Glutethimide MCQs With Answer

Glutethimide MCQs With Answer is a focused revision resource for B. Pharm students—covers pharmacology, mechanism of action, adverse effects, drug interactions, pharmacokinetics, dosing, dependence and toxicology. This concise, Student-friendly post highlights key topics such as GABAergic modulation, clinical uses and high abuse potential, management of overdose, and laboratory detection. Each question is designed to deepen understanding of pharmacodynamics, safety considerations, regulatory status and patient counselling relevant to pharmacy exams and clinical practice. Questions emphasize critical thinking, drug-drug interaction risks with opioids and alcohol, and practical monitoring parameters. Ideal for exam prep and clinical revision. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. What is the primary pharmacological classification of glutethimide?

• Non-barbiturate sedative-hypnotic
• Benzodiazepine
• Barbiturate
• Opioid analgesic

Correct Answer: Non-barbiturate sedative-hypnotic

Q2. The main mechanism of action of glutethimide involves modulation of which neurotransmitter system?

• Dopaminergic system
• GABAergic system
• Serotonergic system
• Cholinergic system

Correct Answer: GABAergic system

Q3. Historically, glutethimide was primarily indicated for which clinical condition?

• Severe chronic pain
• Short-term treatment of insomnia
• Hypertension
• Diabetes mellitus

Correct Answer: Short-term treatment of insomnia

Q4. Which major safety concern led to decreased clinical use of glutethimide?

• Renal toxicity at therapeutic doses
• High abuse, dependence potential and narrow therapeutic index
• Ineffectiveness compared with placebo
• Excessive anticholinergic effects

Correct Answer: High abuse, dependence potential and narrow therapeutic index

Q5. Which of the following is a prominent adverse effect of glutethimide overdose?

• Severe hyperglycemia
• Respiratory depression
• Profound hypertension
• Acute renal failure

Correct Answer: Respiratory depression

Q6. Which drug class produces additive CNS depression when co-administered with glutethimide?

• Beta-blockers
• CNS depressants such as alcohol and opioids
• Proton pump inhibitors
• Selective serotonin reuptake inhibitors

Correct Answer: CNS depressants such as alcohol and opioids

Q7. Glutethimide shows cross-tolerance with which group of sedative drugs?

• Benzodiazepines only
• Barbiturates and other central sedatives
• Opioids only
• Antipsychotics only

Correct Answer: Barbiturates and other central sedatives

Q8. Common withdrawal symptoms after chronic glutethimide use include:

• Weight gain and hyperphagia
• Anxiety, tremors and risk of seizures
• Persistent cough and bronchospasm
• Hypoactive reflexes only

Correct Answer: Anxiety, tremors and risk of seizures

Q9. In cases of acute glutethimide poisoning, the most appropriate immediate management is:

• Use of flumazenil as an antidote
• Supportive care including airway management and activated charcoal if indicated
• Forced diuresis with mannitol
• High-dose naloxone infusion

Correct Answer: Supportive care including airway management and activated charcoal if indicated

Q10. Which statement best describes the legal/regulatory status of glutethimide historically in many countries?

• Available OTC without restrictions
• Unregulated herbal supplement
• Controlled substance due to abuse potential
• Banned due to absolute toxicity at any dose

Correct Answer: Controlled substance due to abuse potential

Q11. The primary organ responsible for the metabolism of glutethimide is:

• Liver
• Kidney
• Lungs
• Skin

Correct Answer: Liver

Q12. The majority of glutethimide elimination occurs via:

• Fecal excretion of unchanged drug
• Renal excretion of metabolites
• Exhalation as unchanged vapor
• Secretion into saliva

Correct Answer: Renal excretion of metabolites

Q13. For patient monitoring after therapeutic dosing, which parameter is most critical?

• Blood glucose levels
• Respiratory rate and level of consciousness
• Serum potassium concentration
• Visual acuity

Correct Answer: Respiratory rate and level of consciousness

Q14. Which condition is a contraindication to prescribing glutethimide?

