Lovastatin MCQs With Answer

Lovastatin MCQs With Answer

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Lovastatin MCQs With Answer provides B. Pharm students a focused review of lovastatin’s pharmacology, mechanism, clinical uses, pharmacokinetics, adverse effects, monitoring and drug interactions. This set emphasizes key keywords such as lovastatin, HMG-CoA reductase inhibitor, prodrug, active hydroxy acid, CYP3A4 metabolism, lipid-lowering therapy, myopathy, rhabdomyolysis, hepatotoxicity, and therapeutic monitoring. Questions range from basic concepts to applied clinical scenarios, helping students master dosing rationale, formulation differences, food effects, and important contraindications. Designed to deepen understanding rather than surface facts, these MCQs support exam preparation and practical dispensing decisions. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. What is the primary mechanism of action of lovastatin?

  • Activation of lipoprotein lipase
  • Inhibition of HMG-CoA reductase
  • Activation of PPAR-alpha receptors
  • Inhibition of cholesterol absorption in intestine

Correct Answer: Inhibition of HMG-CoA reductase

Q2. Lovastatin is administered as which chemical form that is converted to the active metabolite in vivo?

  • Hydrophilic acid form
  • Lactone prodrug form
  • Sodium salt form
  • Decarboxylated active form

Correct Answer: Lactone prodrug form

Q3. Which cytochrome P450 enzyme primarily metabolizes lovastatin?

  • CYP2D6
  • CYP1A2
  • CYP3A4
  • CYP2C9

Correct Answer: CYP3A4

Q4. Which food effect is associated with lovastatin oral absorption?

  • Food decreases bioavailability significantly
  • Food has no effect on absorption
  • Food increases absorption and bioavailability
  • Only high-fat meals reduce absorption

Correct Answer: Food increases absorption and bioavailability

Q5. The principal lipid parameter reduced by lovastatin is:

  • Triglycerides primarily
  • High-density lipoprotein (HDL) cholesterol
  • Low-density lipoprotein (LDL) cholesterol
  • Very-low-density lipoprotein (VLDL) only

Correct Answer: Low-density lipoprotein (LDL) cholesterol

Q6. Which adverse effect is most strongly associated with lovastatin therapy?

  • Hypoglycemia
  • Myopathy and risk of rhabdomyolysis
  • Neutropenia
  • Ototoxicity

Correct Answer: Myopathy and risk of rhabdomyolysis

Q7. Which laboratory tests are routinely monitored in patients starting lovastatin?

  • Serum creatinine and electrolytes
  • Liver function tests and creatine kinase
  • Coagulation profile and platelet count
  • Thyroid function tests and fasting glucose

Correct Answer: Liver function tests and creatine kinase

Q8. Which drug interaction significantly increases risk of lovastatin toxicity?

  • Concurrent use of beta blockers
  • Concurrent use of strong CYP3A4 inhibitors like ketoconazole
  • Concurrent use of ACE inhibitors
  • Concurrent use of metformin

Correct Answer: Concurrent use of strong CYP3A4 inhibitors like ketoconazole

Q9. Lovastatin’s pleiotropic effects refer to:

  • Effects on blood glucose only
  • Multiple beneficial effects beyond LDL lowering such as improved endothelial function and anti-inflammatory actions
  • Adverse drug reactions unrelated to lipid-lowering
  • Effects limited to hepatic enzyme induction

Correct Answer: Multiple beneficial effects beyond LDL lowering such as improved endothelial function and anti-inflammatory actions

Q10. Which patient population is lovastatin contraindicated in?

  • Patients with controlled hypertension
  • Pregnant and lactating women
  • Patients with hyperthyroidism
  • Patients with type 2 diabetes mellitus

Correct Answer: Pregnant and lactating women

Q11. The conversion of lovastatin lactone to its active hydroxy acid occurs primarily in:

  • The gastrointestinal tract lumen only
  • Plasma and liver by esterases
  • Renal tubular cells
  • Lymphatic circulation

Correct Answer: Plasma and liver by esterases

Q12. Grapefruit juice increases lovastatin plasma levels by:

  • Inducing CYP3A4 activity in the intestine
  • Inhibiting intestinal CYP3A4, reducing first-pass metabolism
  • Enhancing renal clearance of lovastatin
  • Binding lovastatin in the gut and reducing absorption

Correct Answer: Inhibiting intestinal CYP3A4, reducing first-pass metabolism

Q13. Which statement about lovastatin’s distribution is correct?

  • It has negligible plasma protein binding
  • It is highly plasma protein bound and concentrated in the liver
  • It crosses the blood-brain barrier readily
  • It is primarily stored in adipose tissue long-term

Correct Answer: It is highly plasma protein bound and concentrated in the liver

Q14. A key counseling point when dispensing lovastatin is:

  • Take at bedtime or with evening meal to align with cholesterol synthesis peak
  • Always take on an empty stomach for best absorption
  • Avoid calcium-rich foods during dosing
  • Increase sunlight exposure while on therapy

Correct Answer: Take at bedtime or with evening meal to align with cholesterol synthesis peak

Q15. Which effect on hepatic enzymes may be seen with statin therapy including lovastatin?

