Tocainide hydrochloride MCQs With Answer

Tocainide hydrochloride MCQs With Answer is a focused review for B. Pharm students covering tocainide hydrochloride — an oral Class IB antiarrhythmic. This concise guide explores mechanism of action, pharmacokinetics, clinical uses in ventricular arrhythmias, adverse effects, monitoring parameters, drug interactions, dosage considerations, and safety in special populations. Key pharmacology terms such as sodium channel blockade, use‑dependence, hepatic metabolism, renal excretion, and hematologic toxicity are emphasized to build strong clinical and mechanistic understanding. The questions are designed to test application, not just recall, and will help prepare you for exams and practical pharmacy practice. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which antiarrhythmic class does tocainide hydrochloride belong to?

• Class IA
• Class IB
• Class IC
• Class III

Correct Answer: Class IB

Q2. The primary electrophysiological action of tocainide is:

• Beta‑adrenergic receptor blockade
• Potassium channel prolongation of action potential
• Blockade of fast sodium channels
• Calcium channel facilitation

Correct Answer: Blockade of fast sodium channels

Q3. Tocainide is most effective against which type of arrhythmia?

• Atrial fibrillation with rapid ventricular response
• Ventricular tachyarrhythmias
• Sinus bradycardia
• Supraventricular tachycardia due to AV nodal reentry

Correct Answer: Ventricular tachyarrhythmias

Q4. Compared with lidocaine, tocainide differs mainly by being:

• Intravenous only
• Orally active with longer duration
• More potent potassium channel blocker
• Less selective for cardiac tissue

Correct Answer: Orally active with longer duration

Q5. Tocainide hydrochloride is administered primarily by which route?

• Intravenous infusion
• Intramuscular injection
• Oral tablets
• Transdermal patch

Correct Answer: Oral tablets

Q6. A characteristic pharmacodynamic property of Class IB drugs like tocainide is:

• Marked prolongation of action potential duration
• Preferential block of ischemic or depolarized tissue
• Strong vagolytic activity
• High affinity for inactivated potassium channels

Correct Answer: Preferential block of ischemic or depolarized tissue

Q7. Which adverse effect is particularly important to monitor with tocainide therapy?

• Neutropenia and other hematologic abnormalities
• Significant hyperkalemia
• Severe hypothyroidism
• Ototoxicity

Correct Answer: Neutropenia and other hematologic abnormalities

Q8. Tocainide’s elimination is most influenced by which organ function?

• Pulmonary function
• Renal function
• Gastrointestinal motility
• Pancreatic exocrine function

Correct Answer: Renal function

Q9. Which monitoring is commonly recommended during chronic tocainide therapy?

• Weekly blood glucose tests
• Regular white blood cell counts
• Daily liver biopsy
• Monthly audiometry

Correct Answer: Regular white blood cell counts

Q10. Tocainide’s antiarrhythmic effect is described as “use‑dependent.” This means:

• It only works during physical exercise
• Block increases with higher heart rates or more frequent depolarizations
• Its action depends on kidney usage
• It must be taken with food for effect

Correct Answer: Block increases with higher heart rates or more frequent depolarizations

Q11. Which of the following is a common central nervous system adverse effect of tocainide?

• Visual hallucinations
• Dizziness and tremor
• Severe memory loss
• Insomnia only at night

Correct Answer: Dizziness and tremor

Q12. The hydrochloride salt form of tocainide primarily improves the drug’s:

• Cardiotoxicity profile
• Water solubility and oral absorption
• Ability to cross the blood‑brain barrier
• Binding to plasma proteins

Correct Answer: Water solubility and oral absorption

Q13. Co‑administration of tocainide with drugs that impair renal function may cause:

• Reduced antiarrhythmic efficacy due to faster clearance
• Increased plasma levels and risk of toxicity
• Complete inactivation by the kidneys
• No clinically relevant interaction

Correct Answer: Increased plasma levels and risk of toxicity

Q14. Structural and mechanistic similarity makes tocainide most comparable to which drug?

