Structure and uses of amphetamine MCQs With Answer

Introduction:

Amphetamine is a phenethylamine derivative with an alpha‑methyl group that enhances central nervous system stimulation, making it important in pharmacology and therapeutics. B.Pharm students should understand amphetamine structure, stereochemistry (d- vs l‑enantiomers), mechanism of action (monoamine release, DAT/NET interaction, VMAT2 effects), pharmacokinetics, therapeutic uses (ADHD, narcolepsy), adverse effects, interactions (MAO inhibitors), and regulatory status. This concise, keyword-rich overview prepares students for exam questions and clinical reasoning on amphetamine pharmacology, metabolism, formulations, toxicology, and monitoring. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which structural feature distinguishes amphetamine from its parent phenethylamine?

• An alpha‑methyl group on the carbon adjacent to the amine
• An extra hydroxyl group on the aromatic ring
• A carboxyl group replacing the amine
• A fused benzene ring system

Correct Answer: An alpha‑methyl group on the carbon adjacent to the amine

Q2. What is the primary effect of the alpha‑methyl substitution on amphetamine?

• Increases susceptibility to peripheral deamination
• Reduces central nervous system penetration
• Increases resistance to monoamine oxidase and prolongs action
• Makes the compound acidic

Correct Answer: Increases resistance to monoamine oxidase and prolongs action

Q3. Which description best characterizes amphetamine’s stereochemistry relevant to clinical effects?

• The dextro (d) enantiomer has greater central stimulant activity than the levo (l) enantiomer
• The levo (l) enantiomer is exclusively responsible for therapeutic effects
• Both enantiomers are pharmacologically inactive until metabolized
• Stereochemistry does not affect pharmacodynamic properties

Correct Answer: The dextro (d) enantiomer has greater central stimulant activity than the levo (l) enantiomer

Q4. Which molecular target is directly involved when amphetamine causes increased synaptic dopamine?

• Dopamine transporter (DAT) reversal and vesicular monoamine transporter 2 (VMAT2) inhibition
• Direct agonism at D2 receptors
• Irreversible blockade of monoamine oxidase A
• Selective inhibition of acetylcholinesterase

Correct Answer: Dopamine transporter (DAT) reversal and vesicular monoamine transporter 2 (VMAT2) inhibition

Q5. Which statement best explains amphetamine’s mechanism for increasing extracellular norepinephrine?

• Amphetamine facilitates reverse transport through the norepinephrine transporter (NET) and releases vesicular stores
• Amphetamine is a direct NET agonist
• Amphetamine blocks NET irreversibly
• Amphetamine increases synthesis of norepinephrine by upregulating tyrosine hydroxylase transcription

Correct Answer: Amphetamine facilitates reverse transport through the norepinephrine transporter (NET) and releases vesicular stores

Q6. Which pharmacokinetic property explains amphetamine’s good oral bioavailability and CNS effects?

• It is a weak base with sufficient lipophilicity to cross the blood‑brain barrier
• It is a strong acid that concentrates in the stomach
• It is protein bound to albumin >99%
• It is a large polar peptide

Correct Answer: It is a weak base with sufficient lipophilicity to cross the blood‑brain barrier

Q7. Which metabolic pathways are primarily involved in amphetamine biotransformation?

• Hepatic metabolism including CYP2D6‑mediated reactions and monoamine oxidase deamination
• Complete renal excretion unchanged within minutes
• Conjugation exclusively by UDP‑glucuronosyltransferase
• Oxidation by alcohol dehydrogenase producing ethanol

Correct Answer: Hepatic metabolism including CYP2D6‑mediated reactions and monoamine oxidase deamination

Q8. Which statement about amphetamine enantiomers used in pharmaceuticals is correct?

• Prescription formulations often contain mixtures of d‑ and l‑amphetamine salts to balance effects
• Only the l‑enantiomer is used clinically due to fewer central effects
• The racemate is inactive and not used in therapy
• Enantiomeric composition has no effect on side‑effect profile

Correct Answer: Prescription formulations often contain mixtures of d‑ and l‑amphetamine salts to balance effects

Q9. Which clinical indication is a primary therapeutic use of amphetamine in modern medicine?

