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Hydroxychloroquine is typically administered intravenously for rapid absorption.
Answer: False
Hydroxychloroquine is typically administered orally in tablet form, not intravenously, and is characterized by rapid gastrointestinal absorption.
Hydroxychloroquine belongs to the antibiotic and antiviral drug families.
Answer: False
Hydroxychloroquine is classified within the antimalarial and 4-aminoquinoline drug families, not as an antibiotic or antiviral.
Hydroxychloroquine treats inflammatory conditions by directly stimulating the release of pro-inflammatory chemicals.
Answer: False
Hydroxychloroquine treats inflammatory conditions by blocking the effects of certain chemicals released in autoimmune diseases, thereby reducing inflammation and immune system overactivity, rather than stimulating pro-inflammatory chemicals.
Hydroxychloroquine is primarily eliminated through hepatic metabolism, not renal excretion.
Answer: False
Hydroxychloroquine is primarily eliminated by the kidneys, although it undergoes metabolism by Cytochrome P450 enzymes.
Hydroxychloroquine is known to induce CYP2D6 activity, leading to faster metabolism of other drugs.
Answer: False
Hydroxychloroquine is known to inhibit CYP2D6 activity, which can lead to altered metabolism and potentially increased levels of other drugs that are substrates for this enzyme.
Increasing lysosomal pH due to hydroxychloroquine leads to enhanced proteolysis by lysosomal acidic proteases.
Answer: False
The increase in lysosomal pH caused by hydroxychloroquine inhibits lysosomal acidic proteases, resulting in a diminished, rather than enhanced, proteolysis effect.
Hydroxychloroquine increases lysosomal pH solely through its action as a weak base and proton acceptor.
Answer: False
Hydroxychloroquine increases lysosomal pH not only as a weak base and proton acceptor but also by interfering with hemoglobin endocytosis and inhibiting lysosomal enzymes in susceptible parasites, leading to a more significant pH elevation.
Hydroxychloroquine is typically sold as a free base because it offers superior stability and absorption compared to its sulfate salt form.
Answer: False
Hydroxychloroquine is typically sold as its sulfate salt form, which offers improved stability, solubility, and absorption compared to the free base.
In which drug families is hydroxychloroquine classified?
Answer: Antimalarial and 4-aminoquinoline
Hydroxychloroquine is classified as an antimalarial and belongs to the 4-aminoquinoline family of medications.
What is the approximate Tmax for hydroxychloroquine?
Answer: Between 2 and 4.5 hours
The approximate time to reach maximum plasma concentration (Tmax) for hydroxychloroquine is typically between 2 and 4.5 hours.
Antimalarials like hydroxychloroquine are characterized as:
Answer: Lipophilic weak bases
Antimalarials such as hydroxychloroquine are characterized as lipophilic weak bases, enabling them to cross plasma membranes and accumulate in acidic cellular compartments.
In antigen-presenting cells, hydroxychloroquine's effect on lysosomal pH primarily limits the association of autoantigenic peptides with which molecules?
Answer: Class II MHC molecules
In antigen-presenting cells, hydroxychloroquine's elevation of lysosomal pH primarily limits the association of autoantigenic peptides with Class II MHC molecules, thereby affecting immune responses.
The accepted antimalarial mechanism of action for quinoline drugs like hydroxychloroquine involves the inhibition of:
Answer: Hemozoin biocrystallization
The accepted antimalarial mechanism of action for quinoline drugs such as hydroxychloroquine involves the inhibition of hemozoin biocrystallization, which leads to the accumulation of cytotoxic heme in malaria parasites.
Hydroxychloroquine inhibits the action of which protease, involved in SARS-CoV-2 S2 spike protein cleavage, but ultimately has little effect on viral entry due to the greater role of TMPRSS2?
Answer: Cathepsin L
Hydroxychloroquine inhibits cathepsin L, a protease involved in SARS-CoV-2 S2 spike protein cleavage; however, its overall impact on viral entry is limited due to the more significant role of TMPRSS2.
Hydroxychloroquine is primarily used to treat bacterial infections and is not indicated for autoimmune diseases.
Answer: False
Hydroxychloroquine is primarily indicated for autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis, and certain types of malaria, not bacterial infections.
Plaquenil, Hydroquin, and Quensyl are among the common brand names associated with hydroxychloroquine.
