Flurobuterophenones – Droperidol MCQs With Answer

Flurobuterophenones – Droperidol MCQs With Answer

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Flurobuterophenones – Droperidol MCQs With Answer

Flurobuterophenones (commonly written as fluorobutyrophenones) include droperidol, a butyrophenone-class antipsychotic and antiemetic widely covered in B.Pharm curricula. This introduction reviews key points: chemical class, structure–activity relationships, D2 receptor antagonism, antiemetic and sedative uses, pharmacokinetics (rapid IV onset, hepatic metabolism, short half‑life), major adverse effects (extrapyramidal symptoms, QT prolongation, hypotension), drug interactions, and monitoring. Understanding these concepts helps in formulation, dosing, safety screening, and therapeutic decision-making. Keywords: Flurobuterophenones, droperidol, butyrophenone, D2 antagonism, pharmacokinetics, adverse effects, QT prolongation, B.Pharm. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. What chemical class does droperidol belong to?

  • Phenothiazines
  • Butyrophenones
  • Benzodiazepines
  • Barbiturates

Correct Answer: Butyrophenones

Q2. The term “Flurobuterophenones” in the context of droperidol most closely refers to:

  • A specific manufacturing impurity
  • A class of molecules with a butyrophenone core and halogen substituents
  • An unrelated opioid subclass
  • A brand name formulation

Correct Answer: A class of molecules with a butyrophenone core and halogen substituents

Q3. The primary pharmacological mechanism of droperidol is:

  • GABA-A receptor agonism
  • Norepinephrine reuptake inhibition
  • Dopamine D2 receptor antagonism
  • Serotonin 5-HT3 receptor agonism

Correct Answer: Dopamine D2 receptor antagonism

Q4. Which clinical use is droperidol most commonly associated with in perioperative care?

  • Preoperative anxiolysis via oral route
  • Prophylaxis of postoperative nausea and vomiting (PONV)
  • Long-term maintenance therapy for schizophrenia
  • Chronic pain management

Correct Answer: Prophylaxis of postoperative nausea and vomiting (PONV)

Q5. A key safety concern that led to regulatory warnings for droperidol is:

  • Renal toxicity with single doses
  • Severe hyperglycemia
  • QT interval prolongation and risk of torsades de pointes
  • High risk of drug dependence

Correct Answer: QT interval prolongation and risk of torsades de pointes

Q6. Typical intravenous antiemetic dosing of droperidol for PONV in adults is closest to:

  • 0.01–0.05 mg
  • 0.625–1.25 mg
  • 10–20 mg
  • 50–100 mg

Correct Answer: 0.625–1.25 mg

Q7. Which organ system is primarily responsible for the metabolism of droperidol?

  • Kidneys
  • Lungs
  • Liver
  • Skin

Correct Answer: Liver

Q8. Which adverse effect is characteristic of D2 receptor blockade and can occur with droperidol?

  • Bronchospasm
  • Extrapyramidal symptoms (EPS)
  • Hyperkalemia
  • Neutropenia

Correct Answer: Extrapyramidal symptoms (EPS)

Q9. Droperidol’s onset of action after intravenous administration is typically:

  • Several hours
  • Within minutes
  • 24–48 hours
  • Unpredictable and very delayed

Correct Answer: Within minutes

Q10. Which monitoring is recommended when giving droperidol IV in patients at risk for QT prolongation?

  • Blood glucose monitoring only
  • No monitoring required
  • Electrocardiogram (ECG) monitoring
  • Pulmonary function testing

Correct Answer: Electrocardiogram (ECG) monitoring

Q11. An important drug interaction with droperidol that increases QT risk is co-administration with:

  • Aspirin
  • Other QT-prolonging agents such as certain antiarrhythmics or macrolides
  • Insulin
  • Topical corticosteroids

Correct Answer: Other QT-prolonging agents such as certain antiarrhythmics or macrolides

Q12. Which patient population should be treated with caution or avoided for droperidol due to sensitivity to dopamine blockade?

  • Patients with Parkinson’s disease
  • Patients with hypothyroidism
  • Patients with hyperlipidemia
  • Patients with asthma

Correct Answer: Patients with Parkinson’s disease

Q13. The term structure–activity relationship (SAR) for flurobuterophenones typically studies:

  • How chemical substitutions affect color
  • How substitutions on the butyrophenone core affect pharmacologic potency and selectivity
  • Only the melting point of the compound
  • How to manufacture tablets cheaply

Correct Answer: How substitutions on the butyrophenone core affect pharmacologic potency and selectivity

Q14. Which adverse drug reaction is a rare but life‑threatening complication of antipsychotics including droperidol?

