Promazine hydrochloride MCQs With Answer

Promazine hydrochloride MCQs With Answer is a focused study resource for B. Pharm students preparing for pharmacology exams. This concise introduction covers promazine hydrochloride’s classification as a phenothiazine antipsychotic, mechanism of action (D2 receptor antagonism), key therapeutic uses, adverse effects, pharmacokinetics, drug interactions and dosage forms. These MCQs emphasize clinical relevance, formulation considerations, stability and safety monitoring to strengthen understanding for pharmaceutical practice and exams. Ideal for revision, each question targets core concepts and problem-solving skills needed by pharmacy undergraduates. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which chemical class does promazine hydrochloride belong to?

• Butyrophenone
• Phenothiazine
• Thioxanthene
• Benzodiazepine

Correct Answer: Phenothiazine

Q2. The primary mechanism of action of promazine hydrochloride is:

• Selective serotonin reuptake inhibition
• GABA-A receptor agonism
• Dopamine D2 receptor antagonism
• NMDA receptor antagonism

Correct Answer: Dopamine D2 receptor antagonism

Q3. Promazine is best described as a:

• High-potency typical antipsychotic
• Low-potency phenothiazine derivative
• Atypical antipsychotic
• Selective serotonin antagonist

Correct Answer: Low-potency phenothiazine derivative

Q4. A common centrally mediated adverse effect of promazine hydrochloride is:

• Fine tremor only
• Severe bronchospasm
• Sedation and drowsiness
• Renal tubular necrosis

Correct Answer: Sedation and drowsiness

Q5. Which receptor blockade contributes to promazine’s orthostatic hypotension?

• Muscarinic cholinergic receptors
• H1 histamine receptors
• Alpha-1 adrenergic receptors
• D2 dopamine receptors

Correct Answer: Alpha-1 adrenergic receptors

Q6. Promazine’s anticholinergic side effects include all except:

• Dry mouth
• Constipation
• Urinary retention
• Excessive sweating

Correct Answer: Excessive sweating

Q7. Which adverse effect is more associated with low-potency antipsychotics like promazine?

• High risk of acute dystonia
• Pronounced anticholinergic and hypotensive effects
• Marked EPS at low doses
• Severe neutropenia as primary risk

Correct Answer: Pronounced anticholinergic and hypotensive effects

Q8. Promazine hydrochloride is most likely to cause which endocrine effect?

• Hypoglycemia due to insulin secretion
• Hyperprolactinemia due to D2 blockade
• Hyperthyroidism
• Adrenal insufficiency

Correct Answer: Hyperprolactinemia due to D2 blockade

Q9. Which route of administration is commonly available for promazine hydrochloride?

• Oral tablets and intramuscular injection
• Inhalation aerosol
• Topical cream
• Intrathecal infusion

Correct Answer: Oral tablets and intramuscular injection

Q10. Promazine hydrochloride’s hydrochloride salt form is primarily used to:

• Reduce potency
• Improve water solubility for formulation
• Increase lipid solubility for CNS accumulation
• Convert it into a prodrug

Correct Answer: Improve water solubility for formulation

Q11. Which monitoring parameter is most relevant for long-term use of promazine?

• Liver enzymes every month only
• Regular assessment for extrapyramidal symptoms and metabolic effects
• Daily chest X-ray
• Frequent ophthalmic pressure checks

Correct Answer: Regular assessment for extrapyramidal symptoms and metabolic effects

Q12. Which of the following is a severe but rare hematologic adverse effect associated with phenothiazines?

• Agranulocytosis
• Polycythemia vera
• Hemophilia A
• Thalassemia

Correct Answer: Agranulocytosis

Q13. Promazine’s antiemetic effect is primarily due to antagonism at which receptor?