  • Marked decrease in ALT and AST
  • Asymptomatic mild to moderate increase in ALT and AST
  • Immediate severe hepatic necrosis in all patients
  • No hepatic effects are possible

Correct Answer: Asymptomatic mild to moderate increase in ALT and AST

Q16. Which lipid fraction is most likely to increase modestly with lovastatin therapy?

  • HDL cholesterol
  • LDL cholesterol
  • Chylomicrons
  • Lp(a) markedly

Correct Answer: HDL cholesterol

Q17. Which pharmacokinetic property explains why lovastatin has significant first-pass hepatic metabolism?

  • Low hepatic uptake and slow clearance
  • High oral bioavailability exceeding 90%
  • Extensive metabolism by liver enzymes reducing systemic exposure
  • Complete renal excretion of unchanged drug

Correct Answer: Extensive metabolism by liver enzymes reducing systemic exposure

Q18. Which clinical use is an approved indication for lovastatin?

  • Primary hypercholesterolemia to reduce LDL and cardiovascular risk
  • Treatment of acute myocardial infarction pain
  • Immediate lowering of triglycerides in pancreatitis
  • Management of hypertension

Correct Answer: Primary hypercholesterolemia to reduce LDL and cardiovascular risk

Q19. Combining lovastatin with fibrates increases risk of:

  • Hyperkalemia
  • Myopathy and rhabdomyolysis
  • Hypoglycemia
  • Hyperthyroidism

Correct Answer: Myopathy and rhabdomyolysis

Q20. Which dose adjustment is generally required for lovastatin in patients with moderate renal impairment?

  • Major dose increase due to renal clearance
  • No specific adjustment usually required but monitor carefully
  • Immediate discontinuation in all renal impairment
  • Switch to intravenous formulation

Correct Answer: No specific adjustment usually required but monitor carefully

Q21. Which structural class does lovastatin belong to?

  • Bile acid sequestrant
  • HMG-CoA reductase inhibitor (statin), fungal-derived compound
  • Fibric acid derivative
  • Cholesterol absorption inhibitor

Correct Answer: HMG-CoA reductase inhibitor (statin), fungal-derived compound

Q22. The most appropriate monitoring frequency for liver enzymes after starting lovastatin is:

  • No monitoring ever needed
  • Baseline LFTs and as clinically indicated; periodic monitoring thereafter
  • Daily LFT testing for the first month
  • Only monitor if symptoms of myopathy occur

Correct Answer: Baseline LFTs and as clinically indicated; periodic monitoring thereafter

Q23. Which sign would most directly suggest statin-induced myopathy?

  • Asymptomatic elevation of blood glucose
  • Muscle pain with marked elevation of creatine kinase
  • New onset cough and dyspnea
  • Yellowing of the skin without enzyme changes

Correct Answer: Muscle pain with marked elevation of creatine kinase

Q24. Lovastatin’s elimination primarily involves:

  • Renal excretion of unchanged drug as main route
  • Metabolic degradation in liver and biliary excretion of metabolites
  • Exhalation as unmetabolized drug
  • Sequestration into bone matrix

Correct Answer: Metabolic degradation in liver and biliary excretion of metabolites

Q25. In comparing lovastatin to pravastatin, a distinguishing pharmacokinetic difference is:

  • Lovastatin is hydrophilic while pravastatin is highly lipophilic
  • Lovastatin is extensively metabolized by CYP3A4; pravastatin is less reliant on CYP metabolism
  • Pravastatin is a lactone prodrug like lovastatin
  • Both have identical metabolism and drug interaction profiles

Correct Answer: Lovastatin is extensively metabolized by CYP3A4; pravastatin is less reliant on CYP metabolism

Q26. Which is a common dosage form for lovastatin used in clinical practice?

  • Intravenous injection
  • Oral tablets/capsules
  • Transdermal patch
  • Inhalation powder

Correct Answer: Oral tablets/capsules

Q27. Which factor increases the risk of statin-associated muscle symptoms?

  • Young age and active lifestyle
  • Concomitant use of strong CYP3A4 inhibitors, high statin dose, and renal impairment
  • Concurrent vitamin D supplementation
  • Low dietary cholesterol intake only

Correct Answer: Concomitant use of strong CYP3A4 inhibitors, high statin dose, and renal impairment

Q28. Which therapeutic effect is expected within weeks of starting lovastatin?

  • Immediate plaque regression within 24 hours
  • Reduction in LDL cholesterol and modest triglyceride lowering
  • Rapid HDL reduction
  • Permanent cure of atherosclerosis

Correct Answer: Reduction in LDL cholesterol and modest triglyceride lowering

Q29. A pharmacist counseling a patient on lovastatin should recommend reporting which urgent symptom?

  • Mild headache that resolves in a day
  • Persistent unexplained muscle pain, weakness, or dark urine
  • Temporary mild bloating after meals
  • Intermittent sneezing

Correct Answer: Persistent unexplained muscle pain, weakness, or dark urine

Q30. Which statement about lovastatin dosing in clinical practice is true?

  • Higher doses guarantee proportionally greater safety
  • Start low and titrate dose based on lipid response and tolerance
  • Single fixed dose is effective for all patients regardless of baseline LDL
  • Dosing frequency must be every 4 hours for efficacy

Correct Answer: Start low and titrate dose based on lipid response and tolerance

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