• Attention deficit hyperactivity disorder (ADHD)
• Generalized anxiety disorder as first‑line therapy
• Chronic bacterial infections
• Type 2 diabetes mellitus

Correct Answer: Attention deficit hyperactivity disorder (ADHD)

Q10. Which sleep disorder is amphetamine or related stimulants commonly prescribed to treat?

• Narcolepsy
• Insomnia due to sleep onset delay
• Obstructive sleep apnea
• Restless legs syndrome

Correct Answer: Narcolepsy

Q11. What cardiovascular adverse effect is most associated with amphetamine use?

• Elevated blood pressure and tachycardia
• Bradycardia and hypotension
• Complete heart block exclusively
• Cardiac glycoside toxicity

Correct Answer: Elevated blood pressure and tachycardia

Q12. Which psychiatric adverse effect can occur with high doses or prolonged amphetamine use?

• Amphetamine‑induced psychosis resembling paranoia and hallucinations
• Immediate permanent dementia after a single dose
• Selective memory improvement without side effects
• Complete abolition of anxiety disorders

Correct Answer: Amphetamine‑induced psychosis resembling paranoia and hallucinations

Q13. Why are amphetamines contraindicated with monoamine oxidase inhibitors (MAOIs)?

• Risk of severe hypertensive crisis due to excessive monoamine accumulation
• MAOIs prevent absorption of amphetamine in the gut
• The combination causes profound hypoglycemia only
• MAOIs convert amphetamine into inactive metabolites

Correct Answer: Risk of severe hypertensive crisis due to excessive monoamine accumulation

Q14. Which laboratory method is commonly used to confirm amphetamine exposure after a positive urine screen?

• Gas chromatography‑mass spectrometry (GC‑MS) confirmation
• Random blood glucose measurement
• Complete blood count (CBC)
• Urine culture

Correct Answer: Gas chromatography‑mass spectrometry (GC‑MS) confirmation

Q15. Which pharmacodynamic action differentiates amphetamine from methylphenidate?

• Amphetamine causes reverse transport and release of monoamines, whereas methylphenidate primarily blocks reuptake
• Methylphenidate irreversibly inhibits VMAT2 and amphetamine does not
• Amphetamine acts only peripherally, methylphenidate acts centrally
• There is no functional difference between the two

Correct Answer: Amphetamine causes reverse transport and release of monoamines, whereas methylphenidate primarily blocks reuptake

Q16. Which formulation term refers to commonly prescribed mixtures of amphetamine salts?

• Mixed amphetamine salts (e.g., Adderall)
• Extended‑release loratadine salts
• Immediate aspirin salts
• Beta‑adrenergic mixed salts

Correct Answer: Mixed amphetamine salts (e.g., Adderall)

Q17. How does urinary pH influence amphetamine excretion?

• Acidic urine increases renal excretion by increasing ionized drug fraction
• Urinary pH has no effect on amphetamine excretion
• Alkaline urine greatly increases excretion due to protein binding
• Only fecal excretion is affected by urinary pH

Correct Answer: Acidic urine increases renal excretion by increasing ionized drug fraction

Q18. Which adverse metabolic effect is commonly observed with chronic amphetamine use?

• Appetite suppression and weight loss
• Hypercholesterolemia as the primary effect
• Marked hypokalemia independent of diet
• Increased bone density

Correct Answer: Appetite suppression and weight loss

Q19. Which receptor family is most directly implicated in amphetamine’s reinforcing and addictive potential?

• Dopaminergic pathways in the mesolimbic system
• GABA‑B receptors in the cerebellum
• Opioid mu receptors in the kidney
• Insulin receptors in adipose tissue

Correct Answer: Dopaminergic pathways in the mesolimbic system

Q20. Which clinical monitoring parameter is important when a patient is prescribed amphetamine?

• Blood pressure and heart rate monitoring
• Routine liver biopsy every month
• Daily INR measurement for anticoagulation
• EEG monitoring for all patients

Correct Answer: Blood pressure and heart rate monitoring

Q21. Which of the following best describes amphetamine’s effect on serotonin?