• Alpha-2 adrenergic receptor
• Histamine H2 receptor
• Dopamine D2 receptor in chemoreceptor trigger zone
• GABA-B receptor

Correct Answer: Dopamine D2 receptor in chemoreceptor trigger zone

Q14. A major drug interaction risk with promazine is additive sedation when combined with:

• SSRIs alone
• CNS depressants such as benzodiazepines or alcohol
• Beta blockers
• Thyroid hormones

Correct Answer: CNS depressants such as benzodiazepines or alcohol

Q15. In case of acute extrapyramidal reactions caused by promazine, the preferred immediate treatment is:

• Anticholinergic agent such as benztropine or diphenhydramine
• High-dose corticosteroids
• Beta agonists
• Loop diuretics

Correct Answer: Anticholinergic agent such as benztropine or diphenhydramine

Q16. Which statement about cardiac risk with promazine is correct?

• It has no effect on cardiac conduction
• It can prolong QT interval, increasing arrhythmia risk
• It causes irreversible heart block in all patients
• It protects against torsades de pointes

Correct Answer: It can prolong QT interval, increasing arrhythmia risk

Q17. For a B.Pharm student studying formulations, which excipient concern is key for promazine oral tablets?

• Ensuring compatibility with strong oxidizers only
• Maintaining chemical stability in presence of moisture and light
• Avoiding any fillers to increase potency
• Adding high levels of ethanol to improve taste

Correct Answer: Maintaining chemical stability in presence of moisture and light

Q18. Promazine is contraindicated in patients with which of the following conditions?

• Controlled hypertension with no symptoms
• Comatose states or severe CNS depression
• Mild seasonal allergies
• Stable hypothyroidism adequately treated

Correct Answer: Comatose states or severe CNS depression

Q19. Which pharmacokinetic process primarily occurs to promazine in the liver?

• Renal glomerular filtration unchanged
• Extensive hepatic metabolism (biotransformation)
• Excretion as unchanged drug in bile only
• No metabolism; excreted in breath

Correct Answer: Extensive hepatic metabolism (biotransformation)

Q20. Which clinical use is historically associated with promazine?

• Management of acute psychomotor agitation and sedation
• Primary treatment for diabetes mellitus
• First-line therapy for Parkinson’s disease
• Treatment of bacterial infections

Correct Answer: Management of acute psychomotor agitation and sedation

Q21. The relative risk of extrapyramidal symptoms with promazine compared to high-potency antipsychotics is:

• Higher with promazine
• Lower with promazine due to lower D2 blockade potency
• Equal for all antipsychotics
• Nonexistent for promazine

Correct Answer: Lower with promazine due to lower D2 blockade potency

Q22. Which drug class can increase plasma levels of promazine via CYP inhibition?

• CYP3A4 or CYP2D6 inhibitors such as some macrolides or SSRIs
• Broad-spectrum antibiotics that induce CYP enzymes
• Antacids and sucralfate alone
• Topical antifungals only

Correct Answer: CYP3A4 or CYP2D6 inhibitors such as some macrolides or SSRIs

Q23. In pharmaceutical analysis, which technique is commonly used to assay promazine in formulations?

• Infrared spectroscopy only
• High-performance liquid chromatography (HPLC)
• Gravimetric analysis only
• pH titration exclusively

Correct Answer: High-performance liquid chromatography (HPLC)

Q24. When counselling patients, which warning is most important for promazine therapy?

• It causes immediate hair loss
• Avoid driving or operating machinery until effects are known due to sedation
• There is no interaction with alcohol
• It enhances alertness and concentration

Correct Answer: Avoid driving or operating machinery until effects are known due to sedation

Q25. Which laboratory test should be considered before starting long-term treatment with phenothiazines like promazine?

• Complete blood count to monitor for hematologic adverse effects
• Serum uric acid only
• Routine daily EEG
• Arterial blood gases weekly

Correct Answer: Complete blood count to monitor for hematologic adverse effects

Q26. In terms of pregnancy, promazine should be used:

• Without any caution or monitoring
• Only if potential benefits justify potential risks to fetus
• As a first-line drug for morning sickness
• At double doses routinely

Correct Answer: Only if potential benefits justify potential risks to fetus

Q27. Which of the following best describes promazine’s affinity for histamine receptors?

