Glimepiride MCQs With Answer

Glimepiride MCQs With Answer

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Glimepiride MCQs With Answer is a targeted revision resource for B. Pharm students focusing on glimepiride pharmacology, mechanism of action, pharmacokinetics, dosing principles, adverse effects, contraindications, and drug interactions. This set emphasizes sulfonylurea class features, ATP‑sensitive K+ channel binding, hepatic metabolism (CYP2C9), renal considerations, hypoglycaemia risk, monitoring (blood glucose, HbA1c), and counselling points. Questions are clinically oriented to deepen understanding of therapeutic use, dose adjustment, management of overdose, and safe prescribing. Use these MCQs to reinforce pathway‑level knowledge and exam preparedness. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. What is the primary molecular mechanism by which glimepiride lowers blood glucose?

  • Inhibition of alpha‑glucosidase in the intestinal brush border
  • Activation of PPAR‑gamma leading to increased insulin sensitivity
  • Closure of pancreatic beta‑cell ATP‑sensitive K+ channels leading to insulin release
  • Suppression of hepatic gluconeogenesis via AMPK activation

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

Q2. To which generation of sulfonylureas does glimepiride belong?

  • First generation sulfonylurea
  • Second generation sulfonylurea
  • Third generation sulfonylurea
  • Meglitinide class

Correct Answer: Second generation sulfonylurea

Q3. What is the primary clinical indication for glimepiride?

  • Type 1 diabetes mellitus
  • Type 2 diabetes mellitus as an oral hypoglycaemic agent
  • Diabetic ketoacidosis emergency therapy
  • Gestational diabetes first‑line therapy

Correct Answer: Type 2 diabetes mellitus as an oral hypoglycaemic agent

Q4. Which cytochrome enzyme is mainly responsible for hepatic metabolism of glimepiride?

  • CYP3A4
  • CYP2D6
  • CYP2C9
  • CYP1A2

Correct Answer: CYP2C9

Q5. What is the major clinical concern when prescribing glimepiride to patients with renal impairment?

  • Excessive hepatic accumulation leading to jaundice
  • Increased risk of prolonged hypoglycaemia due to reduced excretion of metabolites
  • Complete lack of efficacy due to decreased absorption
  • Induction of nephrotoxicity directly causing renal failure

Correct Answer: Increased risk of prolonged hypoglycaemia due to reduced excretion of metabolites

Q6. Compared to glyburide (glibenclamide), glimepiride generally has which advantage?

  • Higher risk of severe hypoglycaemia
  • Lower potency at equivalent milligram doses
  • Lower incidence of prolonged hypoglycaemia
  • Stronger inhibition of hepatic gluconeogenesis

Correct Answer: Lower incidence of prolonged hypoglycaemia

Q7. When is the recommended time to administer glimepiride to reduce hypoglycaemia risk?

  • At bedtime on an empty stomach
  • With the first main meal of the day (breakfast)
  • Only when blood glucose measured is >200 mg/dL
  • Immediately before strenuous exercise

Correct Answer: With the first main meal of the day (breakfast)

Q8. What is the most important adverse effect students must counsel patients about when taking glimepiride?

  • Hypoglycaemia
  • Neutropenia
  • Ototoxicity
  • Hypercalcaemia

Correct Answer: Hypoglycaemia

Q9. In which condition is glimepiride absolutely contraindicated?

  • Type 2 diabetes with insulin resistance
  • Type 1 diabetes mellitus
  • Mild hepatic dysfunction
  • Stable chronic kidney disease stage 2

Correct Answer: Type 1 diabetes mellitus

Q10. Which co‑administered drug is most likely to increase glimepiride plasma concentration and risk of hypoglycaemia?

  • Rifampicin
  • Phenobarbital
  • Fluconazole
  • St. John’s wort

Correct Answer: Fluconazole

Q11. What is the approximate elimination half‑life of glimepiride after oral dosing?

  • 30 minutes
  • 5–8 hours
  • 24–48 hours
  • 72 hours

Correct Answer: 5–8 hours

Q12. How soon after oral administration does glimepiride typically begin to lower blood glucose (onset of action)?

  • Within 5 minutes
  • Approximately 1 hour
  • After 48 hours
  • Only after several weeks of therapy

Correct Answer: Approximately 1 hour

Q13. Which statement about protein binding of glimepiride is correct?

  • Negligible protein binding (<10%)
  • Moderate protein binding (~50%)
  • High protein binding (>99%)
  • Protein binding is variable and unpredictable

Correct Answer: High protein binding (>99%)

Q14. The major hepatic metabolite of glimepiride has what pharmacological activity?

  • Highly potent hypoglycaemic activity exceeding parent drug
  • Clinically insignificant or minimal glucose‑lowering activity
  • Strong antagonistic activity causing hyperglycaemia
  • Potent ACE inhibitory activity

Correct Answer: Clinically insignificant or minimal glucose‑lowering activity

Q15. What is a typical starting daily dose of glimepiride for an adult with newly diagnosed type 2 diabetes?

