Tezosentan MCQs With Answer

Tezosentan MCQs With Answer

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Tezosentan MCQs With Answer introduces B.Pharm students to tezosentan — a non‑peptide, non‑selective endothelin receptor antagonist (ETA/ETB) studied for acute heart failure and pulmonary hypertension. This concise, keyword‑rich overview covers mechanism of action, pharmacology, hemodynamic effects, clinical trial outcomes, adverse effects (hypotension, liver enzyme changes), monitoring, and drug interaction considerations relevant to pharmacy practice. Questions emphasize practical pharmacotherapeutics, mechanism‑based reasoning, safety monitoring, and clinical implications, helping students understand both molecular action and patient care issues. Now let’s test your knowledge with 30 MCQs on this topic.

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

  • Selective ETA receptor agonist
  • Non‑selective endothelin A and B (ETA/ETB) receptor antagonist
  • Angiotensin‑converting enzyme inhibitor
  • Calcium channel blocker

Correct Answer: Non‑selective endothelin A and B (ETA/ETB) receptor antagonist

Q2. What is the usual clinical route of administration for tezosentan in studies?

  • Oral tablet
  • Intravenous infusion
  • Subcutaneous injection
  • Inhalation aerosol

Correct Answer: Intravenous infusion

Q3. For which acute condition was tezosentan primarily developed and trialed?

  • Chronic stable angina
  • Acute decompensated heart failure
  • Type 2 diabetes mellitus
  • Chronic obstructive pulmonary disease

Correct Answer: Acute decompensated heart failure

Q4. ETA receptors are predominantly located on which cell type and mediate what effect?

  • Endothelial cells — vasodilation
  • Vascular smooth muscle cells — vasoconstriction and proliferation
  • Renal tubular cells — diuresis
  • Cardiac pacemaker cells — rate slowing

Correct Answer: Vascular smooth muscle cells — vasoconstriction and proliferation

Q5. What is a major physiological role of ETB receptors?

  • Primarily mediate vasoconstriction
  • Mediate endothelin‑1 clearance and stimulate nitric oxide‑dependent vasodilation
  • Act as ion channels for calcium influx
  • Stimulate renin release directly

Correct Answer: Mediate endothelin‑1 clearance and stimulate nitric oxide‑dependent vasodilation

Q6. Hemodynamic effect expected after tezosentan infusion in pulmonary vascular disease is:

  • Increased pulmonary vascular resistance
  • No change in vascular resistance
  • Reduced pulmonary vascular resistance and vasodilation
  • Increased systemic vascular resistance only

Correct Answer: Reduced pulmonary vascular resistance and vasodilation

Q7. Which adverse effect is most commonly associated with potent systemic vasodilation from tezosentan?

  • Hypertension
  • Hyperglycaemia
  • Hypotension
  • Bradycardia

Correct Answer: Hypotension

Q8. Due to class effects seen with endothelin receptor antagonists, which laboratory parameter should be routinely monitored?

  • Serum creatinine only
  • Liver function tests (transaminases)
  • Fasting blood glucose
  • Thyroid function tests

Correct Answer: Liver function tests (transaminases)

Q9. Which statement regarding pregnancy and tezosentan is correct?

  • Safe in pregnancy at low doses
  • Contraindicated in pregnancy due to teratogenic risk of endothelin antagonists
  • Recommended to treat preeclampsia
  • No data exists but routinely used in pregnancy

Correct Answer: Contraindicated in pregnancy due to teratogenic risk of endothelin antagonists

Q10. Chemically, tezosentan is best described as:

  • A peptide endothelin analog
  • A non‑peptide small‑molecule endothelin receptor antagonist
  • A monoclonal antibody against endothelin‑1
  • A prostaglandin analog

Correct Answer: A non‑peptide small‑molecule endothelin receptor antagonist

Q11. What was the general outcome of large clinical trials of tezosentan in acute heart failure?

  • Clear mortality benefit and widespread approval
  • No significant improvement in mortality and limited clinical benefit
  • Complete cure of heart failure symptoms in most patients
  • Worsened outcomes in all trials

Correct Answer: No significant improvement in mortality and limited clinical benefit

Q12. Which drug interaction concern is most relevant when tezosentan is co‑administered with other cardiovascular agents?

  • Reduced anticoagulant effect of warfarin
  • Potentiation of hypotensive effects with other vasodilators
  • Severe hyperkalemia with ACE inhibitors
  • Marked bradycardia with beta‑agonists

Correct Answer: Potentiation of hypotensive effects with other vasodilators

Q13. Compared with oral endothelin antagonists used chronically, IV tezosentan provides which pharmacokinetic advantage in acute care?

