Rosiglitazone MCQs With Answer

Rosiglitazone MCQs With Answer is a focused review for B.Pharm students covering pharmacology, mechanism, therapeutic use, adverse effects and clinical monitoring of rosiglitazone. This concise, keyword-rich introduction highlights PPAR-gamma activation, thiazolidinedione class, insulin sensitivity, cardiovascular concerns, hepatic and renal considerations, drug interactions (CYP2C8), dosing, and safety monitoring. The questions emphasize molecular actions (adiponectin, GLUT4), practical pharmacy implications (combination therapy, hypoglycaemia risk), and regulatory history to deepen clinical understanding. These MCQs will reinforce pharmacokinetics, adverse-event recognition (edema, weight gain, fractures), and counselling points important for dispensary practice and patient safety. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which nuclear receptor is the primary molecular target of rosiglitazone?

  • Peroxisome proliferator-activated receptor alpha (PPAR-alpha)
  • Peroxisome proliferator-activated receptor gamma (PPAR-gamma)
  • Glucagon-like peptide-1 (GLP-1) receptor
  • Dipeptidyl peptidase-4 (DPP-4)

Correct Answer: Peroxisome proliferator-activated receptor gamma (PPAR-gamma)

Q2. To which drug class does rosiglitazone belong?

  • Sulfonylureas
  • Biguanides
  • Thiazolidinedione (glitazone)
  • Dipeptidyl peptidase-4 inhibitors

Correct Answer: Thiazolidinedione (glitazone)

Q3. The primary therapeutic effect of rosiglitazone in type 2 diabetes is:

  • Increasing insulin secretion from pancreatic beta cells
  • Reducing renal glucose reabsorption
  • Improving insulin sensitivity in peripheral tissues
  • Blocking intestinal glucose absorption

Correct Answer: Improving insulin sensitivity in peripheral tissues

Q4. What is the major approved clinical indication for rosiglitazone?

  • Type 1 diabetes mellitus
  • Type 2 diabetes mellitus
  • Gestational diabetes as first-line therapy
  • Diabetic ketoacidosis

Correct Answer: Type 2 diabetes mellitus

Q5. Which cellular effects are produced by rosiglitazone-mediated PPAR-gamma activation?

  • Inhibition of GLUT4 expression and decreased adiponectin
  • Activation of PPAR-gamma leading to increased adiponectin and GLUT4 expression
  • Direct stimulation of insulin secretion
  • Inhibition of hepatic gluconeogenesis via AMPK activation

Correct Answer: Activation of PPAR-gamma leading to increased adiponectin and GLUT4 expression

Q6. Which adverse effect is most characteristic and clinically important for rosiglitazone?

  • Severe hypoglycaemia when used alone
  • Renal tubular necrosis
  • Fluid retention and exacerbation of heart failure
  • Acute pancreatitis as a common effect

Correct Answer: Fluid retention and exacerbation of heart failure

Q7. Historically, rosiglitazone has been associated with which cardiovascular concern?

  • Marked reduction in myocardial ischemia risk
  • Increased risk of myocardial ischemia and ischemic events
  • No cardiovascular effects reported
  • Definitive protection against stroke

Correct Answer: Increased risk of myocardial ischemia and ischemic events

Q8. Which cytochrome P450 isoenzyme is primarily responsible for rosiglitazone metabolism?

  • CYP3A4
  • CYP2D6
  • CYP2C8
  • CYP1A2

Correct Answer: CYP2C8

Q9. Co-administration of which lipid-lowering drug is most likely to increase rosiglitazone plasma concentrations?

  • Atorvastatin (CYP3A4 substrate)
  • Gemfibrozil (CYP2C8 inhibitor)
  • Fenofibrate (no significant CYP2C8 inhibition)
  • Colestipol (resin, no CYP interaction)

Correct Answer: Gemfibrozil (CYP2C8 inhibitor)

Q10. Combining rosiglitazone with which drug class increases the risk of hypoglycaemia?

  • Insulin or sulfonylureas
  • ACE inhibitors
  • Statins
  • Beta blockers

Correct Answer: Insulin or sulfonylureas

Q11. Rosiglitazone tends to have which effect on serum lipid profile?

  • Marked decrease in LDL cholesterol
  • Increase in LDL cholesterol with variable HDL changes
  • No effect on lipids
  • Decrease in HDL and triglycerides

Correct Answer: Increase in LDL cholesterol with variable HDL changes

Q12. Long-term therapy with rosiglitazone has been linked to an increased risk of which skeletal complication?

  • Osteomalacia
  • Bone fractures, especially in women
  • Accelerated bone healing
  • Increased bone density and osteoporosis prevention

Correct Answer: Bone fractures, especially in women

Q13. Rosiglitazone is contraindicated in patients with which condition?

  • Mild controlled hypertension
  • NYHA class III/IV heart failure
  • Hyperthyroidism
  • Stable angina controlled with medication

Correct Answer: NYHA class III/IV heart failure

Q14. Which laboratory parameter should be monitored before and during rosiglitazone therapy?