• Amphetamine can increase synaptic serotonin by promoting release and reverse transport, though effects vary by compound
• Amphetamine is a selective serotonin receptor antagonist only
• Amphetamine permanently depletes serotonin stores after a single dose
• Amphetamine has no interaction with serotonergic systems

Correct Answer: Amphetamine can increase synaptic serotonin by promoting release and reverse transport, though effects vary by compound

Q22. Which clinical condition is a relative contraindication to prescribing amphetamine?

• Uncontrolled hypertension
• Chronic uncomplicated osteoarthritis
• Mild seasonal allergic rhinitis
• Controlled hypothyroidism on replacement therapy

Correct Answer: Uncontrolled hypertension

Q23. Which statement about amphetamine tolerance and dependence is correct?

• Tolerance to some effects (e.g., appetite suppression) can develop; psychological dependence risk exists
• No tolerance or dependence is ever observed with amphetamine
• Physical dependence occurs after a single therapeutic dose
• Tolerance prevents any adverse cardiovascular effects

Correct Answer: Tolerance to some effects (e.g., appetite suppression) can develop; psychological dependence risk exists

Q24. In forensic toxicology, which specimen and test combination is standard for initial amphetamine screening?

• Urine immunoassay followed by confirmatory GC‑MS
• Hair microscopy without chemical testing
• Saliva culture for bacteria
• Complete blood count as the primary screen

Correct Answer: Urine immunoassay followed by confirmatory GC‑MS

Q25. Which neurotransmitter synthesis enzyme is indirectly affected by amphetamine’s activity?

• Tyrosine hydroxylase activity may be modulated by intracellular monoamine feedback
• Acetylcholinesterase is directly inhibited by amphetamine
• Amylase secretion is increased directly
• DNA polymerase activity is inhibited in neurons

Correct Answer: Tyrosine hydroxylase activity may be modulated by intracellular monoamine feedback

Q26. Which clinical sign suggests acute amphetamine intoxication rather than chronic use?

• Agitation, diaphoresis, dilated pupils, and hyperthermia
• Long‑term weight gain and bradycardia
• Chronic anemia and alopecia
• Persistent hypothermia and miosis

Correct Answer: Agitation, diaphoresis, dilated pupils, and hyperthermia

Q27. Which of the following is a common prescribed dextroamphetamine preparation?

• Dextroamphetamine sulfate
• L‑amphetamine chloride only
• Pure racemic adrenaline tablets
• Sublingual naloxone spray

Correct Answer: Dextroamphetamine sulfate

Q28. Which interaction is clinically significant when amphetamine is coadministered with antihypertensive agents?

• Amphetamine can reduce effectiveness of some antihypertensives by increasing sympathetic tone
• Amphetamine universally enhances antihypertensive efficacy without exception
• Amphetamine neutralizes diuretics chemically
• There are no known interactions with antihypertensives

Correct Answer: Amphetamine can reduce effectiveness of some antihypertensives by increasing sympathetic tone

Q29. Which clinical manifestation differentiates amphetamine withdrawal from intoxication?

• Withdrawal presents with fatigue, depression, and increased appetite
• Withdrawal is characterized by acute delirium and hyperthermia
• Withdrawal causes persistent hypertension and psychosis only
• Withdrawal manifests as immediate euphoria and agitation

Correct Answer: Withdrawal presents with fatigue, depression, and increased appetite

Q30. How does amphetamine affect attention and cognitive performance in ADHD at therapeutic doses?

• It enhances attention and executive function by modulating prefrontal catecholamine signaling
• It causes global cognitive decline in all patients
• It selectively impairs long‑term memory formation only
• It acts as a sedative to improve attention by reducing arousal

Correct Answer: It enhances attention and executive function by modulating prefrontal catecholamine signaling

Q31. Which adverse endocrine effect can be associated with chronic amphetamine therapy?

