A nurse reads in a drug information guide that PO morphine has a high first-pass effect. Which of the following would the nurse expect?
The drug will be most effective when given orally.
The drug will be more effective when given in a non-enteral route.
The drug is excreted by the kidneys at a slower rate than most medications.
The kidney will metabolize some of the drug before it reaches the bloodstream.
The Correct Answer is B
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.
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Correct Answer is A
Explanation
A. Sodium intake is crucial for clients on lithium, as low sodium levels can lead to lithium toxicity; therefore, maintaining a normal sodium level is important.
B. While potassium is important for general health, it does not specifically impact lithium levels.
C. Vitamin C is beneficial for overall health but does not have a direct relationship with lithium therapy.
D. Vitamin K is related to blood clotting and does not have a significant interaction with lithium treatment or its efficacy.
Correct Answer is C
Explanation
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C. NSAIDs, like aspirin, can help reduce the flushing associated with niacin. This flushing occurs due to prostaglandin release, which NSAIDs can inhibit.
D. While fibric acid derivatives are used to lower cholesterol, they do not alleviate the flushing side effect of niacin.