  • Serum amylase only
  • Liver function tests (transaminases)
  • Serum creatine kinase weekly
  • Serum calcium monthly

Correct Answer: Liver function tests (transaminases)

Q15. What is the typical onset of glycaemic effect after starting rosiglitazone?

  • Immediate (within hours)
  • Within 24–48 hours
  • Several weeks to months (delayed onset)
  • No measurable glycaemic effect

Correct Answer: Several weeks to months (delayed onset)

Q16. A common metabolic adverse effect of rosiglitazone is:

  • Weight loss
  • Weight gain
  • Hyperkalemia
  • Severe lactic acidosis like metformin

Correct Answer: Weight gain

Q17. Is rosiglitazone indicated for treatment of type 1 diabetes?

  • Yes, as first-line therapy
  • Only in combination with insulin for all patients
  • No, it is not indicated for type 1 diabetes
  • Yes, it replaces insulin in selected cases

Correct Answer: No, it is not indicated for type 1 diabetes

Q18. Regarding use in pregnancy, rosiglitazone is generally:

  • Recommended as first-line therapy for gestational diabetes
  • Not recommended and generally avoided unless benefits outweigh risks
  • Proven safe in large randomized trials for pregnancy
  • Contraindicated in all trimesters without exception

Correct Answer: Not recommended and generally avoided unless benefits outweigh risks

Q19. How should rosiglitazone dosing be adjusted in significant renal impairment?

  • Contraindicated in any renal impairment
  • No dose adjustment required solely for renal impairment in most cases
  • Must be halved in all renal impairment
  • Increased dose is required due to reduced clearance

Correct Answer: No dose adjustment required solely for renal impairment in most cases

Q20. What is the usual route of administration for rosiglitazone?

  • Intravenous infusion
  • Intramuscular injection
  • Oral tablets
  • Subcutaneous injection

Correct Answer: Oral tablets

Q21. The approximate elimination half-life of rosiglitazone is closest to:

  • 30 minutes
  • 3–4 hours
  • 48–72 hours
  • One week

Correct Answer: 3–4 hours

Q22. Rosiglitazone improves peripheral glucose uptake mainly by affecting which transporter/process?

  • Decreasing GLUT2 in the liver
  • Increasing GLUT4 expression and translocation in adipose and muscle
  • Inhibiting SGLT2 in the kidneys
  • Blocking intestinal glucose transporters

Correct Answer: Increasing GLUT4 expression and translocation in adipose and muscle

Q23. Which hematological change can be observed with rosiglitazone therapy?

  • Polycythemia with increased hemoglobin
  • May cause anemia or decreased hemoglobin
  • Marked leukocytosis
  • Thrombocytopenia in all patients

Correct Answer: May cause anemia or decreased hemoglobin

Q24. A common starting adult dose regimen for rosiglitazone (where indicated) is:

  • 4 mg once daily
  • 50 mg once daily
  • 0.5 mg twice daily
  • Initiate with IV loading dose then oral maintenance

Correct Answer: 4 mg once daily

Q25. Co-administration of rifampicin is expected to have what effect on rosiglitazone plasma levels?

  • Increase levels by inhibiting CYP2C8
  • Decrease levels by inducing CYP enzymes
  • No effect on rosiglitazone metabolism
  • Cause immediate toxicity due to interaction

Correct Answer: Decrease levels by inducing CYP enzymes

Q26. Which clinical signs should be monitored to detect early fluid retention during rosiglitazone therapy?

  • Weight gain, peripheral edema, worsening dyspnea
  • Excessive sweating and tremor
  • Polyuria and polydipsia only
  • Visual disturbances and photophobia

Correct Answer: Weight gain, peripheral edema, worsening dyspnea

Q27. Rosiglitazone influences adipose tissue by:

  • Inhibiting adipocyte differentiation completely
  • Promoting adipocyte differentiation and redistributing fat to subcutaneous depots
  • Causing rapid lipolysis and fat loss
  • Directly destroying adipocytes

Correct Answer: Promoting adipocyte differentiation and redistributing fat to subcutaneous depots

Q28. Regulatory action historically taken for rosiglitazone included:

  • Unrestricted promotion as the safest antidiabetic drug
  • Warnings and restrictions due to cardiovascular safety concerns
  • Complete over-the-counter availability
  • Approval as first-line therapy for all diabetic patients

Correct Answer: Warnings and restrictions due to cardiovascular safety concerns

Q29. Which of the following drugs belongs to the same pharmacological class as rosiglitazone?

  • Metformin
  • Sitagliptin
  • Pioglitazone
  • Glibenclamide (glyburide)

Correct Answer: Pioglitazone

Q30. Which parameters are most appropriate to monitor to assess rosiglitazone efficacy in diabetes management?

  • Serum creatinine and potassium only
  • HbA1c and fasting plasma glucose
  • Liver biopsy results weekly
  • Daily ECG monitoring

Correct Answer: HbA1c and fasting plasma glucose

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