• Mild tension headache
• Severe respiratory insufficiency
• Seasonal allergic rhinitis
• Controlled hypothyroidism

Correct Answer: Severe respiratory insufficiency

Q15. How does glutethimide typically affect sleep architecture?

• Increases REM sleep and decreases total sleep time
• Reduces REM sleep and may alter normal sleep stages
• Has no effect on sleep stages
• Eliminates slow-wave sleep while increasing REM sleep

Correct Answer: Reduces REM sleep and may alter normal sleep stages

Q16. The common pharmaceutical formulation of glutethimide for therapeutic use was:

• Intravenous infusion only
• Oral tablets
• Topical cream
• Transdermal patch

Correct Answer: Oral tablets

Q17. The therapeutic index of glutethimide is best described as:

• Wide and very safe
• Narrow, requiring careful dosing
• Nonexistent since it is an essential nutrient
• High but ineffective for insomnia

Correct Answer: Narrow, requiring careful dosing

Q18. In elderly patients, glutethimide use is associated with increased risk of:

• Cardiac arrhythmias exclusively
• Falls, cognitive impairment and prolonged sedation
• Immunity enhancement
• Improved coordination

Correct Answer: Falls, cognitive impairment and prolonged sedation

Q19. Regarding pregnancy, glutethimide is generally recommended to be:

• Used as first-line therapy for insomnia
• Avoided due to potential fetal and neonatal risks
• Safe during all trimesters without restrictions
• Switched to higher doses during labor

Correct Answer: Avoided due to potential fetal and neonatal risks

Q20. Which of the following best describes a key clinical difference between glutethimide and benzodiazepines?

• Glutethimide has lower abuse potential than benzodiazepines
• Glutethimide carries a higher risk of severe respiratory depression and dependence
• Benzodiazepines cause more renal toxicity than glutethimide
• They are identical in mechanism and safety

Correct Answer: Glutethimide carries a higher risk of severe respiratory depression and dependence

Q21. A reliable laboratory method for detecting glutethimide or its metabolites in biological samples is:

• Urine analysis by gas chromatography–mass spectrometry (GC-MS)
• Visual inspection of urine color only
• Skin biopsy
• Pulse oximetry

Correct Answer: Urine analysis by gas chromatography–mass spectrometry (GC-MS)

Q22. Co-administration of glutethimide with opioids can lead to which clinical consequence?

• Reduced analgesic effect of opioids
• Potentiation of opioid-induced respiratory depression and sedation
• Complete antagonism of opioid receptors
• Enhanced renal clearance of opioids

Correct Answer: Potentiation of opioid-induced respiratory depression and sedation

Q23. Which monitoring is important when a patient is taking glutethimide long-term?

• Regular assessment for signs of tolerance, dependence and cognitive impairment
• Daily bone mineral density scans
• Frequent audiometry tests
• Monthly MRI scans

Correct Answer: Regular assessment for signs of tolerance, dependence and cognitive impairment

Q24. In toxicology, which sign is most indicative of severe central nervous system depression from glutethimide?

• Hyperreflexia and agitation
• Coma with depressed respiratory effort
• Isolated peripheral neuropathy
• Persistent hypertension

Correct Answer: Coma with depressed respiratory effort

Q25. Which counseling point is essential for patients prescribed glutethimide?

• It is safe to drive after a single dose
• Avoid alcohol and other CNS depressants while taking this medicine
• Double the dose if the first dose is missed
• Use with herbal sedatives increases wakefulness

Correct Answer: Avoid alcohol and other CNS depressants while taking this medicine

Q26. Which of the following best explains why glutethimide has high abuse potential?

• It causes marked stimulant effects and euphoria at low doses
• It produces sedative-hypnotic euphoria and tolerance leading to dependence
• It enhances appetite strongly
• It has strong hallucinogenic properties

Correct Answer: It produces sedative-hypnotic euphoria and tolerance leading to dependence

Q27. In formulation development, a pharmacist preparing oral tablets of sedatives must consider which property most critically?

