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
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B. Psyllium is a bulk-forming laxative that works by increasing the bulk of stool and does not typically lead to dependency.
C. Polyethylene glycol is an osmotic laxative that can be used daily without a significant risk of dependency, as it draws water into the bowel to facilitate stool passage.
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Correct Answer is B
Explanation
A. Folic acid does not specifically lower blood glucose; rather, it is primarily involved in DNA synthesis and cell division.
B. Folic acid is essential during pregnancy as it significantly reduces the risk of neural tube defects, such as spina bifida and anencephaly, in the developing fetus, making it a critical nutrient for pregnant women.
C. Folic acid does not prevent celiac disease; rather, celiac disease is an autoimmune disorder related to gluten intake.
D. While some studies suggest that folic acid may have a role in reducing the frequency of migraines, it is not a primary indication during pregnancy.