• Suppression of appetite leading to weight loss and possible growth retardation in children
• Marked insulin overproduction causing hyperinsulinemia
• Primary hypothyroidism in all patients
• Permanent pituitary failure after a single dose

Correct Answer: Suppression of appetite leading to weight loss and possible growth retardation in children

Q32. Which of the following best describes amphetamine’s legal classification in many countries such as the US?

• Controlled stimulant (e.g., Schedule II in the United States) due to abuse potential
• Available over the counter without restriction
• Uncontrolled supplement regulated as food
• Complete prohibition with no medical exceptions worldwide

Correct Answer: Controlled stimulant (e.g., Schedule II in the United States) due to abuse potential

Q33. Which clinical test finding is consistent with chronic heavy amphetamine use?

• Evidence of mucosal or dental problems and weight loss
• Marked hyperpigmentation of the skin due to melanin increase
• Severe hypercholesterolemia exclusively
• Elevated hemoglobin A1c in all users

Correct Answer: Evidence of mucosal or dental problems and weight loss

Q34. Which mechanism contributes to amphetamine‑induced increase in synaptic monoamines besides transporter reversal?

• Interference with vesicular storage by binding VMAT2 and promoting cytosolic release
• Direct enzymatic conversion of amino acids into monoamines extracellularly
• Stimulation of hepatic monoamine production
• Activation of nicotinic acetylcholine receptors to synthesize monoamines

Correct Answer: Interference with vesicular storage by binding VMAT2 and promoting cytosolic release

Q35. Which of the following is a recognized pediatric consideration when prescribing amphetamine?

• Monitor growth parameters routinely due to potential appetite suppression
• Amphetamine is contraindicated in all children under 18 without exception
• There is no need for monitoring beyond initial dose
• Use of amphetamine guarantees improved height outcomes

Correct Answer: Monitor growth parameters routinely due to potential appetite suppression

Q36. Which symptom cluster suggests amphetamine intoxication rather than opioid intoxication?

• Hyperactivity, dilated pupils, and insomnia
• Pinpoint pupils, respiratory depression, and lethargy
• Bradycardia, hypothermia, and miosis
• Skin flushing and cholinergic diarrhea

Correct Answer: Hyperactivity, dilated pupils, and insomnia

Q37. Which of the following best explains why amphetamine can cause both peripheral and central sympathomimetic effects?

• It increases release of norepinephrine in both peripheral sympathetic terminals and central neurons
• It selectively binds peripheral alpha‑2 receptors only
• It acts as a synthetic catecholamine restricted to the adrenal medulla
• It blocks all adrenergic receptors causing sympatholysis

Correct Answer: It increases release of norepinephrine in both peripheral sympathetic terminals and central neurons

Q38. Which drug interaction raises concern for serotonin syndrome when combined with amphetamine?

• Concurrent use of serotonergic antidepressants (e.g., SSRIs or SNRIs)
• Coadministration with topical antifungals with no CNS activity
• Use with oral contraceptives without serotonergic properties
• Combination with antacids only

Correct Answer: Concurrent use of serotonergic antidepressants (e.g., SSRIs or SNRIs)

Q39. Which laboratory parameter most directly affects amphetamine renal clearance?

• Urine pH due to ion trapping of the weak base
• Serum sodium concentration only
• Plasma albumin levels exclusively
• Fasting blood glucose

Correct Answer: Urine pH due to ion trapping of the weak base

Q40. Which pharmacological strategy reduces abuse potential in extended‑release amphetamine formulations?

• Designing sustained‑release matrices that slow absorption and deter rapid release
• Making tablets taste sweet to encourage chewing
• Including easily extractable immediate‑release beads
• Using formulations that increase peak plasma levels quickly

Correct Answer: Designing sustained‑release matrices that slow absorption and deter rapid release

Q41. Which toxic cardiovascular event is a potential risk with amphetamine overdose?

• Acute myocardial ischemia or stroke due to vasospasm and hypertension
• Essential aortic stenosis caused by a single dose
• Instantaneous aneurysm formation in the pulmonary artery
• Complete reversal of coronary artery disease

Correct Answer: Acute myocardial ischemia or stroke due to vasospasm and hypertension

Q42. Which adverse dermatologic sign can be associated with chronic stimulant abuse including amphetamine?