Answer: True
Plaquenil, Hydroquin, and Quensyl are indeed recognized brand names for hydroxychloroquine, alongside others like Axemal, Dolquine, and Quinoric.
Hydroxychloroquine is considered a first-line treatment for rheumatoid arthritis.
Answer: False
Hydroxychloroquine is considered a first-line treatment for systemic lupus erythematosus, not rheumatoid arthritis, although it is used for both conditions.
Clinical trials demonstrated hydroxychloroquine's effectiveness in preventing and treating COVID-19.
Answer: False
Clinical trials consistently demonstrated that hydroxychloroquine was ineffective for both preventing and treating COVID-19, and it was associated with potential dangerous side effects.
Hydroxychloroquine is widely used and effective in treating primary Sjögren syndrome.
Answer: False
Although hydroxychloroquine is widely used for primary Sjögren syndrome, current evidence suggests it does not appear to be effective for this condition.
Which of the following is NOT a primary medical use of hydroxychloroquine?
Answer: Treatment of acute bacterial pneumonia
Hydroxychloroquine is indicated for systemic lupus erythematosus, rheumatoid arthritis, and malaria. It is not used for the treatment of acute bacterial pneumonia.
For which condition is hydroxychloroquine considered a first-line treatment?
Answer: Systemic lupus erythematosus
Hydroxychloroquine is recognized as a first-line treatment for systemic lupus erythematosus.
What was the primary finding of clinical trials regarding hydroxychloroquine's effectiveness against COVID-19?
Answer: It was ineffective for preventing and treating COVID-19.
Clinical trials concluded that hydroxychloroquine was ineffective for both the prevention and treatment of COVID-19, and it carried a risk of dangerous side effects.
Hydroxychloroquine is prescribed for all of the following rheumatic disorders EXCEPT:
Answer: Fibromyalgia
Hydroxychloroquine is prescribed for systemic lupus erythematosus, rheumatoid arthritis, and porphyria cutanea tarda. Fibromyalgia is not listed as an indication.
Which of the following is a common brand name for hydroxychloroquine?
Answer: Plaquenil
Plaquenil is a widely recognized common brand name for hydroxychloroquine.
Retinopathy and irregular heart rate are classified as common and generally mild side effects of hydroxychloroquine.
Answer: False
Retinopathy and irregular heart rate are classified as severe side effects of hydroxychloroquine, not common and mild ones. Common side effects include vomiting, headache, and nausea.
Neuropsychiatric effects such as psychosis, paranoia, and suicidal thoughts have been reported as severe side effects of hydroxychloroquine.
Answer: True
Neuropsychiatric effects, including psychosis, paranoia, and suicidal thoughts, are indeed among the severe side effects reported with hydroxychloroquine use.
Hydroxychloroquine is contraindicated for rheumatic disease during pregnancy due to high risks to the fetus.
Answer: False
Hydroxychloroquine is not contraindicated for rheumatic disease during pregnancy; it remains a treatment option, although risks cannot be entirely excluded.
According to the US FDA drug label, hydroxychloroquine should not be prescribed to individuals with known hypersensitivity to 4-aminoquinoline compounds.
Answer: True
The US FDA drug label explicitly states that hydroxychloroquine is contraindicated for individuals with a known hypersensitivity to 4-aminoquinoline compounds.
The risk of macular toxicity from hydroxychloroquine primarily increases after only one year of use, regardless of daily dose.
Answer: False
The risk of macular toxicity from hydroxychloroquine typically increases after five years of use or with a high cumulative dose, and it is dependent on the daily dosage, not regardless of it.
The 'bull's eye' macular lesion is a characteristic sign of early-stage hydroxychloroquine retinopathy.
Answer: False
The 'bull's eye' macular lesion is a characteristic sign of advanced hydroxychloroquine retinopathy, not an early-stage indicator.
Hydroxychloroquine is known to improve existing cases of psoriasis.
Answer: False
Hydroxychloroquine is known to potentially worsen existing cases of psoriasis, rather than improve them.
The risk of hemolytic anemia in patients with glucose-6-phosphate dehydrogenase deficiency taking hydroxychloroquine is generally high, especially in individuals of African descent.
Answer: False
The risk of hemolytic anemia in patients with glucose-6-phosphate dehydrogenase deficiency taking hydroxychloroquine is considered low, particularly in individuals of African descent.
Which of these is listed as a common side effect of hydroxychloroquine?
