blockers like felodipine?

  • Peripheral edema (ankle edema)
  • Neutropenia
  • Hypoglycemia
  • Bronchospasm

Correct Answer: Peripheral edema (ankle edema)

Q6. Which hepatic enzyme is primarily responsible for the metabolism of felodipine?

  • CYP2D6
  • CYP1A2
  • CYP3A4
  • CYP2C9

Correct Answer: CYP3A4

Q7. What is the effect of grapefruit juice on felodipine plasma concentration?

  • It decreases concentration by inducing CYP3A4
  • It increases concentration by inhibiting intestinal CYP3A4
  • No significant effect
  • It increases renal clearance leading to lower plasma levels

Correct Answer: It increases concentration by inhibiting intestinal CYP3A4

Q8. Which formulation of felodipine is commonly used to provide once‑daily dosing?

  • Immediate‑release intravenous formulation
  • Extended‑release oral tablets
  • Transdermal patch applied hourly
  • Sublingual spray

Correct Answer: Extended‑release oral tablets

Q9. What is the approximate elimination half‑life of felodipine in adults on ER formulations?

  • 1–2 hours
  • 4–6 hours
  • 11–16 hours
  • 48–72 hours

Correct Answer: 11–16 hours

Q10. Which statement best describes felodipine oral bioavailability?

  • High bioavailability (>80%) with minimal first‑pass effect
  • Low oral bioavailability (~15–20%) due to extensive first‑pass metabolism
  • Bioavailability is 100% when taken with food
  • Bioavailability is negligible, requiring IV dosing for effect

Correct Answer: Low oral bioavailability (~15–20%) due to extensive first‑pass metabolism

Q11. In which condition should felodipine be used with extreme caution or avoided?

  • Stable controlled hypertension
  • Severe aortic stenosis
  • Mild seasonal allergies
  • Controlled hyperthyroidism

Correct Answer: Severe aortic stenosis

Q12. Combining felodipine with which drug class can help blunt reflex tachycardia?

  • ACE inhibitors
  • Loop diuretics
  • Beta‑blockers
  • Thiazide diuretics

Correct Answer: Beta‑blockers

Q13. What parameters should be routinely monitored in a patient starting felodipine?

  • Blood pressure and heart rate; monitor for peripheral edema
  • Serum potassium and phosphate only
  • Complete blood count weekly
  • Urine glucose twice daily

Correct Answer: Blood pressure and heart rate; monitor for peripheral edema

Q14. How is felodipine generally classified regarding pregnancy risk under older FDA categories?

  • Category A — safe in pregnancy
  • Category B — no risk in animals, unknown in humans
  • Category C — use only if benefits justify risks
  • Category X — contraindicated in pregnancy

Correct Answer: Category C — use only if benefits justify risks

Q15. What is the recommended approach to dosing felodipine in severe hepatic impairment?

  • No adjustment needed; safe at standard doses
  • Dose reduction or avoid use in severe hepatic impairment
  • Double the dose due to increased clearance
  • Switch to intravenous felodipine

Correct Answer: Dose reduction or avoid use in severe hepatic impairment

Q16. Compared to non‑dihydropyridine calcium channel blockers (verapamil, diltiazem), felodipine primarily affects:

  • Cardiac conduction and contractility more than vessels
  • Vascular smooth muscle more than cardiac conduction
  • Renal sodium transport directly
  • Beta‑adrenergic receptors in the heart

Correct Answer: Vascular smooth muscle more than cardiac conduction

Q17. Which statement about protein binding of felodipine is correct?

  • Felodipine is minimally protein bound (<10%)
  • Felodipine is moderately protein bound (~50%)
  • Felodipine is highly protein bound (~98%)
  • Protein binding of felodipine is negligible and clinically irrelevant

Correct Answer: Felodipine is highly protein bound (~98%)

Q18. Co‑administration of rifampicin (a strong CYP3A4 inducer) with felodipine will most likely cause:

  • Increased felodipine plasma concentration and toxicity
  • Decreased felodipine plasma concentration and reduced effect
  • No interaction because felodipine is renally excreted unchanged
  • Immediate hypersensitivity reaction

Correct Answer: Decreased felodipine plasma concentration and reduced effect

Q19. Which oral adverse effect has been reported with calcium channel blockers including felodipine?

