The nurse is preparing to administer medications to a 54-year old client. Which medications taken would be affected by the first-pass effect? (Select All that Apply.)
Nitroglycerin 10mg Sublingual Tablet
Morphine 2mg IV (Intravenously)
Famotidine 10mg Tablet
Nitroglycerin 4mg Sublingual Tablet
Acetaminophen 325mg Capsule
Diphenhydramine (Benadryl) 25mg Tablet
Correct Answer : C,E,F
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
A) Right to education: While educating patients about their medications is important, it is not one of the traditional Five Rights of Medication Administration. Education ensures that patients understand their treatment, potential side effects, and the importance of adherence, but it is not a core component of the Five Rights.
B) Right Dose: Ensuring the correct dose is administered is crucial to avoid underdosing or overdosing, which can lead to ineffective treatment or adverse effects. The right dose is determined based on factors such as the patient’s age, weight, and medical condition.
C) Right Drug: Administering the correct drug is essential to ensure the patient receives the intended therapeutic effect. This involves verifying the medication name, checking for potential drug interactions, and confirming the prescription details.
D) Right Patient: Verifying the patient’s identity before administering medication is critical to prevent medication errors. This typically involves checking the patient’s wristband, asking for their name and date of birth, and cross-referencing with the medication order.
E) Right Assessment: While assessing the patient before medication administration is important, it is not one of the traditional Five Rights. Assessment involves evaluating the patient’s condition, allergies, and potential contraindications to ensure safe medication administration.
F) Right Evaluation: Evaluating the patient’s response to medication is important for ongoing care, but it is not one of the traditional Five Rights. Evaluation helps determine the effectiveness of the medication and identify any adverse reactions or need for dosage adjustments.
Correct Answer is C
Explanation
A. Increase the duration of action of the medication:
A loading dose is not intended to increase the duration of action of a medication. Instead, it aims to rapidly achieve therapeutic levels in the bloodstream. The duration of action is primarily influenced by the drug's half-life and how it's metabolized and excreted, rather than the initial dose.
B. Decrease the frequency of subsequent doses:
The primary goal of a loading dose is to reach therapeutic levels quickly, not necessarily to alter the frequency of future doses. While a loading dose can help achieve therapeutic levels faster, the dosing schedule is determined by the drug's pharmacokinetics and the condition being treated.
C. Achieve therapeutic drug levels more rapidly:
The main purpose of a loading dose is to quickly achieve a concentration of the medication in the blood that is sufficient to be therapeutic. By giving a larger initial dose, the medication reaches effective levels faster compared to gradually reaching those levels with smaller, incremental doses.
D. Minimize the risk of adverse effects:
Minimizing adverse effects is not the primary aim of a loading dose. While achieving therapeutic levels quickly may indirectly help in reducing symptoms and improving outcomes, the main purpose of a loading dose is to reach effective drug levels promptly, not specifically to reduce adverse effects.
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