  • Neuroleptic malignant syndrome (NMS)
  • Acute appendicitis
  • Myocardial infarction within minutes of dosing
  • Immediate anaphylactic shock in all patients

Correct Answer: Neuroleptic malignant syndrome (NMS)

Q15. Droperidol’s elimination half‑life is best described as:

  • Extremely long (>72 hours)
  • Very short (minutes only)
  • Short to moderate (around 2–4 hours)
  • Indefinite and accumulative

Correct Answer: Short to moderate (around 2–4 hours)

Q16. A structural feature often present in fluorobutyrophenones that increases lipophilicity and potency is:

  • A large carbohydrate side chain
  • A para-halogen (e.g., fluorine) substitution on an aromatic ring
  • An attached peptide sequence
  • A charged quaternary ammonium group

Correct Answer: A para-halogen (e.g., fluorine) substitution on an aromatic ring

Q17. Which formulation routes are commonly available for droperidol in clinical practice?

  • Oral tablets only
  • Intravenous and intramuscular injections
  • Topical cream
  • Transdermal patch

Correct Answer: Intravenous and intramuscular injections

Q18. In patients with hepatic impairment, droperidol dosing should be:

  • Unchanged since it’s renally cleared only
  • Used with caution and dose adjustment may be necessary
  • Increased to overcome decreased clearance
  • Given as a continuous high-dose infusion

Correct Answer: Used with caution and dose adjustment may be necessary

Q19. Which receptor blockade besides D2 is responsible for droperidol-associated hypotension?

  • Beta-2 adrenergic agonism
  • Alpha-1 adrenergic blockade
  • Muscarinic M3 activation
  • Glycine receptor antagonism

Correct Answer: Alpha-1 adrenergic blockade

Q20. For B.Pharm students studying droperidol, which analytical method is commonly used to quantify plasma concentrations in pharmacokinetic studies?

  • UV-visible spectroscopy without extraction
  • High-performance liquid chromatography (HPLC) with appropriate detection
  • Simple pH paper test
  • Gram staining

Correct Answer: High-performance liquid chromatography (HPLC) with appropriate detection

Q21. Which side effect may be managed acutely using anticholinergic agents like benztropine when caused by droperidol?

  • Tardive dyskinesia
  • Acute dystonic reactions
  • QT prolongation
  • Hypotension unresponsive to fluids

Correct Answer: Acute dystonic reactions

Q22. Which patient history element increases the risk of droperidol-induced torsades de pointes?

  • History of peptic ulcer disease
  • Family history of long QT syndrome
  • Prior cholecystectomy
  • Seasonal allergies

Correct Answer: Family history of long QT syndrome

Q23. In the context of drug development, modifying butyrophenone scaffolds with electron-withdrawing groups like fluorine generally:

  • Decreases central nervous system penetration
  • Increases lipophilicity and often enhances CNS potency
  • Eliminates pharmacologic activity entirely
  • Converts the drug into a peptide

Correct Answer: Increases lipophilicity and often enhances CNS potency

Q24. Which laboratory parameter is most directly relevant to assess a patient at risk before administering droperidol?

  • Liver function tests and baseline ECG
  • Serum amylase only
  • Fasting lipid profile
  • Serum magnesium only if symptomatic

Correct Answer: Liver function tests and baseline ECG

Q25. Droperidol can antagonize which antiemetic receptor to reduce nausea?

  • Histamine H1 receptor
  • Serotonin 5-HT3 receptor
  • Dopamine D2 receptor in the chemoreceptor trigger zone
  • Opioid mu receptor

Correct Answer: Dopamine D2 receptor in the chemoreceptor trigger zone

Q26. The phenomenon of tardive dyskinesia associated with chronic dopamine blockade is characterized by:

  • Acute bronchospasm
  • Irreversible involuntary, repetitive movements often of the face and tongue
  • Rapid improvement after single dose
  • Severe hypotension only

Correct Answer: Irreversible involuntary, repetitive movements often of the face and tongue

Q27. A pharmacokinetic property that influences droperidol’s quick clinical effect after IV dosing is:

  • High plasma protein binding prevents CNS access
  • Rapid distribution to brain due to lipophilicity
  • Delayed absorption from the stomach
  • Extensive renal reabsorption

Correct Answer: Rapid distribution to brain due to lipophilicity

Q28. Which of the following is an appropriate immediate management step for suspected droperidol-induced torsades de pointes?

