Reserpine MCQs With Answer

Reserpine MCQs With Answer offers B. Pharm students a focused review of reserpine’s pharmacology, mechanism, clinical uses and safety. This resource emphasizes key keywords such as reserpine, VMAT inhibition, monoamine depletion, Rauwolfia serpentina, antihypertensive therapy, adverse effects, depression risk, drug interactions, pharmacokinetics and monitoring. Questions probe deeper topics: vesicular monoamine transporter (VMAT2) blockade, downstream MAO-mediated degradation, effects on norepinephrine, dopamine and serotonin, hemodynamic consequences, contraindications and laboratory markers. Practical points like clinical indications, duration of action, and interactions with sympathomimetics are covered to strengthen exam preparedness and clinical reasoning. Now let’s test your knowledge with 30 MCQs on this topic.

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

• Inhibition of monoamine oxidase (MAO)
• Blockade of postsynaptic adrenergic receptors
• Inhibition of vesicular monoamine transporter (VMAT)
• Stimulation of catecholamine synthesis

Correct Answer: Inhibition of vesicular monoamine transporter (VMAT)

Q2. Reserpine is classically derived from which plant source?

• Atropa belladonna
• Rauwolfia serpentina
• Cinchona officinalis
• Digitalis purpurea

Correct Answer: Rauwolfia serpentina

Q3. In neurons, blockade of VMAT by reserpine leads to which immediate intracellular effect?

• Increased vesicular storage of norepinephrine
• Enhanced exocytosis of neurotransmitters
• Monoamine leakage into cytoplasm and degradation by MAO
• Upregulation of tyrosine hydroxylase

Correct Answer: Monoamine leakage into cytoplasm and degradation by MAO

Q4. Which neurotransmitters are depleted by reserpine?

• Only acetylcholine
• Norepinephrine, dopamine and serotonin
• GABA and glycine
• Histamine and bradykinin

Correct Answer: Norepinephrine, dopamine and serotonin

Q5. The antihypertensive effect of reserpine is mainly due to:

• Direct vasodilation through nitric oxide release
• Reduced sympathetic tone from depletion of norepinephrine
• Diuretic-mediated volume loss
• Increased renal perfusion

Correct Answer: Reduced sympathetic tone from depletion of norepinephrine

Q6. Which major adverse psychiatric effect is most commonly associated with reserpine?

• Mania
• Psychotic hallucinations
• Major depression
• Enhanced cognitive function

Correct Answer: Major depression

Q7. Reserpine’s duration of action is prolonged because:

• It irreversibly inhibits VMAT and requires synthesis of new vesicles and proteins
• It is rapidly eliminated unchanged in urine
• It is converted to an active metabolite with a long half-life
• It accumulates in plasma albumin

Correct Answer: It irreversibly inhibits VMAT and requires synthesis of new vesicles and proteins

Q8. Which laboratory marker is likely decreased after chronic reserpine therapy?

• Urinary vanillylmandelic acid (VMA)
• Serum creatinine
• Plasma fibrinogen
• Serum alkaline phosphatase

Correct Answer: Urinary vanillylmandelic acid (VMA)

Q9. Reserpine reduces the efficacy of which class of indirectly acting sympathomimetics?

• Direct beta-agonists like isoproterenol
• Indirect agents like amphetamine and tyramine
• Calcium channel blockers
• ACE inhibitors

Correct Answer: Indirect agents like amphetamine and tyramine

Q10. Which clinical sign is commonly seen due to peripheral sympathetic depletion by reserpine?

• Hypertension
• Orthostatic hypotension
• Severe tachycardia
• Mydriasis

Correct Answer: Orthostatic hypotension

Q11. Reserpine may precipitate Parkinsonian symptoms because it:

• Acts as a dopamine receptor antagonist
• Depletes central dopamine stores
• Inhibits acetylcholinesterase
• Enhances striatal dopamine turnover

Correct Answer: Depletes central dopamine stores

Q12. Which patient condition is a strong contraindication for reserpine use?

• Well-controlled hypertension without mood disorders
• Major depressive disorder
• Mild seasonal allergies
• Stable angina controlled with nitrates

Correct Answer: Major depressive disorder

Q13. The pharmacokinetic property of reserpine that explains its long-lasting effects is:

• High first-pass metabolism leading to rapid clearance
• Irreversible binding to intracellular targets and slow recovery
• Exclusive renal excretion as unchanged drug
• Short plasma half-life with continuous dosing needed

Correct Answer: Irreversible binding to intracellular targets and slow recovery

Q14. Which of the following explains why reserpine can reduce both blood pressure and heart rate?