• Melting point only
• Drug stability, controlled release and dose accuracy
• Color preference of the patient
• Magnetic susceptibility

Correct Answer: Drug stability, controlled release and dose accuracy

Q28. Which adverse effect is particularly relevant when combining glutethimide with MAO inhibitors?

• Severe hypoglycemia
• Potential for unpredictable and severe CNS depression and interaction risk
• Guaranteed therapeutic synergy without risk
• Marked diuresis

Correct Answer: Potential for unpredictable and severe CNS depression and interaction risk

Q29. During withdrawal management from glutethimide, which approach is generally recommended?

• Immediate abrupt cessation in all patients
• Gradual tapering and symptomatic/supportive care with medical supervision
• Doubling the dose intermittently
• No intervention as withdrawal does not occur

Correct Answer: Gradual tapering and symptomatic/supportive care with medical supervision

Q30. Which adverse cardiovascular effect may occur with overdose of central sedative agents like glutethimide?

• Severe bradycardia and hypotension
• Isolated peripheral vasodilation with hypertension
• Increased cardiac contractility and hypertension
• Only transient palpitations with no blood pressure change

Correct Answer: Severe bradycardia and hypotension

Q31. A pharmacist identifying potential abuse should look for which red flag in prescription patterns?

• Single short-term prescription from one prescriber
• Multiple early refill requests and prescriptions from multiple prescribers
• Refusal to accept discounted pricing
• Requests for extended-release formulations for pediatric use

Correct Answer: Multiple early refill requests and prescriptions from multiple prescribers

Q32. Which laboratory parameter is most directly useful to monitor organ clearance of glutethimide metabolites?

• Serum creatinine and renal function tests
• Serum amylase only
• Liver ultrasound weekly
• Hemoglobin electrophoresis

Correct Answer: Serum creatinine and renal function tests

Q33. Which term best describes the relationship between therapeutic dose and toxic dose for glutethimide?

• High therapeutic index
• Narrow margin of safety
• No toxicity at any dose
• Inverse therapeutic ratio

Correct Answer: Narrow margin of safety

Q34. Forensic detection of glutethimide in postmortem samples is important because:

• It confirms antibiotic resistance
• It helps establish cause of death due to CNS and respiratory depression
• It indicates vitamin deficiency
• It proves the presence of heavy metals

Correct Answer: It helps establish cause of death due to CNS and respiratory depression

Q35. Which of the following is an appropriate storage recommendation for sedative tablets like glutethimide?

• Store in a cool, dry place away from light and children
• Store in direct sunlight to increase potency
• Keep in the bathroom cabinet where humidity is high
• Freeze tablets to enhance shelf life

Correct Answer: Store in a cool, dry place away from light and children

Q36. What role does patient counselling about driving and machinery operation play when dispensing glutethimide?

• Not necessary; the drug increases alertness
• Essential, because it impairs cognition and psychomotor performance
• Only required for pediatric patients
• Only required when combined with stimulants

Correct Answer: Essential, because it impairs cognition and psychomotor performance

Q37. Which of the following pharmacological properties explains rapid onset of hypnotic action for some sedative-hypnotics?

• High lipid solubility leading to quick CNS penetration
• High water solubility preventing BBB crossing
• Binding only to plasma proteins without CNS effect
• Large molecular weight preventing absorption

Correct Answer: High lipid solubility leading to quick CNS penetration

Q38. In community pharmacy practice, scheduling and record-keeping for drugs like glutethimide are important primarily to:

• Improve drug taste and appearance
• Prevent misuse, diversion and detect patterns of abuse
• Increase sales volume
• Reduce the need for patient counselling

Correct Answer: Prevent misuse, diversion and detect patterns of abuse

Q39. Which clinical sign differentiates sedation due to glutethimide from opioid toxicity?