  • Administer IV magnesium sulfate and cardioversion if unstable
  • Give oral antiemetic immediately
  • Start long-term beta blocker therapy
  • Administer high-dose insulin

Correct Answer: Administer IV magnesium sulfate and cardioversion if unstable

Q29. Which statement about droperidol and pregnancy is most appropriate for B.Pharm counselling?

  • Droperidol is absolutely safe in all trimesters
  • Use in pregnancy requires risk–benefit assessment and avoidance if unnecessary
  • It is a recommended routine therapy for morning sickness
  • Droperidol is an essential vitamin supplement

Correct Answer: Use in pregnancy requires risk–benefit assessment and avoidance if unnecessary

Q30. The term “butyrophenone” refers to which aspect of the molecule?

  • Presence of a benzodiazepine ring
  • A phenyl ring attached to a butanone (butyro) backbone
  • A sugar moiety
  • An esterified fatty acid

Correct Answer: A phenyl ring attached to a butanone (butyro) backbone

Q31. When combining droperidol with opioids during anesthesia, pharmacists should be aware that:

  • The combination always eliminates QT risk
  • Combined CNS depressant effects may increase sedation and respiratory depression
  • Opioids neutralize droperidol’s antiemetic action
  • There are no interactions of clinical relevance

Correct Answer: Combined CNS depressant effects may increase sedation and respiratory depression

Q32. Which adverse effect is more likely with higher doses of droperidol used for sedation compared with low antiemetic doses?

  • Increased extrapyramidal symptoms and hypotension
  • Improved renal function
  • Reduced sedation
  • Immediate hair growth

Correct Answer: Increased extrapyramidal symptoms and hypotension

Q33. In drug stability and compounding for parenteral use, droperidol solutions should be stored how?

  • Exposed to direct sunlight at room temperature
  • According to manufacturer guidance, typically protected from light and refrigerated if required
  • Frozen and thawed repeatedly
  • Mixed with alkaline solutions to increase potency

Correct Answer: According to manufacturer guidance, typically protected from light and refrigerated if required

Q34. Which pharmacodynamic effect explains droperidol’s antiemetic action in the chemoreceptor trigger zone (CTZ)?

  • 5-HT3 receptor activation in the GI tract
  • D2 receptor blockade in the CTZ
  • NMDA receptor agonism
  • Activation of histamine H2 receptors

Correct Answer: D2 receptor blockade in the CTZ

Q35. Which regulatory action affected droperidol’s use in some countries due to cardiac safety concerns?

  • Complete over-the-counter availability
  • Black box warnings or restricted use recommendations related to QT prolongation
  • Mandatory co-prescription with benzodiazepines
  • Ban on intravenous formulations only

Correct Answer: Black box warnings or restricted use recommendations related to QT prolongation

Q36. Droperidol’s effect on prolactin levels is an example of which pharmacological consequence?

  • Decreased insulin release
  • Dopamine blockade leading to hyperprolactinemia
  • Increased thyroid hormone activation
  • Direct adrenal stimulation

Correct Answer: Dopamine blockade leading to hyperprolactinemia

Q37. For forensic or analytical purposes, which sample matrix is commonly used to detect droperidol post-administration?

  • Hair samples only
  • Plasma or urine samples
  • Nail clippings exclusively
  • Saliva cannot be used

Correct Answer: Plasma or urine samples

Q38. Which descriptor best characterizes droperidol’s receptor binding profile relevant to its clinical effects?

  • Selective serotonin reuptake inhibition
  • Predominant D2 antagonism with some alpha-adrenergic blockade
  • Full opioid receptor agonist
  • Pure muscarinic agonist

Correct Answer: Predominant D2 antagonism with some alpha-adrenergic blockade

Q39. If a patient develops acute dystonia after droperidol, the fastest symptomatic treatment is:

  • Oral NSAIDs
  • Intravenous or intramuscular anticholinergic like benztropine or diphenhydramine
  • High-dose oral vitamin C
  • Topical anesthetic

Correct Answer: Intravenous or intramuscular anticholinergic like benztropine or diphenhydramine

Q40. Which characteristic of droperidol contributes to its use as a short‑acting perioperative agent?

