Which of the following medications is considered a controlled substance classified as Schedule V when mixed with other antitussive medications?
Diphenhydramine (Benadryl).
Codeine (Co-Caf).
Benzonatate (Tessalon Perles).
Guaifenesin (Mucinex).
The Correct Answer is B
Choice A rationale
Diphenhydramine is an antihistamine used to relieve allergy symptoms.
Choice B rationale
Codeine is a narcotic pain reliever and cough suppressant classified as a Schedule V controlled substance when combined with other antitussive medications.
Choice C rationale
Benzonatate is a non-narcotic cough suppressant that numbs the throat and lungs.
Choice D rationale
Guaifenesin is an expectorant and not a controlled substance.
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Correct Answer is D
Explanation
Choice A rationale
Intravenous, intramuscular, and intradermal routes bypass the first-pass effect as they do not pass through the liver first.
Choice B rationale
Enteric-coated tablets and capsules are designed to bypass the stomach and dissolve in the intestines, reducing the first-pass effect.
Choice C rationale
The first-pass effect involves the liver metabolizing and inactivating a portion of the medication on its first pass through the liver.
Choice D rationale
Enteral medications, which pass through the digestive system, may require higher doses due to the first-pass effect where the liver metabolizes the medication before it reaches systemic circulation. .
Correct Answer is A
Explanation
Choice A rationale
Prazosin, an alpha-blocker, is often started at the lowest dose and taken at night to minimize the risk of orthostatic hypotension, a sudden drop in blood pressure upon standing.
Choice B rationale
Starting prazosin at the highest dose is not recommended due to the risk of severe orthostatic hypotension, which can lead to dizziness and fainting.
Choice C rationale
It is important to monitor blood pressure with the first dose of prazosin to assess the patient's response and avoid significant drops in blood pressure.
Choice D rationale
Prazosin may take several weeks to achieve full therapeutic effect. It does not control hypertension within a week.
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