• Pinpoint pupils are more characteristic of opioid toxicity
• Respiratory depression occurs only with glutethimide
• Opioids never cause sedation
• Glutethimide causes severe muscle spasms not seen with opioids

Correct Answer: Pinpoint pupils are more characteristic of opioid toxicity

Q40. Which approach is recommended for reducing the abuse potential of sedative-hypnotics in clinical settings?

• Prescribe large quantities to reduce pharmacy visits
• Use the lowest effective dose for the shortest duration and monitor closely
• Never educate patients about risks
• Combine with alcohol to reduce craving

Correct Answer: Use the lowest effective dose for the shortest duration and monitor closely

Q41. Which metabolic consideration is important when prescribing sedatives to patients with liver impairment?

• No dose adjustment is ever needed
• Reduced hepatic metabolism may increase drug levels and toxicity risk
• Liver impairment accelerates drug clearance
• Hepatic function only affects topical drugs

Correct Answer: Reduced hepatic metabolism may increase drug levels and toxicity risk

Q42. Which symptom would most likely prompt immediate referral to emergency services for a patient taking glutethimide?

• Mild dry mouth
• Severe difficulty breathing and decreased responsiveness
• Transient mild headache
• Occasional yawning

Correct Answer: Severe difficulty breathing and decreased responsiveness

Q43. For analytical quality control in a formulation containing a sedative, which parameter is critical?

• Uniformity of dosage units and assay of active ingredient
• Color uniformity only
• Magnetic resonance imagery of tablets
• Patient satisfaction score

Correct Answer: Uniformity of dosage units and assay of active ingredient

Q44. Which public health measure helps reduce harm from prescription sedative abuse?

• Encouraging over-the-counter availability
• Prescription monitoring programs and clinician education
• Reducing warnings on labels
• Promoting nonmedical sharing of medications

Correct Answer: Prescription monitoring programs and clinician education

Q45. In patients with polypharmacy, why is pharmacist review essential when glutethimide is prescribed?

• To ensure the brand is preferred by marketing teams
• To identify and manage potential drug–drug interactions and duplicated CNS depressant therapy
• Pharmacist review is unnecessary
• To change the dosage form without prescriber knowledge

Correct Answer: To identify and manage potential drug–drug interactions and duplicated CNS depressant therapy

Q46. Which tolerance phenomenon is commonly seen with prolonged use of sedative-hypnotics like glutethimide?

• Decreased sedative effect requiring higher doses
• Increased sedation at the same dose over time
• Development of immunity to CNS infections
• Improved renal clearance with chronic use

Correct Answer: Decreased sedative effect requiring higher doses

Q47. Which of the following is a reasonable alternative approach to manage chronic insomnia to reduce reliance on drugs like glutethimide?

• Long-term high-dose sedative use without monitoring
• Cognitive behavioral therapy for insomnia (CBT-I) and sleep hygiene measures
• Abrupt cessation of all sleep aids without support
• Combination of multiple CNS depressants

Correct Answer: Cognitive behavioral therapy for insomnia (CBT-I) and sleep hygiene measures

Q48. Which sign in a patient under treatment should alert the pharmacist to possible development of dependence?

• Strict adherence to prescribed dose without requests
• Frequent requests for dose escalation or early refills
• Interest in nonpharmacologic sleep strategies
• Asking about storage instructions

Correct Answer: Frequent requests for dose escalation or early refills

Q49. Which pharmacovigilance activity is most relevant after withdrawal of a sedative from widespread use due to safety concerns?

• Stopping all reporting of adverse events
• Continued monitoring for legacy adverse events and misuse in archived supplies
• Encouraging off-label distribution
• Removing all safety communications

Correct Answer: Continued monitoring for legacy adverse events and misuse in archived supplies

Q50. For B. Pharm students preparing for exams, which study strategy will best help master topics like glutethimide?

• Rote memorization without understanding clinical context
• Integrating pharmacology, toxicology, clinical cases and MCQ practice with answers
• Only reading headline summaries without practice questions
• Ignoring drug interactions and safety profiles

Correct Answer: Integrating pharmacology, toxicology, clinical cases and MCQ practice with answers

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