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 C
Explanation
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B. Dairy does not interfere with metronidazole's absorption or effectiveness, so it is not a contraindication.
C. Alcohol should be strictly avoided during and for at least 48 hours after metronidazole treatment, as it can cause a severe reaction, including nausea, vomiting, flushing, and rapid heart rate.
D. Tyramine-based foods do not interact with metronidazole, so they are not a contraindication for this medication.
Correct Answer is D
Explanation
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B. Zidovudine is an antiretroviral medication used primarily for HIV treatment and does not target pinworms.
C. Ketoconazole is an antifungal medication that is not indicated for treating pinworm infections.
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