Prochlorperazine maleate MCQs With Answer

Prochlorperazine maleate MCQs With Answer is a focused study resource for B. Pharm students covering pharmacology, mechanism of action, pharmacokinetics, dosage forms, adverse effects, and drug interactions of this phenothiazine antiemetic and antipsychotic. These multiple-choice questions emphasize clinical uses for nausea, vomiting and psychosis, common and serious side effects such as extrapyramidal symptoms, sedation, hypotension and neuroleptic malignant syndrome, plus safe prescribing considerations and interactions with CNS depressants. Each MCQ targets curriculum-relevant concepts to reinforce learning and improve exam readiness with concise answer keys for quick revision. Now let’s test your knowledge with 50 MCQs on this topic.

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

• Dopamine D2 receptor antagonism in the chemoreceptor trigger zone
• Serotonin 5-HT3 receptor blockade in the gut
• Muscarinic receptor agonism in the vomiting center
• Histamine H1 receptor activation centrally

Correct Answer: Dopamine D2 receptor antagonism in the chemoreceptor trigger zone

Q2. Prochlorperazine maleate belongs to which chemical class?

• Benzodiazepines
• Phenothiazines
• Butyrophenones
• Phenylpiperazines

Correct Answer: Phenothiazines

Q3. Which clinical indication is most commonly associated with prochlorperazine?

• Chronic hypertension
• Severe nausea and vomiting
• Acute bacterial infection
• Type 2 diabetes mellitus

Correct Answer: Severe nausea and vomiting

Q4. Which extrapyramidal adverse effect is commonly seen early after prochlorperazine administration?

• Tardive dyskinesia
• Acute dystonia
• Nephrotoxicity
• Hyperglycemia

Correct Answer: Acute dystonia

Q5. Which of the following formulations is available for prochlorperazine maleate?

• Oral tablets, rectal suppositories, and parenteral injections
• Only transdermal patches
• Only inhalation aerosol
• Only ophthalmic drops

Correct Answer: Oral tablets, rectal suppositories, and parenteral injections

Q6. Which receptor blockade by prochlorperazine contributes to sedation?

• Beta-adrenergic receptor blockade
• H1 histamine receptor blockade
• NMDA receptor activation
• GABA-A receptor antagonism

Correct Answer: H1 histamine receptor blockade

Q7. A major long-term risk associated with chronic prochlorperazine use is:

• Osteoporosis
• Tardive dyskinesia
• Hypoglycemia
• Renal calculi

Correct Answer: Tardive dyskinesia

Q8. Which adverse reaction is characteristic of neuroleptic malignant syndrome (NMS) caused by prochlorperazine?

• Bradycardia without fever
• Hyperthermia with muscle rigidity
• Persistent cough and wheeze
• Isolated rash only

Correct Answer: Hyperthermia with muscle rigidity

Q9. Which population has an increased risk of mortality with antipsychotic drugs including prochlorperazine?

• Young healthy adults
• Elderly patients with dementia-related psychosis
• Athletes under 30
• Pregnant adolescents

Correct Answer: Elderly patients with dementia-related psychosis

Q10. Which symptom indicates hyperprolactinemia due to prochlorperazine?

• Polyuria and polydipsia
• Galactorrhea and amenorrhea
• Excessive sweating only
• Visual field constriction

Correct Answer: Galactorrhea and amenorrhea

Q11. Which drug class increases the risk of central nervous system depression when combined with prochlorperazine?

• Selective serotonin reuptake inhibitors exclusively
• Opioids and benzodiazepines
• Topical antibiotics
• Nonsteroidal anti-inflammatory drugs only

Correct Answer: Opioids and benzodiazepines

Q12. For acute dystonic reactions from prochlorperazine, which agent is commonly used as treatment?

• Benztropine (anticholinergic)
• Insulin
• Amoxicillin
• Propranolol

Correct Answer: Benztropine (anticholinergic)

Q13. Which cardiac risk must be monitored with prochlorperazine therapy?