• Excoriations, ulcerations, and hyperpigmented scarring from chronic picking
• Rapid regrowth of nails and hair strengthening
• Uniform tanning without skin damage
• Total loss of epidermal cells in all exposed areas

Correct Answer: Excoriations, ulcerations, and hyperpigmented scarring from chronic picking

Q43. Which statement about amphetamine use during pregnancy is most appropriate for counseling?

• Amphetamine use in pregnancy is associated with potential risks and requires specialist consultation and risk‑benefit assessment
• Amphetamine is completely safe and recommended for all pregnant patients
• Amphetamine causes immediate teratogenesis in every case and must never be discussed
• There is no need to alter treatment or perform monitoring during pregnancy

Correct Answer: Amphetamine use in pregnancy is associated with potential risks and requires specialist consultation and risk‑benefit assessment

Q44. Which property distinguishes amphetamine from amphetamine‑like designer drugs in forensic analysis?

• Specific mass spectral fragmentation patterns and retention times identified by GC‑MS or LC‑MS/MS
• Designer drugs are always identical and cannot be distinguished analytically
• Amphetamine cannot be detected by any laboratory method
• Designer drugs never affect analytical assays

Correct Answer: Specific mass spectral fragmentation patterns and retention times identified by GC‑MS or LC‑MS/MS

Q45. Which counseling point is important when initiating amphetamine therapy for ADHD in adolescents?

• Monitor sleep, appetite, growth, and cardiovascular signs regularly
• No follow-up is necessary after the first prescription
• The medication should be stopped abruptly without tapering when needed
• There is no need to inform school or caregivers about treatment

Correct Answer: Monitor sleep, appetite, growth, and cardiovascular signs regularly

Q46. Which of the following best describes amphetamine’s effect on the peripheral nervous system?

• Enhanced sympathetic neurotransmission resulting in vasoconstriction and increased heart rate
• Complete parasympathetic dominance producing bradycardia and salivation
• Direct blockade of peripheral nicotinic receptors leading to paralysis
• Specific inhibition of skeletal muscle contraction only

Correct Answer: Enhanced sympathetic neurotransmission resulting in vasoconstriction and increased heart rate

Q47. Which clinical scenario would raise concern for misuse of prescribed amphetamine?

• Frequent requests for early refills, escalating doses, and doctor shopping behaviors
• Regular attendance at scheduled follow‑up visits and stable dosing
• Improved academic performance and stable weight
• Careful storage and adherence to prescribed instructions

Correct Answer: Frequent requests for early refills, escalating doses, and doctor shopping behaviors

Q48. Which factor can alter plasma concentrations and effects of amphetamine in an individual patient?

• Genetic variability in CYP2D6 metabolism and renal pH variations
• Use of topical hydrating creams only
• Seasonal changes in ambient temperature exclusively
• Presence of non‑active dietary fiber without other changes

Correct Answer: Genetic variability in CYP2D6 metabolism and renal pH variations

Q49. Which concept is important when differentiating therapeutic versus recreational amphetamine exposure?

• Dose, route of administration, formulation, and pattern of use determine risk and effects
• All exposures are identical regardless of dose or route
• Only the color of the tablet determines safety
• Therapeutic exposure always causes severe addiction within hours

Correct Answer: Dose, route of administration, formulation, and pattern of use determine risk and effects

Q50. Which of the following best summarizes safe academic practice for B.Pharm students studying amphetamine pharmacology?

• Focus on molecular structure, mechanism, therapeutic uses, adverse effects, interactions, and legal/monitoring considerations without providing synthesis or misuse instructions
• Prioritize teaching methods to synthesize amphetamine at home
• Encourage unregulated distribution to peers as a study method
• Ignore regulatory status and adverse effects during study

Correct Answer: Focus on molecular structure, mechanism, therapeutic uses, adverse effects, interactions, and legal/monitoring considerations without providing synthesis or misuse instructions

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