  • 0.1 mg once daily
  • 1 mg once daily
  • 20 mg once daily
  • 50 mg once daily

Correct Answer: 1 mg once daily

Q16. For women who are pregnant or planning pregnancy, what is the preferred glucose‑lowering therapy instead of glimepiride?

  • Continue glimepiride throughout pregnancy
  • Metformin as the sole agent in all cases
  • Insulin therapy
  • Sitagliptin as first‑line in pregnancy

Correct Answer: Insulin therapy

Q17. Glimepiride binds to which subunit of the pancreatic beta‑cell KATP channel?

  • Kir6.2 pore subunit only
  • SUR1 regulatory subunit
  • Voltage‑gated calcium channel alpha subunit
  • GLUT2 transporter

Correct Answer: SUR1 regulatory subunit

Q18. Compared with metformin, which clinical effect is more commonly associated with glimepiride?

  • Weight neutrality or loss
  • Reduction in insulin secretion
  • Weight gain due to increased insulin levels
  • Primary improvement in insulin sensitivity

Correct Answer: Weight gain due to increased insulin levels

Q19. Which laboratory parameter best reflects long‑term glycaemic control to monitor glimepiride efficacy?

  • Fasting plasma insulin
  • Random blood glucose
  • Glycated haemoglobin (HbA1c)
  • Serum C‑peptide

Correct Answer: Glycated haemoglobin (HbA1c)

Q20. In sulfonylurea overdose with recurrent hypoglycaemia, which adjunctive drug can be used to prevent recurrent episodes?

  • Octreotide
  • Metformin
  • Acetylcysteine
  • Allopurinol

Correct Answer: Octreotide

Q21. Glimepiride chemical structure is characterized by which functional group central to its class?

  • Sulfonylurea moiety
  • Beta‑lactam ring
  • Biguanide group
  • Thiazolidinedione ring

Correct Answer: Sulfonylurea moiety

Q22. Which statement correctly contrasts second‑generation sulfonylureas like glimepiride with first‑generation agents?

  • Second‑generation agents are less potent and require larger doses
  • Second‑generation agents have greater potency and improved safety profile
  • First‑generation agents have no risk of hypoglycaemia
  • There is no pharmacologic or clinical difference between generations

Correct Answer: Second‑generation agents have greater potency and improved safety profile

Q23. Sulfonylureas including glimepiride lower blood glucose primarily by which glucose‑dependency characteristic?

  • They only stimulate insulin release when glucose is high (strictly glucose‑dependent)
  • They stimulate insulin release by direct KATP closure and can cause hypoglycaemia even at low glucose
  • They increase renal glucose excretion via SGLT2 inhibition
  • They act solely by increasing peripheral insulin sensitivity

Correct Answer: They stimulate insulin release by direct KATP closure and can cause hypoglycaemia even at low glucose

Q24. Which organ impairment requires cautious use or dose adjustment of glimepiride due to altered metabolism and risk?

  • Hepatic impairment
  • Isolated ear infection
  • Uncomplicated hypertension
  • Mild seasonal allergies

Correct Answer: Hepatic impairment

Q25. Common tablet strengths available for glimepiride are which of the following?

  • 1 mg, 2 mg, and 4 mg
  • 0.01 mg, 0.05 mg, 0.1 mg
  • 10 mg, 20 mg, 50 mg
  • 100 mg only

Correct Answer: 1 mg, 2 mg, and 4 mg

Q26. The pathophysiological basis of hypoglycaemia caused by glimepiride is primarily due to:

  • Enhanced renal excretion of glucose
  • Excessive insulin secretion from pancreatic beta cells
  • Direct stimulation of hepatic glucose production
  • Impaired intestinal absorption of glucose

Correct Answer: Excessive insulin secretion from pancreatic beta cells

Q27. Co‑administration of rifampicin with glimepiride is expected to have what effect?

  • Increase glimepiride plasma levels and risk of hypoglycaemia
  • Decrease glimepiride plasma concentration and reduce hypoglycaemic effect
  • No pharmacokinetic interaction
  • Convert glimepiride into an inactive toxin

Correct Answer: Decrease glimepiride plasma concentration and reduce hypoglycaemic effect

Q28. Which target HbA1c is commonly used as a general treatment goal when assessing efficacy of glimepiride therapy in many adults?

  • HbA1c <4.0%
  • HbA1c <7.0%
  • HbA1c >10.0%
  • HbA1c exactly 8.5%

Correct Answer: HbA1c <7.0%

Q29. In patients with end‑stage renal disease on dialysis, how should glimepiride be managed?

  • No adjustment; continue usual dose
  • Prefer alternative therapy (insulin) or use with extreme caution and frequent monitoring
  • Double the dose to overcome reduced efficacy
  • Switch to first‑generation sulfonylurea

Correct Answer: Prefer alternative therapy (insulin) or use with extreme caution and frequent monitoring

Q30. Which symptoms should patients be counselled to recognise as early signs of hypoglycaemia from glimepiride?

  • Tremor, sweating, palpitations, confusion
  • Joint pain, rash, blurred vision
  • Hearing loss, constipation, hair growth
  • Weight loss, dry skin, fever

Correct Answer: Tremor, sweating, palpitations, confusion

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