• QT interval prolongation and arrhythmias
• Aortic dissection risk
• Immediate myocardial infarction in all patients
• Primary pulmonary hypertension

Correct Answer: QT interval prolongation and arrhythmias

Q14. The maleate in prochlorperazine maleate refers to:

• A therapeutic adjuvant compound
• The salt form (maleate) of the active drug
• An inactive impurity
• A manufacturing solvent

Correct Answer: The salt form (maleate) of the active drug

Q15. Which laboratory parameter may be elevated due to dopamine blockade by prochlorperazine?

• Serum creatinine
• Serum prolactin
• Serum potassium
• Amylase only

Correct Answer: Serum prolactin

Q16. Which contraindication is most appropriate for prochlorperazine?

• Known hypersensitivity to phenothiazines
• Mild seasonal allergies
• Controlled hypothyroidism
• History of childhood chickenpox

Correct Answer: Known hypersensitivity to phenothiazines

Q17. Prochlorperazine primarily exerts antiemetic effects by acting on which brain area?

• Medullary vomiting center directly without CTZ involvement
• Chemoreceptor trigger zone (CTZ) in the area postrema
• Hypothalamic thirst center
• Cerebellar vestibular nuclei exclusively

Correct Answer: Chemoreceptor trigger zone (CTZ) in the area postrema

Q18. Which adverse effect is related to anticholinergic activity of prochlorperazine?

• Excessive salivation
• Urinary retention and dry mouth
• Hypersalivation and diarrhea
• Increased lacrimation

Correct Answer: Urinary retention and dry mouth

Q19. A pharmacist counseling a patient on prochlorperazine should warn about which driving-related effect?

• Increased alertness and improved reaction time
• Sedation and impaired coordination
• Enhanced night vision
• Immediate increase in athletic performance

Correct Answer: Sedation and impaired coordination

Q20. Tardive dyskinesia associated with prochlorperazine is best described as:

• An acute life-threatening allergic reaction
• Irreversible or persistent involuntary movements after long-term use
• Transient itch resolving in minutes
• Immediate hypotension after first dose

Correct Answer: Irreversible or persistent involuntary movements after long-term use

Q21. Which of the following is TRUE about the pharmacokinetics of prochlorperazine?

• It is primarily excreted unchanged in urine
• It undergoes hepatic metabolism before excretion
• It is not metabolized and has 100% oral bioavailability
• It is eliminated exclusively via the lungs

Correct Answer: It undergoes hepatic metabolism before excretion

Q22. Which symptom suggests an acute anticholinergic overdose from prochlorperazine?

• Bradycardia and sweating
• Dry mouth, flushed skin, and urinary retention
• Excessive salivation and lacrimation
• Profuse diarrhea

Correct Answer: Dry mouth, flushed skin, and urinary retention

Q23. When switching from oral to parenteral prochlorperazine, the pharmacist should be aware that:

• Parenteral forms are less bioavailable than oral
• Parenteral administration provides more rapid onset of action
• There is no difference in onset between routes
• Parenteral forms cannot be used for severe vomiting

Correct Answer: Parenteral administration provides more rapid onset of action

Q24. Which symptom is the earliest sign of extrapyramidal side effects?

• Gradual weight loss over months
• Acute restlessness and inability to sit still (akathisia)
• Delayed wound healing
• Hearing loss

Correct Answer: Acute restlessness and inability to sit still (akathisia)

Q25. Which drug interaction can reduce the antiemetic efficacy of prochlorperazine?

• Concurrent use of metoclopramide
• Concurrent use of haloperidol causing additive EPS
• Concurrent use of anticholinergics increasing side effects and potentially masking EPS
• Concurrent use of proton pump inhibitors increasing efficacy

Correct Answer: Concurrent use of haloperidol causing additive EPS

Q26. The preferred immediate treatment for suspected neuroleptic malignant syndrome from prochlorperazine is:

• Initiate antipsychotic dose escalation
• Stop the offending agent and provide supportive care
• Give high-dose benzodiazepines only without stopping the drug
• Administer NSAIDs and continue drug

Correct Answer: Stop the offending agent and provide supportive care

Q27. In which condition should prochlorperazine be used with caution due to risk of hypotension?