  • Aphthous ulcers exclusively
  • Gingival hyperplasia
  • Permanent tooth discoloration
  • Increased salivary flow only

Correct Answer: Gingival hyperplasia

Q20. Which is an appropriate initial management step in severe felodipine overdose?

  • Immediate dialysis as first‑line therapy
  • Supportive care including IV calcium, vasopressors, and high‑dose insulin therapy as indicated
  • Oral activated charcoal after 48 hours
  • No treatment; monitor and expect spontaneous recovery

Correct Answer: Supportive care including IV calcium, vasopressors, and high‑dose insulin therapy as indicated

Q21. Felodipine exerts its antihypertensive effect primarily by dilating which vascular segment?

  • Large veins only
  • Peripheral arterioles (resistance vessels)
  • Pulmonary capillaries exclusively
  • Coronary sinus

Correct Answer: Peripheral arterioles (resistance vessels)

Q22. For an extended‑release tablet of felodipine, the time to peak plasma concentration is typically:

  • 5–10 minutes
  • 30–60 minutes
  • 2–5 hours
  • 24–48 hours

Correct Answer: 2–5 hours

Q23. How does felodipine typically affect AV nodal conduction compared with verapamil?

  • Felodipine markedly depresses AV nodal conduction more than verapamil
  • Felodipine has minimal direct effect on AV nodal conduction compared with verapamil
  • Both drugs are identical in AV nodal suppression
  • Felodipine causes complete AV block in therapeutic doses

Correct Answer: Felodipine has minimal direct effect on AV nodal conduction compared with verapamil

Q24. Beyond hypertension, felodipine can be used therapeutically for which condition?

  • Stable angina pectoris
  • Bacterial endocarditis prophylaxis
  • Acute ischemic stroke thrombolysis
  • Rheumatoid arthritis

Correct Answer: Stable angina pectoris

Q25. What is the primary pathophysiological mechanism for peripheral edema caused by felodipine?

  • Increased renal sodium retention via aldosterone stimulation
  • Precapillary arteriolar dilation increasing capillary hydrostatic pressure and fluid extravasation
  • Lymphatic obstruction due to drug deposition
  • Direct increase in plasma oncotic pressure

Correct Answer: Precapillary arteriolar dilation increasing capillary hydrostatic pressure and fluid extravasation

Q26. What key counseling point should be given to a patient starting felodipine ER tablets?

  • Take felodipine only on an empty stomach and skip doses with food
  • Take consistently with or without food and avoid grapefruit juice
  • Do not take with water
  • Stop immediately if you feel any reduction in blood pressure

Correct Answer: Take consistently with or without food and avoid grapefruit juice

Q27. Herbal supplement St. John’s wort is known to interact with felodipine by:

  • Inhibiting CYP3A4 and increasing felodipine levels
  • Inducing CYP3A4 and decreasing felodipine levels
  • Directly blocking L‑type calcium channels synergistically
  • Preventing renal excretion of felodipine

Correct Answer: Inducing CYP3A4 and decreasing felodipine levels

Q28. Relative to nifedipine, felodipine is characterized by:

  • A shorter duration of action requiring multiple daily dosing
  • Longer duration of action and smoother blood pressure control with ER formulations
  • Complete lack of vasodilatory effects
  • Primary use only in emergency intravenous settings

Correct Answer: Longer duration of action and smoother blood pressure control with ER formulations

Q29. At the molecular level, felodipine binds to which component of the calcium channel?

  • Beta subunit of the sodium channel
  • Alpha‑1 subunit of the L‑type calcium channel
  • Gamma subunit of the potassium channel
  • Sodium‑calcium exchanger on the mitochondria

Correct Answer: Alpha‑1 subunit of the L‑type calcium channel

Q30. Which clinical sign may indicate severe felodipine toxicity requiring urgent intervention?

  • Mild ankle swelling only
  • Severe hypotension with bradycardia requiring vasopressors
  • Isolated dry mouth without vital sign changes
  • Asymptomatic laboratory abnormality only

Correct Answer: Severe hypotension with bradycardia requiring vasopressors

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