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. Nystatin is an antifungal medication used to treat oral candidiasis (thrush), which is consistent with the client's symptoms of soreness in the mouth and the presence of a white, milky plaque that does not rub off.
B. Amoxicillin is an antibiotic that treats bacterial infections but would not be effective against fungal infections like oral thrush.
C. Metronidazole is an antibiotic and antiprotozoal medication, which is not appropriate for treating oral candidiasis.
D. Acyclovir is an antiviral medication used to treat infections caused by certain viruses, such as herpes, and is not effective for fungal infections like thrush.
Correct Answer is ["B","D","F"]
Explanation
A. Dry mouth is not a cholinergic side effect; cholinergic effects typically increase secretions.
B. Diarrhea is a common cholinergic side effect due to increased gastrointestinal motility.
C. Decreased urination is not expected; cholinergic agents may increase urination.
D. Excessive lacrimation (tearing) is a common cholinergic effect, as these agents stimulate glandular secretions.
E. Tachycardia is not a cholinergic side effect; bradycardia is more likely due to cholinergic effects.
F. Excessive sweating is a cholinergic effect due to increased glandular activity.