• Patients with controlled hyperthyroidism
• Elderly patients and those with cardiovascular disease
• Adolescents engaged in sports
• Patients with seasonal allergies

Correct Answer: Elderly patients and those with cardiovascular disease

Q28. Which sign suggests serotonin syndrome rather than prochlorperazine adverse effects?

• Severe muscle rigidity with elevated CK only
• Hyperreflexia and clonus associated with serotonergic agents
• Isolated parkinsonian tremor after long-term use
• Localized rash at injection site only

Correct Answer: Hyperreflexia and clonus associated with serotonergic agents

Q29. Which monitoring is important during long-term therapy with prochlorperazine?

• Regular dental X-rays
• Periodic assessment for movement disorders and prolactin-related effects
• Continuous blood glucose monitoring hourly
• Weekly liver biopsies

Correct Answer: Periodic assessment for movement disorders and prolactin-related effects

Q30. Which statement about prochlorperazine use in pregnancy is most appropriate?

• It is absolutely contraindicated in all trimesters
• It should be used only if clearly needed and benefit outweighs risk
• It enhances fetal brain development and is recommended
• It has no effect on the fetus and requires no caution

Correct Answer: It should be used only if clearly needed and benefit outweighs risk

Q31. Which adverse effect is specifically related to alpha-adrenergic blockade by prochlorperazine?

• Orthostatic hypotension and dizziness
• Hyperthermia and sweating
• Hyperactivity and insomnia
• Excessive lacrimation

Correct Answer: Orthostatic hypotension and dizziness

Q32. The term ‘antiemetic’ refers to a drug’s ability to:

• Increase appetite dramatically
• Prevent or treat nausea and vomiting
• Cause diuresis
• Lower blood pressure

Correct Answer: Prevent or treat nausea and vomiting

Q33. Which adverse effect may present as a late complication even after stopping prochlorperazine?

• Tardive dyskinesia
• Acute liver failure immediately
• Transient food allergy
• Immediate seizure within minutes only

Correct Answer: Tardive dyskinesia

Q34. What is an important counsel point for patients receiving prochlorperazine suppositories?

• Store at high temperatures only
• Expect slower onset than parenteral but faster than oral in vomiting patients
• They are intended for inhalation therapy
• Use them as eye drops if oral route fails

Correct Answer: Expect slower onset than parenteral but faster than oral in vomiting patients

Q35. Which is an appropriate action if a patient develops severe akathisia on prochlorperazine?

• Increase the dose immediately
• Consider dose reduction or add a beta-blocker or benzodiazepine
• Advise vigorous exercise only
• Switch to a high-dose anticholinergic without evaluation

Correct Answer: Consider dose reduction or add a beta-blocker or benzodiazepine

Q36. Which medication should be used cautiously with prochlorperazine due to additive QT prolongation risk?

• Amoxicillin
• Macrolide antibiotics such as erythromycin
• Metformin
• Vitamin C

Correct Answer: Macrolide antibiotics such as erythromycin

Q37. Prochlorperazine’s antiemetic effect is least likely mediated by which mechanism?

• Dopamine receptor blockade in the CTZ
• Peripheral serotonin 5-HT3 antagonism in gut
• Reduction of vestibular input through dopaminergic pathways
• Central neurotransmitter modulation in vomiting center

Correct Answer: Peripheral serotonin 5-HT3 antagonism in gut

Q38. In case of overdose of prochlorperazine, which feature is expected?

• Severe CNS depression and hypotension
• Excessive lacrimation and rhinorrhea only
• Isolated pruritus without systemic signs
• Marked hyperactivity and euphoria only

Correct Answer: Severe CNS depression and hypotension

Q39. Which dosing consideration is important for elderly patients on prochlorperazine?

• They often need higher doses due to tolerance
• Start at lower doses and monitor for sedation, hypotension, and EPS
• No dose adjustment is ever necessary
• They can take double doses if symptoms persist

Correct Answer: Start at lower doses and monitor for sedation, hypotension, and EPS

Q40. Which neurotransmitter increase is associated with Parkinsonism-like side effects when blocked by antipsychotics?