• Strong H1 antagonism contributing to sedation
• Pure H2 agonism causing acid secretion
• No interaction with histamine receptors
• Selective H3 receptor activation only

Correct Answer: Strong H1 antagonism contributing to sedation

Q28. Which symptom suggests neuroleptic malignant syndrome (NMS) potentially related to promazine?

• Hypothermia with slow reflexes
• Hyperthermia, muscle rigidity and autonomic instability
• Gradual weight loss over months
• Mild headache that resolves

Correct Answer: Hyperthermia, muscle rigidity and autonomic instability

Q29. For formulation stability, promazine tablets should be stored:

• In a cool, dry place protected from light
• In direct sunlight for activation
• Frozen at -20°C
• In a humid bathroom cabinet

Correct Answer: In a cool, dry place protected from light

Q30. Which pharmacodynamic property of promazine explains its usefulness as a sedative premedicant?

• Selective dopamine agonism
• Antihistaminic and central depressant effects
• Peripheral vasoconstriction
• Beta-adrenergic stimulation

Correct Answer: Antihistaminic and central depressant effects

Q31. Which adverse effect is an anticholinergic manifestation of promazine?

• Excessive lacrimation
• Blurred vision and dry eyes
• Bradycardia with increased salivation
• Profuse sweating and rhinorrhea

Correct Answer: Blurred vision and dry eyes

Q32. A B.Pharm student should recognize that promazine’s therapeutic index is:

• Extremely wide with no overdose risk
• Narrower than many safe OTC drugs, requiring careful dosing
• Irrelevant for antipsychotics
• Infinite

Correct Answer: Narrower than many safe OTC drugs, requiring careful dosing

Q33. Which adverse metabolic effect can be seen with long-term use of phenothiazines including promazine?

• Hypolipidemia only
• Weight gain and lipid disturbances
• Reduced appetite and weight loss exclusively
• Type I diabetes induction

Correct Answer: Weight gain and lipid disturbances

Q34. Which drug would most likely reduce the antipsychotic effect of promazine by increasing dopaminergic activity?

• Levodopa or dopamine agonists
• SSRIs
• Antacids
• Antihistamines

Correct Answer: Levodopa or dopamine agonists

Q35. In compounding or dispensing, what precaution is important when handling promazine injection?

• Ensure sterility and inspect for particulate matter before administration
• Heat the vial to 60°C before use
• Shake vigorously to create a foam for administration
• Freeze the vial to increase shelf life

Correct Answer: Ensure sterility and inspect for particulate matter before administration

Q36. Which adverse effect requires immediate drug discontinuation and emergency care?

• Mild constipation manageable by diet
• Signs of neuroleptic malignant syndrome
• Transient mild sedation after the first dose
• Minor transient headaches

Correct Answer: Signs of neuroleptic malignant syndrome

Q37. Which population requires extra caution when prescribing promazine?

• Elderly patients due to increased sensitivity to sedation and orthostatic hypotension
• Young healthy adults with no comorbidities
• Patients with robust cardiovascular function only
• People with high pain tolerance

Correct Answer: Elderly patients due to increased sensitivity to sedation and orthostatic hypotension

Q38. In drug stability testing, photodegradation of promazine indicates the need for:

• Packaging in light-protective containers
• Exposing the drug to UV light before use
• Storing tablets under direct sunlight
• Using transparent packaging exclusively

Correct Answer: Packaging in light-protective containers

Q39. Promazine’s activity at which receptor contributes to its antiemetic properties?