  • Extremely long tissue retention
  • Rapid onset and relatively short duration of action
  • Permanent receptor binding
  • Lack of central nervous system penetration

Correct Answer: Rapid onset and relatively short duration of action

Q41. Which symptom is most indicative of anticholinergic toxicity rather than droperidol-induced EPS?

  • Severe facial grimacing and tongue protrusion
  • Dry mouth, blurred vision, urinary retention, and hyperthermia
  • Prominent bradykinesia only
  • Profound hypotension without other signs

Correct Answer: Dry mouth, blurred vision, urinary retention, and hyperthermia

Q42. In structure–activity relationship (SAR) studies of butyrophenones, removing a bulky lipophilic substituent typically:

  • Increases CNS potency dramatically
  • May reduce blood–brain barrier penetration and decrease potency
  • Converts molecule into an antibiotic
  • Has no effect on pharmacology

Correct Answer: May reduce blood–brain barrier penetration and decrease potency

Q43. Which feature distinguishes droperidol from typical benzodiazepines in clinical use?

  • Droperidol is primarily an antipsychotic/antiemetic with dopamine antagonism; benzodiazepines act via GABA-A facilitation
  • Droperidol is a GABA-A agonist while benzodiazepines antagonize dopamine
  • Both drug classes are chemically identical
  • Benzodiazepines cause QT prolongation, droperidol does not

Correct Answer: Droperidol is primarily an antipsychotic/antiemetic with dopamine antagonism; benzodiazepines act via GABA-A facilitation

Q44. When teaching formulation considerations, B.Pharm students should note that droperidol parenteral products must be free from:

  • Pyrogens and particulate matter
  • Any sodium content
  • All preservatives
  • Lipophilic solvents always present

Correct Answer: Pyrogens and particulate matter

Q45. Which clinical sign would most likely prompt discontinuation of droperidol and urgent evaluation?

  • Mild dry mouth after a single dose
  • Onset of syncope, palpitations, or documented polymorphic ventricular tachycardia
  • Transient mild sedation
  • Temporary mild nausea

Correct Answer: Onset of syncope, palpitations, or documented polymorphic ventricular tachycardia

Q46. For pharmacology exams, a reliable mnemonic to remember droperidol’s main effects would emphasize:

  • Anticholinergic, insulinotropic, prokinetic
  • Dopamine D2 blockade (antiemetic/antipsychotic), alpha-1 blockade (hypotension), QT risk
  • Pure opioid-like analgesia only
  • Direct antiviral activity

Correct Answer: Dopamine D2 blockade (antiemetic/antipsychotic), alpha-1 blockade (hypotension), QT risk

Q47. Which clinical scenario is a relative contraindication to droperidol use?

  • Well-controlled hypertension on a single ACE inhibitor
  • History of prolonged QT interval or torsades de pointes
  • Seasonal allergic rhinitis
  • Noncomplicated controlled diabetes mellitus

Correct Answer: History of prolonged QT interval or torsades de pointes

Q48. In overdose, droperidol toxicity management focuses on:

  • Supportive care, airway/ventilation, managing hypotension, treating arrhythmias
  • Immediate gastric lavage only without supportive care
  • Administering oral activated charcoal after 48 hours
  • Rapid infusion of glucose and potassium only

Correct Answer: Supportive care, airway/ventilation, managing hypotension, treating arrhythmias

Q49. From a medicinal chemistry perspective, introducing a fluorine atom into butyrophenones often affects:

  • Stability, lipophilicity, and sometimes receptor binding affinity
  • Color of the compound only
  • The ability to form ionic salts exclusively
  • Conversion into a peptide bond

Correct Answer: Stability, lipophilicity, and sometimes receptor binding affinity

Q50. For B.Pharm students preparing for exams, the most important practical counseling point for droperidol used perioperatively is:

  • It causes instant immune tolerance
  • Inform about potential sedation, blood pressure effects, and rare cardiac arrhythmia risk; monitor appropriately
  • Recommend it for routine outpatient use without monitoring
  • Advise patients it will permanently cure motion sickness

Correct Answer: Inform about potential sedation, blood pressure effects, and rare cardiac arrhythmia risk; monitor appropriately

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