• Direct agonism of muscarinic receptors
• Depletion of cardiac and vascular norepinephrine stores
• Blockade of L-type calcium channels
• Activation of the renin-angiotensin system

Correct Answer: Depletion of cardiac and vascular norepinephrine stores

Q15. Compared with modern antihypertensives, reserpine is less used primarily because of:

• Poor oral bioavailability
• High incidence of CNS adverse effects like depression
• Excessive diuretic effect
• Lack of effect on peripheral resistance

Correct Answer: High incidence of CNS adverse effects like depression

Q16. Reserpine’s effect on monoamine metabolism is most closely linked to which enzyme that degrades leaked neurotransmitters?

• Acetylcholinesterase
• Monoamine oxidase (MAO)
• Tyrosine hydroxylase
• Catechol-O-methyltransferase (COMT)

Correct Answer: Monoamine oxidase (MAO)

Q17. When treating hypertension, reserpine is commonly combined with which of the following to mitigate side effects?

• Tricyclic antidepressants to boost mood
• A diuretic to counter fluid retention and optimize BP control
• MAO inhibitors to enhance monoamine levels
• CNS stimulants to reverse sedation

Correct Answer: A diuretic to counter fluid retention and optimize BP control

Q18. Which monitoring parameter is most relevant during reserpine therapy?

• Serum potassium weekly
• Mood and signs of depression
• Fasting glucose daily
• Liver function tests every dose

Correct Answer: Mood and signs of depression

Q19. Reserpine’s chemical classification is best described as:

• A benzodiazepine derivative
• An indole alkaloid
• A steroidal glycoside
• A synthetic catecholamine

Correct Answer: An indole alkaloid

Q20. Which adverse gastrointestinal effect may be seen with reserpine due to increased parasympathetic activity?

• Constipation and dry mouth
• Diarrhea and increased gastric acid secretion
• Decreased appetite and dysphagia
• Pancreatitis

Correct Answer: Diarrhea and increased gastric acid secretion

Q21. In experimental pharmacology, reserpine is used to model which condition by inducing neurotransmitter depletion?

• Hyperthyroidism
• Depression and parkinsonism models
• Asthma exacerbation
• Acute inflammation

Correct Answer: Depression and parkinsonism models

Q22. Which feature distinguishes reserpine from direct-acting sympatholytics?

• Reserpine reduces neurotransmitter stores rather than blocking receptors directly
• It selectively blocks beta-1 receptors
• It increases synaptic norepinephrine levels
• It acts as a competitive antagonist at alpha receptors

Correct Answer: Reserpine reduces neurotransmitter stores rather than blocking receptors directly

Q23. Which patient education point is most important before starting reserpine?

• Expect immediate mood improvement
• Report any new or worsening depression or suicidal thoughts
• No need to monitor blood pressure after initiation
• It is safe in pregnancy without restrictions

Correct Answer: Report any new or worsening depression or suicidal thoughts

Q24. Which drug interaction is clinically significant with reserpine?

• Combination with SSRIs reduces antidepressant effect
• Use with MAO inhibitors may unpredictably alter monoamine balance and risk adverse CNS effects
• Co-administration with thiazides prevents orthostatic hypotension
• Concurrent digoxin increases reserpine clearance

Correct Answer: Use with MAO inhibitors may unpredictably alter monoamine balance and risk adverse CNS effects

Q25. Why might tyramine-containing foods have reduced pressor effects in a patient on reserpine?

• Reserpine increases MAO activity making tyramine inactive
• Depletion of vesicular stores means tyramine cannot displace stored norepinephrine
• Reserpine blocks tyramine absorption from the gut
• Reserpine enhances peripheral conversion of tyramine to inactive compounds

Correct Answer: Depletion of vesicular stores means tyramine cannot displace stored norepinephrine

Q26. Which therapeutic use of reserpine was historically important but is now limited?

• Antidepressant therapy as first-line agent
• Long-term asthma control
• Treatment of hypertension
• Acute pain management

Correct Answer: Treatment of hypertension

Q27. The development of which symptom after starting reserpine would suggest central dopamine depletion?

• Improved memory and concentration
• Bradykinesia and rigidity
• Heightened alertness
• Excessive sweating only

Correct Answer: Bradykinesia and rigidity

Q28. Which statement about reserpine’s effect on heart rate variability is correct?

• It increases sympathetic tone and heart rate variability
• It reduces sympathetic input leading to possible resting bradycardia and reduced variability
• It has no autonomic effects
• It causes sustained tachycardia by increasing catecholamines

Correct Answer: It reduces sympathetic input leading to possible resting bradycardia and reduced variability

Q29. In toxicology, acute overdose of reserpine is most likely to present with:

• Severe hypertension and agitation
• Signs of excessive parasympathetic activity, hypotension and profound depression
• Marked hyperthermia and seizures
• Immediate anaphylaxis only

Correct Answer: Signs of excessive parasympathetic activity, hypotension and profound depression

Q30. Which modern drug has a somewhat similar effect to reserpine by depleting monoamines but is used selectively for chorea?

• Tetrabenazine
• Levodopa
• Propranolol
• Fluoxetine

Correct Answer: Tetrabenazine

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