• Increased serotonin causes Parkinsonism
• Dopamine blockade leading to relative cholinergic dominance and parkinsonism
• Increased GABA causing movement disorders
• Excess acetylcholine reduction causing rigidity

Correct Answer: Dopamine blockade leading to relative cholinergic dominance and parkinsonism

Q41. For chemotherapy-induced nausea, prochlorperazine is typically used:

• As a first-line 5-HT3 antagonist alternative for some patients
• Never used under any circumstances
• Only as an oral rinse
• To cause diuresis before chemotherapy

Correct Answer: As a first-line 5-HT3 antagonist alternative for some patients

Q42. Which class of drugs may reduce the efficacy of prochlorperazine by antagonizing its antiemetic effect?

• Dopamine agonists such as metoclopramide (note: metoclopramide is a D2 antagonist; question aimed at dopamine agonists)
• Dopamine agonists such as levodopa
• Antihistamines alone
• Topical antifungals

Correct Answer: Dopamine agonists such as levodopa

Q43. Which monitoring parameter is important when prochlorperazine is administered intravenously?

• Continuous ECG monitoring for arrhythmias if high-risk
• Immediate ultrasound of the abdomen
• Hourly blood glucose checks in all patients
• Frequent audiometry

Correct Answer: Continuous ECG monitoring for arrhythmias if high-risk

Q44. In comparing prochlorperazine with promethazine, which statement is correct?

• Both are phenothiazines but promethazine has stronger antihistaminic effects
• Prochlorperazine is an opioid analgesic
• Promethazine is a beta blocker
• They are identical in pharmacologic profile and side effects

Correct Answer: Both are phenothiazines but promethazine has stronger antihistaminic effects

Q45. Which adverse effect may necessitate immediate discontinuation of prochlorperazine?

• Mild transient headache
• Agranulocytosis or signs of severe blood dyscrasia
• Mild constipation that resolves on its own
• Temporary mild skin dryness

Correct Answer: Agranulocytosis or signs of severe blood dyscrasia

Q46. The antiemetic dose of prochlorperazine for adults is typically:

• Extremely high single dose only once per year
• Low to moderate doses, titrated to effect (e.g., small mg doses multiple times daily)
• Administered only as micrograms sublingually
• Measured in international units like insulin

Correct Answer: Low to moderate doses, titrated to effect (e.g., small mg doses multiple times daily)

Q47. Which statement about drug storage is appropriate for prochlorperazine suppositories?

• They should be stored frozen solid at all times
• They should be stored at recommended controlled room temperature and protected from heat
• They should be exposed to sunlight to maintain potency
• Storage conditions do not matter for suppositories

Correct Answer: They should be stored at recommended controlled room temperature and protected from heat

Q48. Which sign differentiates acute dystonia from tardive dyskinesia?

• Acute dystonia appears early and is often reversible with anticholinergics, tardive dyskinesia is late and may be persistent
• Both are identical in onset and reversibility
• Tardive dyskinesia responds promptly to anticholinergics but dystonia does not
• Dystonia occurs only after many years and is irreversible

Correct Answer: Acute dystonia appears early and is often reversible with anticholinergics, tardive dyskinesia is late and may be persistent

Q49. Which counseling point is important regarding alcohol consumption while on prochlorperazine?

• Alcohol enhances alertness and is recommended
• Avoid alcohol because it increases sedation and CNS depression
• There is no interaction and alcohol is safe
• Consume large amounts of alcohol to reduce nausea

Correct Answer: Avoid alcohol because it increases sedation and CNS depression

Q50. The role of the B. Pharm student when dispensing prochlorperazine includes all EXCEPT:

• Checking for drug interactions and contraindications
• Providing patient counseling on side effects and precautions
• Ensuring appropriate storage and labeling
• Prescribing dose increases without authority

Correct Answer: Prescribing dose increases without authority

G S Sachin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.

Mail- Sachin@pharmacyfreak.com