A nurse is caring for a client who is currently 34-weeks gestation. Which of the following medications would be avoided due to its category X classification?
morphine
famotidine (Pepcid)
misoprostol (Cytotec)
ibuprofen (Advil)
The Correct Answer is C
A. Morphine is a category C medication, which means it may be used if the benefits outweigh the risks; it is not contraindicated in pregnancy.
B. Famotidine (Pepcid) is also a category B medication and is generally considered safe to use during pregnancy.
C. Misoprostol (Cytotec) is classified as category X due to its association with causing uterine contractions and the potential for fetal harm; thus, it should be avoided during pregnancy.
D. Ibuprofen (Advil) is a category C medication, and while it is not typically recommended in the third trimester, it is not classified as category X.
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Correct Answer is D
Explanation
A. Paroxetine is an SSRI antidepressant used for depression and anxiety disorders, not for Parkinson's Disease.
B. Lisinopril is an ACE inhibitor primarily used for hypertension and heart failure, and it does not address symptoms of Parkinson's Disease.
C. Risperidone is an atypical antipsychotic that may be used in some cases for behavioral symptoms but is not a primary treatment for Parkinson's Disease.
D. Levodopa (Inbrija) is a medication specifically indicated for the management of Parkinson's Disease, as it helps to replenish dopamine levels, alleviating motor symptoms associated with the disease.
Correct Answer is B
Explanation
A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.