  • Predictable rapid onset of action
  • Increased first‑pass effect
  • Long half‑life for once‑weekly dosing
  • No need for monitoring

Correct Answer: Predictable rapid onset of action

Q14. The primary route of clearance for tezosentan is most consistent with:

  • Renal excretion of unchanged drug
  • Hepatic metabolism and biliary elimination
  • Lung exhalation as unchanged drug
  • Major fecal elimination of unchanged drug without metabolism

Correct Answer: Hepatic metabolism and biliary elimination

Q15. Tezosentan’s receptor selectivity is best described as:

  • Highly selective ETA antagonist only
  • Highly selective ETB antagonist only
  • Non‑selective blockade of both ETA and ETB receptors
  • Neither ETA nor ETB—acts on angiotensin receptors

Correct Answer: Non‑selective blockade of both ETA and ETB receptors

Q16. Which of the following clinical uses was tezosentan investigated for besides acute heart failure?

  • Pulmonary arterial hypertension (investigational)
  • Type 1 diabetes mellitus management
  • Antiplatelet therapy post‑MI
  • Chronic kidney stone prevention

Correct Answer: Pulmonary arterial hypertension (investigational)

Q17. Blocking endothelin receptors with tezosentan can reduce which pathological processes in vascular disease?

  • Vascular smooth muscle proliferation and fibrosis
  • Insulin resistance directly
  • Platelet aggregation only
  • Autoimmune antibody production

Correct Answer: Vascular smooth muscle proliferation and fibrosis

Q18. Preventing endothelin‑1 binding to its receptors primarily reduces which immediate cellular event?

  • cAMP accumulation in hepatocytes
  • Smooth muscle contraction via decreased intracellular calcium
  • Activation of beta‑adrenergic receptors
  • Glucose uptake in adipocytes

Correct Answer: Smooth muscle contraction via decreased intracellular calcium

Q19. The typical clinical formulation used in acute settings for tezosentan is:

  • Oral extended‑release capsule
  • Intravenous solution for infusion
  • Topical cream
  • Dry powder inhaler

Correct Answer: Intravenous solution for infusion

Q20. In which patient scenario would tezosentan be relatively contraindicated?

  • Well‑controlled hypertension on monotherapy
  • Pregnant patient due to teratogenic risk
  • Stable chronic osteoarthritis
  • Mild seasonal allergies

Correct Answer: Pregnant patient due to teratogenic risk

Q21. Which clinical parameter would best indicate a haemodynamic response to tezosentan in pulmonary hypertension?

  • Increase in fasting glucose
  • Decrease in pulmonary artery pressure measured by right heart catheterization
  • Reduction in serum sodium
  • Increase in LDL cholesterol

Correct Answer: Decrease in pulmonary artery pressure measured by right heart catheterization

Q22. Tezosentan belongs to the same pharmacologic class as which of the following approved drugs?

  • Amlodipine
  • Bosentan
  • Metoprolol
  • Enalapril

Correct Answer: Bosentan

Q23. An expected effect of tezosentan on cardiac output in suitable patients is:

  • Reduction of cardiac output due to increased afterload
  • No change in cardiac output under any circumstances
  • Potential increase in cardiac output due to reduced afterload
  • Complete cessation of cardiac contractility

Correct Answer: Potential increase in cardiac output due to reduced afterload

Q24. Which adverse event has been observed with endothelin receptor antagonists and may require clinical monitoring?

  • Peripheral edema and fluid retention
  • Marked hypoglycemia
  • Pulmonary fibrosis within hours
  • Severe hyperthermia

Correct Answer: Peripheral edema and fluid retention

Q25. Which receptor subtype is most associated with pro‑proliferative and vasoconstrictive responses targeted by tezosentan?

  • ETB on endothelial cells
  • ETA on vascular smooth muscle cells
  • Beta‑1 adrenergic receptor
  • Muscarinic M2 receptor

Correct Answer: ETA on vascular smooth muscle cells

Q26. In an overdose situation of tezosentan, the primary immediate management concern would be:

  • Severe hypotension requiring vasopressor support
  • Acute hyperglycemia management
  • Immediate dialysis due to renal clearance
  • Antidote administration of naloxone

Correct Answer: Severe hypotension requiring vasopressor support

Q27. Which patient test result change would most likely indicate a safety signal requiring drug discontinuation?

  • Mild transient headache
  • Marked elevation of hepatic transaminases
  • Minor increase in heart rate by 2 bpm
  • Slight change in taste perception

Correct Answer: Marked elevation of hepatic transaminases

Q28. For acute haemodynamic control, tezosentan dosing in trials was typically administered as:

  • Once‑daily oral tablet
  • Continuous or repeated intravenous infusion during the acute phase
  • Weekly intramuscular injection
  • Topical transdermal patch

Correct Answer: Continuous or repeated intravenous infusion during the acute phase

Q29. Which monitoring is most important when combining tezosentan with other agents that affect liver enzymes?

  • Daily hemoglobin checks
  • Frequent liver function tests and clinical assessment
  • Monthly bone density scans
  • 24‑hour urine protein measurement

Correct Answer: Frequent liver function tests and clinical assessment

Q30. Which statement best summarizes the clinical status of tezosentan?

  • Orally approved and widely used for chronic pulmonary hypertension
  • Used as an intravenous agent in acute settings and investigated in trials with limited mortality benefit
  • A first‑line oral antihypertensive for essential hypertension
  • A prodrug converted to bosentan in vivo

Correct Answer: Used as an intravenous agent in acute settings and investigated in trials with limited mortality benefit

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