Nicardipine MCQs With Answer

Nicardipine MCQs With Answer

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Nicardipine MCQs With Answer is a focused review designed for B.Pharm students to master nicardipine pharmacology, clinical uses, dosing, adverse effects, interactions, and monitoring. This collection emphasizes key learning points: nicardipine as a dihydropyridine calcium channel blocker, its vascular selectivity, intravenous infusion use in hypertensive emergencies, oral sustained‑release formulations, hepatic metabolism (CYP3A4), and common adverse effects such as headache, flushing, and peripheral edema. Questions probe mechanism of action, pharmacokinetics, contraindications, clinical decision‑making, and safe medication handling. The set balances recall and application to build exam readiness and clinical reasoning. Now let’s test your knowledge with 30 MCQs on this topic.

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

  • Blockade of beta-1 adrenergic receptors in the heart
  • Inhibition of angiotensin-converting enzyme
  • Blocking L-type calcium channels in vascular smooth muscle
  • Activation of nitric oxide synthase

Correct Answer: Blocking L-type calcium channels in vascular smooth muscle

Q2. To which class of calcium channel blockers does nicardipine belong?

  • Phenylalkylamines
  • Benzothiazepines
  • Dihydropyridines
  • Non-selective calcium channel blockers

Correct Answer: Dihydropyridines

Q3. Which clinical situation is nicardipine IV infusion commonly used for?

  • Long-term chronic stable angina only
  • Hypertensive emergency requiring controlled BP lowering
  • As first-line therapy for bradycardia
  • Routine treatment of hypotension

Correct Answer: Hypertensive emergency requiring controlled BP lowering

Q4. Nicardipine has greater selectivity for which vascular beds compared to some other CCBs?

  • Systemic veins only
  • Renal medullary vasa recta exclusively
  • Coronary and cerebral arteries
  • Pulmonary alveolar capillaries

Correct Answer: Coronary and cerebral arteries

Q5. Which pharmacokinetic property of nicardipine is important when considering drug interactions?

  • Excretion unchanged in urine
  • Metabolism primarily via CYP3A4
  • Not protein bound
  • Eliminated by glomerular filtration only

Correct Answer: Metabolism primarily via CYP3A4

Q6. A common adverse effect of nicardipine related to vasodilation is:

  • Constipation
  • Peripheral edema
  • Hyperkalemia
  • Bronchospasm

Correct Answer: Peripheral edema

Q7. Which monitoring is essential during IV nicardipine infusion?

  • Serum potassium every hour
  • Continuous blood pressure and heart rate monitoring
  • Daily liver function tests only
  • Pulse oximetry alone without BP

Correct Answer: Continuous blood pressure and heart rate monitoring

Q8. Which statement about nicardipine’s effect on cardiac contractility is most accurate?

  • It causes profound negative inotropy in all patients
  • It has minimal negative inotropic effect compared with non-dihydropyridines
  • It increases myocardial contractility directly
  • It blocks beta receptors to increase contractility

Correct Answer: It has minimal negative inotropic effect compared with non-dihydropyridines

Q9. Which drug interaction increases nicardipine plasma concentration?

  • Rifampin
  • Carbamazepine
  • Ketoconazole
  • St. John’s wort

Correct Answer: Ketoconazole

Q10. In patients with severe hepatic impairment, nicardipine dosing should be:

  • Unchanged because it is renally cleared
  • Adjusted because nicardipine is extensively metabolized in the liver
  • Stopped because it is excreted unchanged in bile
  • Increased due to decreased protein binding

Correct Answer: Adjusted because nicardipine is extensively metabolized in the liver

Q11. Which formulation of nicardipine is appropriate for outpatient long-term blood pressure control?

  • Intravenous continuous infusion
  • Oral immediate-release tablets dosed hourly
  • Oral controlled‑release capsules
  • Topical transdermal patch only

Correct Answer: Oral controlled‑release capsules

Q12. Combining nicardipine with which class may blunt reflex tachycardia but requires monitoring for bradycardia?

  • Loop diuretics
  • Beta-adrenergic blockers
  • ACE inhibitors
  • Thiazide diuretics

Correct Answer: Beta-adrenergic blockers

Q13. Which contraindication is most relevant when considering nicardipine therapy?

  • Hypertension with no symptoms
  • Severe hypotension or cardiogenic shock
  • Mild allergic rhinitis
  • Controlled type 2 diabetes

Correct Answer: Severe hypotension or cardiogenic shock

Q14. A pharmacist counseling a patient on oral nicardipine should mention which common side effect?

  • Dry cough
  • Gingival hyperplasia and flushing
  • Insomnia and tremor
  • Weight gain of >10 kg per week

Correct Answer: Gingival hyperplasia and flushing

Q15. Which parameter is NOT a primary target when titrating nicardipine infusion in hypertensive emergency?

  • Rate of blood pressure reduction
  • Absolute blood pressure numeric goal
  • Heart rate trend and ischemic symptoms
  • Serum creatinine every 5 minutes

Correct Answer: Serum creatinine every 5 minutes

Q16. Why is gradual blood pressure reduction recommended when using nicardipine in acute stroke?

