Nokea
Which drugs would be affected by the first-pass effect when administered?
- A. Morphine given by IV push injection
- B. Sublingual nitroglycerin tablet
- C. Diphenhydramine elixir
- D. Levotthroxine (Synthroid) tablet
- E. Transdermal nicotine patches
- F. Esomeparzole capsule
- G. Penicillin given by IV piggyback infusion
Correct Answer: C,D,F
Rationale: Orally administered drugs (elixirs, tablets, and capsules) undergo the first-pass effect, because they are metabolized in the liver after being absorbed into the portal circulation from the small intestine. IV medications (IV push and IV piggyback) enter the bloodstream directly and do not go directly to the liver. Sublingual tablets and transdermal patches also enter the bloodstream without going directly to the liver, thus avoiding the first-pass effect.
You may also like to solve these questions
The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?
- A. Absorption
- B. Distribution
- C. Metabolism
- D. Excretion
Correct Answer: D
Rationale: The kidneys are the organs that are most responsible for drug excretion. Renal function does not affect the absorption and distribution of a drug. Renal function may affect metabolism of drugs to a small extent.
The patient is stating that he has a headache and asks the nurse which over-the-counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest?
- A. A capsule
- B. A tablet
- C. A powder
- D. An enteric-coated tablet
Correct Answer: C
Rationale: Of the types of oral medications listed, the powder form would be absorbed the fastest, thus having a faster onset. The tablet, the capsule, and, finally, the enteric-coated tablet would be absorbed next, in that order.
When given an intravenous medication, the patient says to the nurse, -I usually take pills. Why does this medication have to be given in the arm? What is the nurse's best answer?
- A. The medication will cause fewer adverse effects when given intravenously.
- B. The intravenous medication will have delayed absorption into the body's tissues.
- C. The action of the medication will begin sooner when given intravenously.
- D. There is a lower chance of allergic reactions when drugs are given intravenously.
Correct Answer: C
Rationale: An intravenous (IV) injection provides the fastest route of absorption. The IV route does not affect the number of adverse effects, nor does it cause delayed tissue absorption (it results in faster absorption). The IV route does not affect the number of allergic reactions.
The nurse will be injecting a drug into the superficial skin layers immediately underneath the epidermal layer of skin. Which route does this describe?
- A. Intradermal
- B. Subcutaneous
- C. Intramuscular
- D. Transdermal
Correct Answer: A
Rationale: Injections under the more superficial skin layers immediately underneath the epidermal layer of skin and into the dermal layer are known as intradermal injections. Injections into the fatty subcutaneous tissue under the dermal layer of skin are referred to as subcutaneous injections. Injections into the muscle beneath the subcutaneous fatty tissue are referred to as intramuscular injections. Transdermal drugs are applied to the skin via an adhesive patch.
When administering drugs, the nurse remembers that the duration of action of a drug is defined as which of these?
- A. The time it takes for a drug to elicit a therapeutic response
- B. The amount of time needed to remove a drug from circulation
- C. The time it takes for a drug to achieve its maximum therapeutic response
- D. The time period at which a drug's concentration is sufficient to cause a therapeutic response
Correct Answer: D
Rationale: Duration of action is the time during which drug's concentration is sufficient to elicit a therapeutic response. The other options do not define duration of action. A drug's onset of action is the time it takes for the drug to elicit a therapeutic response. A drug's peak effect is the time it takes for the drug to reach its maximum therapeutic response. Elimination is the length of time it takes to remove a drug from circulation.