• Propranolol
• Lidocaine
• Amiodarone
• Verapamil

Correct Answer: Lidocaine

Q15. A potential serious cardiac risk with tocainide is:

• Excessive shortening of PR interval only
• Proarrhythmia and conduction disturbances
• Isolated increase in left ventricular ejection fraction
• Prevention of all ventricular arrhythmias

Correct Answer: Proarrhythmia and conduction disturbances

Q16. In patients with hepatic impairment, tocainide dosing considerations include:

• No change—hepatic function is irrelevant
• Potential dose reduction and careful monitoring
• Switching to an injectable form
• Administration only with antacids

Correct Answer: Potential dose reduction and careful monitoring

Q17. Tocainide’s onset and half‑life compared to intravenous lidocaine are generally:

• Faster onset and shorter half‑life
• Slower onset and longer half‑life when given orally
• Identical onset and half‑life
• Unpredictable and highly variable in all patients

Correct Answer: Slower onset and longer half‑life when given orally

Q18. Which patient population requires extra caution or dose adjustment with tocainide?

• Young adults with no comorbidities
• Patients with severe renal impairment
• Those receiving topical antifungal creams only
• Patients with well‑controlled asthma

Correct Answer: Patients with severe renal impairment

Q19. Which laboratory abnormality should prompt evaluation for tocainide toxicity?

• Elevated hemoglobin only
• Marked neutropenia or leukopenia
• Low serum amylase without symptoms
• Isolated hypercalcemia

Correct Answer: Marked neutropenia or leukopenia

Q20. A pharmacologic benefit of Class IB agents like tocainide is:

• Prolongation of QT interval to prevent arrhythmias
• Selective shortening of action potential in ventricular myocardium
• Strong vasoconstriction to raise blood pressure
• Direct beta‑agonist activity

Correct Answer: Selective shortening of action potential in ventricular myocardium

Q21. Which symptom would most likely indicate CNS toxicity from tocainide?

• Constipation
• Tremors and confusion
• Visual impairment only during exercise
• Localized skin hyperpigmentation

Correct Answer: Tremors and confusion

Q22. If a patient develops severe leukopenia on tocainide, the appropriate action is:

• Continue therapy and recheck in 6 months
• Immediately discontinue the drug and evaluate
• Double the dose to overcome tolerance
• Add an iron supplement

Correct Answer: Immediately discontinue the drug and evaluate

Q23. Drug interactions of concern with tocainide are most likely to involve:

• Agents that alter sodium channel expression only
• Drugs that affect renal clearance or increase plasma levels
• Topical corticosteroids
• Vitamin supplements with no metabolic effect

Correct Answer: Drugs that affect renal clearance or increase plasma levels

Q24. Which ECG parameter is important to assess before and during tocainide therapy?

• QT dispersion only
• QRS duration and ventricular conduction
• Left atrial volume index
• ST‑segment elevation in all leads

Correct Answer: QRS duration and ventricular conduction

Q25. In pregnancy, tocainide should be used:

• Routinely for any palpitations without risk assessment
• Only if potential benefit justifies potential fetal risk
• Always at double the usual dose
• Never—absolute contraindication in all cases

Correct Answer: Only if potential benefit justifies potential fetal risk

Q26. The mechanism underlying tocainide’s “use‑dependent” block is best explained by:

• Binding preferentially to resting sodium channels
• Binding to open or inactivated sodium channels during frequent depolarizations
• Activation of potassium currents at low heart rates
• Increasing extracellular calcium concentration

Correct Answer: Binding to open or inactivated sodium channels during frequent depolarizations

Q27. Which adverse effect would prompt immediate cardiac monitoring after initiating tocainide?

• Mild dry mouth
• New or worsening syncope or presyncope
• Transient taste change
• Occasional sneezing

Correct Answer: New or worsening syncope or presyncope

Q28. Tocainide’s distribution into tissues and potential CNS effects are influenced by:

• Plasma protein binding and lipid solubility
• Its inability to cross biological membranes
• Complete elimination prior to tissue uptake
• Exclusive binding to red blood cells

Correct Answer: Plasma protein binding and lipid solubility

Q29. Which statement about tocainide’s clinical use is most accurate?

• First‑line therapy for all supraventricular arrhythmias
• Used mainly for life‑threatening or symptomatic ventricular arrhythmias when appropriate
• Preferred agent for controlling chronic hypertension
• Typically used as a topical anesthetic

Correct Answer: Used mainly for life‑threatening or symptomatic ventricular arrhythmias when appropriate

Q30. For safe dispensing and counseling, a B. Pharm student should advise patients on tocainide to:

• Ignore any signs of infection and continue therapy
• Report signs of infection, dizziness, tremor, or palpitations promptly and attend monitoring visits
• Double doses if a dose is missed in the morning
• Stop all other medications without consulting a physician

Correct Answer: Report signs of infection, dizziness, tremor, or palpitations promptly and attend monitoring visits

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