Complete the following sentence using the options in the drop down selection.  _____ Is what the body does with the drug versus ____  which is what the drug does to the body.

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.

A. Encourage elderly clients to keep a list of all medications, including dose and frequency, with them at all times:
Maintaining an accurate list of all medications, including doses and frequencies, helps prevent polypharmacy by ensuring that healthcare providers have a complete picture of what the patient is taking. This list can be critical in preventing drug interactions, avoiding duplicate therapies, and ensuring that the patient does not inadvertently take conflicting medications. It also aids in coordinating care among multiple providers.

B. Provide only written instructions for medications to elderly clients:
While written instructions are helpful, relying solely on them may not be sufficient. Elderly clients may have difficulty reading or understanding written instructions due to various factors like visual impairments or cognitive decline. A comprehensive approach, including verbal instructions and opportunities for clarification, is often more effective.

C. Encourage patients to use multiple pharmacies for convenience:
Using multiple pharmacies can increase the risk of polypharmacy because it may lead to a lack of coordination and awareness of all the medications the patient is taking. A single pharmacy or a centralized medication management system is generally more effective in tracking and managing medications to avoid interactions and duplications.
D. Teach elderly clients to have a spouse or family member be responsible for all of their medications:
While involving family members in medication management can be beneficial, it is not a strategy to prevent polypharmacy. The primary responsibility for managing medications should lie with the patient, in collaboration with healthcare providers, to ensure accuracy and understanding. Family members can assist, but they should not replace the need for personal medication management and monitoring.