  • To prevent reflex hypertension
  • To avoid worsening cerebral perfusion by rapid BP drop
  • Because nicardipine is ineffective in stroke
  • To increase intracranial pressure rapidly

Correct Answer: To avoid worsening cerebral perfusion by rapid BP drop

Q17. Which laboratory change can occur with nicardipine therapy and should be monitored in prolonged infusion?

  • Marked hypoglycemia
  • Elevation in liver enzymes in susceptible patients
  • Severe hypernatremia
  • Rapid fall in hemoglobin

Correct Answer: Elevation in liver enzymes in susceptible patients

Q18. Nicardipine’s onset of action after IV administration is typically:

  • Immediate within seconds
  • Within minutes
  • After 48 hours
  • Only after oral absorption

Correct Answer: Within minutes

Q19. Which statement about reflex cardiovascular responses to nicardipine is correct?

  • It commonly causes reflex bradycardia due to central action
  • It may cause reflex tachycardia secondary to vasodilation
  • It eliminates all autonomic reflexes
  • It causes orthostatic hypertension

Correct Answer: It may cause reflex tachycardia secondary to vasodilation

Q20. When counseling about drug interactions, which herbal product could reduce nicardipine effectiveness by inducing CYP3A4?

  • Ginkgo biloba
  • St. John’s wort
  • Garlic supplements
  • Vitamin C

Correct Answer: St. John’s wort

Q21. Which adverse event suggests too rapid lowering of blood pressure with nicardipine?

  • Improved mental status
  • Acute confusion, dizziness, or signs of cerebral ischemia
  • Decreased peripheral edema
  • Increased urine output only

Correct Answer: Acute confusion, dizziness, or signs of cerebral ischemia

Q22. Which statement best describes nicardipine’s renal effects?

  • It causes immediate renal vasoconstriction in all patients
  • Excessive BP reduction may reduce renal perfusion; monitor renal function
  • It is renally cleared and accumulates in renal failure
  • It specifically increases glomerular filtration rate independent of BP

Correct Answer: Excessive BP reduction may reduce renal perfusion; monitor renal function

Q23. For IV nicardipine infusion, which practical pharmacy consideration is important?

  • Use of an infusion pump and appropriate dilution per protocol
  • It is unstable in all IV solutions and should not be infused
  • It requires refrigerated storage while infusing

Correct Answer: Use of an infusion pump and appropriate dilution per protocol

Q24. Which condition may warrant caution or avoidance of nicardipine therapy?

  • Mild seasonal allergies
  • Severe aortic stenosis due to risk of hypotension
  • Well-controlled hypothyroidism on levothyroxine
  • Uncomplicated hyperlipidemia

Correct Answer: Severe aortic stenosis due to risk of hypotension

Q25. Which monitoring finding would prompt slowing or reducing a nicardipine infusion rate?

  • Systolic BP trending to target range
  • Development of symptomatic hypotension or marked tachycardia
  • Stable BP with no symptoms
  • Mild headache improving with time

Correct Answer: Development of symptomatic hypotension or marked tachycardia

Q26. Which drug class, when combined with nicardipine, requires caution due to additive vasodilatory and hypotensive effects?

  • Statins
  • Nitrates
  • Topical antifungals
  • Selective serotonin reuptake inhibitors

Correct Answer: Nitrates

Q27. In overdose, which supportive measure is most appropriate for nicardipine toxicity?

  • Administration of naloxone
  • Supportive care with fluids, vasopressors, and monitoring
  • Immediate dialysis as primary treatment
  • High-dose aspirin

Correct Answer: Supportive care with fluids, vasopressors, and monitoring

Q28. Which pharmacodynamic feature distinguishes nicardipine from verapamil or diltiazem?

  • Greater effect on heart rate reduction than on vessels
  • More pronounced vascular smooth muscle vasodilation with less cardiac conduction depression
  • Equivalent negative chronotropic and inotropic effects
  • Complete block of neuronal calcium channels only

Correct Answer: More pronounced vascular smooth muscle vasodilation with less cardiac conduction depression

Q29. Which patient counseling point is appropriate for someone starting oral nicardipine controlled-release therapy?

  • Take the capsule and immediately crush it for faster effect
  • Take at consistent times; do not crush or chew extended-release capsules
  • Stop therapy abruptly if you miss a dose
  • Expect immediate BP normalization within 5 minutes

Correct Answer: Take at consistent times; do not crush or chew extended-release capsules

Q30. Which exam-focused concept about nicardipine is most important for a B.Pharm student to remember?

  • It is a beta blocker used primarily for arrhythmias
  • It is a dihydropyridine CCB used for vascular smooth muscle vasodilation and acute BP control, metabolized by CYP3A4
  • It is ineffective in hypertensive emergencies
  • It is only administered intramuscularly

Correct Answer: It is a dihydropyridine CCB used for vascular smooth muscle vasodilation and acute BP control, metabolized by CYP3A4

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