Answer: Vomiting
Vomiting is listed among the common and generally mild side effects of hydroxychloroquine, whereas retinopathy, irregular heart rate, and psychosis are considered severe.
Which of the following is a severe neuropsychiatric effect reported with hydroxychloroquine use?
Answer: Psychosis
Psychosis is explicitly listed as one of the severe neuropsychiatric effects that have been reported with hydroxychloroquine use.
According to the US FDA drug label, a contraindication for hydroxychloroquine prescription is:
Answer: Known hypersensitivity to 4-aminoquinoline compounds
The US FDA drug label specifies that a known hypersensitivity to 4-aminoquinoline compounds is a contraindication for hydroxychloroquine prescription.
The most serious adverse effect of hydroxychloroquine on the eye, particularly with chronic use, is:
Answer: Retinopathy
Retinopathy, which involves damage to the retina, is considered the most serious adverse effect of hydroxychloroquine on the eye, particularly with chronic administration.
When should regular eye screening typically begin for patients taking hydroxychloroquine?
Answer: When risk factors like prolonged use or high cumulative dose are present
Regular eye screening for patients on hydroxychloroquine should typically commence when specific risk factors, such as prolonged use (over five years) or a high cumulative dose, become evident.
Which of the following is a potential adverse effect of prolonged hydroxychloroquine treatment for lupus or rheumatoid arthritis?
Answer: Cardiomyopathy
Cardiomyopathy is listed as a potential adverse effect of prolonged hydroxychloroquine treatment for conditions such as lupus or rheumatoid arthritis.
A narrow therapeutic index for hydroxychloroquine indicates a wide margin of safety between effective and toxic doses.
Answer: False
A narrow therapeutic index for hydroxychloroquine signifies a small margin between effective and toxic doses, requiring careful monitoring to prevent adverse effects.
Adults are generally more vulnerable to hydroxychloroquine adverse effects from overdoses than children.
Answer: False
Children are considered especially vulnerable to developing adverse effects from hydroxychloroquine overdoses, making them more susceptible than adults.
Hydroxychloroquine is estimated to be significantly more toxic than chloroquine in overdose situations.
Answer: False
Hydroxychloroquine is estimated to be two to threefold less toxic than chloroquine in overdose situations, not significantly more toxic.
A common electrolyte abnormality during a hydroxychloroquine overdose is high blood potassium levels.
Answer: False
During a hydroxychloroquine overdose, a common electrolyte abnormality is low blood potassium levels (hypokalemia), not high blood potassium.
In forensic investigations of acute overdosage fatalities, whole blood hydroxychloroquine levels are typically found to be below 5 mg/L.
Answer: False
In forensic investigations of acute overdosage fatalities, whole blood hydroxychloroquine levels are typically found to be in the range of 20-100 mg/L, significantly higher than 5 mg/L.
Combining hydroxychloroquine with cimetidine is generally safe and does not require caution due to potential interactions.
Answer: False
Caution is advised when combining hydroxychloroquine with cimetidine due to potential drug interactions, as cimetidine can alter liver function.
Antacids are known to significantly increase the absorption of hydroxychloroquine.
Answer: False
Antacids are known to decrease the absorption of hydroxychloroquine, which can potentially reduce its therapeutic effectiveness.
Hydroxychloroquine contributes to low blood sugar by increasing insulin clearance from the blood.
Answer: False
Hydroxychloroquine contributes to hypoglycemia by decreasing insulin clearance from the blood, increasing insulin sensitivity, and promoting insulin release, rather than increasing insulin clearance.
Since its introduction in the mid-1950s, how many known hydroxychloroquine overdoses have resulted in death?
Answer: Three
Since hydroxychloroquine's introduction in the mid-1950s, there have been eight known overdoses, with three resulting in fatalities.
Serious signs and symptoms of a hydroxychloroquine overdose typically manifest within what timeframe after ingestion?
Answer: Within an hour
Serious signs and symptoms of a hydroxychloroquine overdose typically manifest rapidly, generally within an hour of ingestion.
Which of the following is NOT considered an effective treatment for a hydroxychloroquine overdose?
Answer: Dialysis
While early mechanical ventilation, continuous heart monitoring, and activated charcoal are recommended treatments for hydroxychloroquine overdose, dialysis has not been found to be effective.
Concurrent use of hydroxychloroquine and azithromycin is associated with an increased risk of which cardiovascular issue?