• Beta-2 adrenergic receptors
• Central dopamine D2 receptors
• Peripheral opioid receptors
• Muscarinic M2 receptors in the heart

Correct Answer: Central dopamine D2 receptors

Q40. Which adverse effect profile differentiates low-potency agents like promazine from high-potency antipsychotics?

• Greater anticholinergic and sedative effects but fewer acute EPS
• Greater incidence of acute dystonia and fewer anticholinergic effects
• No difference at all
• Exclusive gastrointestinal toxicity only

Correct Answer: Greater anticholinergic and sedative effects but fewer acute EPS

Q41. Which is an appropriate step in managing anticholinergic toxicity from promazine overdose?

• Administer physostigmine under monitoring when indicated
• Immediate high-dose insulin infusion
• Rapid infusion of potassium chloride
• Give oral iron supplements

Correct Answer: Administer physostigmine under monitoring when indicated

Q42. Which laboratory abnormality can be seen with long-term phenothiazine therapy?

• Elevated prolactin levels
• Pancytopenia in all patients
• Consistent hypoglycemia
• Marked hypercalcemia exclusively

Correct Answer: Elevated prolactin levels

Q43. For B.Pharm students, which compounding consideration is relevant for preparing a promazine oral solution?

• Ensuring pH and preservative compatibility to maintain stability
• Never use preservatives in any oral solution
• Always prepare using distilled water heated to boiling
• Exclude sweeteners to increase compliance

Correct Answer: Ensuring pH and preservative compatibility to maintain stability

Q44. Which statement about withdrawal of promazine is correct?

• Stopping abruptly may precipitate withdrawal or symptom recurrence; tapering may be advisable
• It can be stopped abruptly without any effects
• Increase the dose before stopping
• Switching to an opioid is recommended

Correct Answer: Stopping abruptly may precipitate withdrawal or symptom recurrence; tapering may be advisable

Q45. Promazine may interfere with which diagnostic test due to its pharmacologic effects?

• Prolactin assay due to elevated prolactin levels
• Blood glucose tests causing false low readings only
• Urine dipstick for ketones exclusively
• ECG has no changes from promazine

Correct Answer: Prolactin assay due to elevated prolactin levels

Q46. Which of the following is a pharmacological property of promazine relevant to drug interactions?

• It is a strong inducer of all CYP enzymes
• It is metabolized by hepatic enzymes and may be affected by CYP inhibitors or inducers
• It is exclusively excreted unchanged in urine
• It neutralizes other drugs in the stomach

Correct Answer: It is metabolized by hepatic enzymes and may be affected by CYP inhibitors or inducers

Q47. Which clinical sign suggests acute anticholinergic toxicity from promazine?

• Bradycardia and increased salivation
• Hyperthermia, dry flushed skin and dilated pupils
• Hypersalivation and lacrimation
• Profuse sweating and pinpoint pupils

Correct Answer: Hyperthermia, dry flushed skin and dilated pupils

Q48. Promazine’s role in modern psychiatry is limited because:

• There are safer and more effective antipsychotics with fewer side effects
• It is the most effective and safest antipsychotic available
• It has no pharmacologic activity
• It cures schizophrenia permanently

Correct Answer: There are safer and more effective antipsychotics with fewer side effects

Q49. Which storage precaution is important for promazine parenteral formulations?

• Do not freeze; store at recommended controlled room temperature and protect from light
• Store at -80°C for stability
• Keep in direct sunlight to maintain potency
• Shake before administration to activate the drug

Correct Answer: Do not freeze; store at recommended controlled room temperature and protect from light

Q50. For examination preparation, which study approach best helps B.Pharm students master promazine hydrochloride?

• Memorize only brand names without understanding pharmacology
• Integrate mechanism, pharmacokinetics, adverse effects, interactions and formulation aspects through active practice MCQs
• Ignore drug interactions and focus on color of tablets
• Study only unrelated drugs

Correct Answer: Integrate mechanism, pharmacokinetics, adverse effects, interactions and formulation aspects through active practice MCQs

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