A client presents to the healthcare setting with a diagnosis of chronic liver failure. The nurse understands this will affect which step of pharmacokinetics?

Absorption

Excretion

Metabolism

Distribution

Answer and Explanation

The Correct Answer is C

A. Absorption:
Chronic liver failure primarily affects the metabolism of drugs rather than their absorption. While liver disease can impact various bodily functions, the absorption of medications is generally more influenced by gastrointestinal factors and not as directly affected by liver function.

B. Excretion:
Excretion of drugs is primarily managed by the kidneys, not the liver. While liver failure can lead to changes in drug metabolism, it does not directly impair the excretion process, which is largely renal. However, compromised liver function can indirectly affect renal excretion due to altered pharmacokinetics.

C. Metabolism:
Liver failure significantly affects drug metabolism. The liver is the primary site for the metabolism of many medications, converting drugs into more water-soluble compounds for excretion. In chronic liver failure, the liver's ability to metabolize drugs is impaired, leading to potential drug accumulation and increased risk of toxicity. This step of pharmacokinetics is most directly impacted by liver dysfunction.

D. Distribution:
While liver function can affect drug distribution to some extent, it is not as directly impacted as metabolism. Distribution can be influenced by factors such as changes in plasma protein levels and blood flow, but the liver's primary role in drug metabolism is more directly affected by chronic liver failure.

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Correct Answer is C

Explanation

A) Distribution, Excretion, Absorption, Metabolism: This order is incorrect because absorption should occur before distribution. The medication must first be absorbed into the bloodstream before it can be distributed throughout the body. Excretion and metabolism follow after distribution, not before.

B) Absorption, Excretion, Metabolism, Distribution: This sequence is incorrect because distribution occurs after absorption and before metabolism. Excretion is the final step and occurs after metabolism.

C) Absorption, Distribution, Metabolism, Excretion: This is the correct order. After oral administration, the medication is first absorbed into the bloodstream from the gastrointestinal tract. It is then distributed throughout the body. Following distribution, the medication undergoes metabolism (primarily in the liver) to be converted into more water-soluble forms for elimination. Finally, the medication is excreted from the body, typically through the kidneys

D) Absorption, Metabolism, Distribution, Excretion: This order is incorrect because metabolism occurs after distribution, not before. After absorption, the drug must be distributed to various tissues before it is metabolized. Excretion is the final step following metabolism.

A. Nitroglycerin 10mg Sublingual Tablet B. Morphine 2mg IV (Intravenously) C. Famotidine 10mg Tablet D. Nitroglycerin 4mg Sublingual Tablet E. Acetaminophen 325mg Capsule F. Diphenhydramine (Benadryl) 25mg Tablet

Correct Answer is ["C","E","F"]

Explanation

A. Nitroglycerin 10mg Sublingual Tablet:
Nitroglycerin taken sublingually (under the tongue) bypasses the gastrointestinal tract and the liver’s first-pass metabolism. It is designed to act quickly and directly enter the bloodstream through the mucous membranes, avoiding significant first-pass effect.

B. Morphine 2mg IV (Intravenously):
Morphine administered intravenously bypasses the gastrointestinal tract and liver, thus avoiding the first-pass effect entirely. The drug directly enters systemic circulation, providing immediate effect.

C. Famotidine 10mg Tablet:
Famotidine, when taken orally, undergoes significant first-pass metabolism. This means that a portion of the drug is metabolized by the liver before it reaches systemic circulation, affecting its bioavailability.

D. Nitroglycerin 4mg Sublingual Tablet:
Similar to the 10mg sublingual tablet, nitroglycerin administered sublingually bypasses the first-pass effect. The medication enters the bloodstream directly through the mucous membranes in the mouth.

E. Acetaminophen 325mg Capsule:
Acetaminophen, when taken orally, undergoes first-pass metabolism. A significant portion of the drug is metabolized in the liver before reaching systemic circulation, which can impact its overall effectiveness.

F. Diphenhydramine (Benadryl) 25mg Tablet:
Diphenhydramine, taken orally, is also affected by the first-pass effect. As with other oral medications, a part of the drug is metabolized by the liver before reaching systemic circulation, which can affect its efficacy and bioavailability.

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A client presents to the healthcare setting with a diagnosis of chronic liver failure. The nurse understands this will affect which step of pharmacokinetics?

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Naxlex Comprehensive Predictor Exams

Select the correct order in which pharmacokinetics process occur when a medication is taken via the oral route.

Correct Answer is C

Explanation

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Correct Answer is ["C","E","F"]

Explanation

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