Answer: Congestive heart failure
Concurrent use of hydroxychloroquine and azithromycin is associated with an increased risk of serious cardiovascular issues, including congestive heart failure, chest pain, and cardiovascular mortality.
Hydroxychloroquine's interaction with insulin and oral hypoglycemic agents primarily involves:
Answer: Enhancing their hypoglycemic effects
Hydroxychloroquine enhances the hypoglycemic effects of insulin and oral hypoglycemic agents, necessitating dose adjustments to prevent low blood sugar.
Which pair of drugs is known to antagonize the action of hydroxychloroquine?
Answer: Neostigmine and Pyridostigmine
Neostigmine and pyridostigmine are known to antagonize the action of hydroxychloroquine, meaning they can counteract its therapeutic effects.
According to the US FDA drug label, hydroxychloroquine can increase the plasma concentrations of which immunosuppressant drug?
Answer: Cyclosporin
The US FDA drug label indicates that hydroxychloroquine can increase the plasma concentrations of cyclosporin, an immunosuppressant drug.
Hydroxychloroquine was approved for medical use in the United States in 1955.
Answer: True
Hydroxychloroquine received approval for medical use in the United States in 1955.
Hydroxychloroquine is not included on the World Health Organization's List of Essential Medicines.
Answer: False
Hydroxychloroquine is included on the World Health Organization's List of Essential Medicines, which comprises medications considered vital for a basic health system.
In 2023, hydroxychloroquine was among the top 100 most commonly prescribed medications in the United States.
Answer: False
In 2023, hydroxychloroquine was ranked as the 131st most commonly prescribed medication in the United States, not among the top 100.
The speculative use of hydroxychloroquine for COVID-19 led to potential shortages for individuals with established medical indications.
Answer: True
The widespread speculative use of hydroxychloroquine for COVID-19 indeed created a risk of shortages for patients who relied on it for approved medical conditions like malaria and autoimmune diseases.
The first synthesis of hydroxychloroquine was disclosed in a patent filed by Bayer laboratories in 1934.
Answer: False
The first synthesis of hydroxychloroquine was disclosed in a patent filed by Sterling Drug in 1949, while chloroquine was discovered by Bayer laboratories in 1934.
The FDA revoked the emergency use authorization for hydroxychloroquine for COVID-19 because new data showed it was highly effective but had severe side effects.
Answer: False
The FDA revoked the emergency use authorization for hydroxychloroquine for COVID-19 because clinical trials demonstrated no clinical benefit and indicated potential risks, not because it was highly effective with severe side effects.
After the FDA revoked its EUA, no country continued to recommend hydroxychloroquine for COVID-19 treatment.
Answer: False
Despite the FDA's revocation of its Emergency Use Authorization, some countries, such as India in 2021, continued to recommend hydroxychloroquine for mild cases of COVID-19.
When was hydroxychloroquine approved for medical use in the United States?
Answer: 1955
Hydroxychloroquine received approval for medical use in the United States in 1955.
What is hydroxychloroquine's status on the World Health Organization's List of Essential Medicines?
Answer: It is included on the list.
Hydroxychloroquine is recognized by the World Health Organization as an essential medicine, signifying its importance in a basic health system.
Chloroquine, a precursor to hydroxychloroquine, was discovered in 1934 by:
Answer: Hans Andersag and his team at Bayer laboratories
Chloroquine, the precursor to hydroxychloroquine, was discovered in 1934 by Hans Andersag and his team working at Bayer laboratories.
A key step in the chemical synthesis of hydroxychloroquine involved reacting 4,7-dichloroquinoline with what other compound?
Answer: A primary amine
A key step in the chemical synthesis of hydroxychloroquine involved the reaction of 4,7-dichloroquinoline with a primary amine.
In April 2020, the US FDA cautioned against the use of hydroxychloroquine for COVID-19 outside of hospital settings or clinical trials primarily due to the risk of:
Answer: Serious heart rhythm problems
In April 2020, the US FDA cautioned against using hydroxychloroquine for COVID-19 outside of controlled settings, citing the primary risk of serious heart rhythm problems.
In Fall 2020, the National Institutes of Health recommended against the use of hydroxychloroquine for COVID-19, with the exception of its administration:
Answer: As part of a clinical trial
In Fall 2020, the National Institutes of Health recommended against hydroxychloroquine for COVID-19, permitting its use only within the context of a clinical trial.