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 D
Explanation
A. Flumazenil is a benzodiazepine antagonist and is not indicated for anticholinergic overdose.
B. Atropine is an anticholinergic medication used to treat bradycardia and other conditions, but it would not be appropriate for treating an anticholinergic overdose, as it can worsen the symptoms.
C. Naloxone is an opioid antagonist and would not be effective in treating scopolamine overdose.
D. Physostigmine is a reversible cholinesterase inhibitor that can counteract the effects of anticholinergic agents, making it the appropriate choice for reversing scopolamine toxicity.
Correct Answer is ["A","B","E"]
Explanation
A. Decongestants are commonly used to relieve nasal congestion in upper respiratory tract infections by constricting blood vessels in the nasal passages.
B. Expectorants help thin mucus and are used in upper respiratory conditions to facilitate coughing up mucus.
C. H2 antagonists are primarily used to reduce stomach acid and are not indicated for upper respiratory conditions.
D. Short-acting beta agonists (SABAs) are primarily used in the management of lower respiratory tract conditions, such as asthma and COPD, rather than upper respiratory conditions.
E. H1 antagonists (antihistamines) are effective for treating allergic reactions and symptoms of upper respiratory infections, such as runny nose and sneezing.
F. Long-acting beta agonists (LABAs) are also used primarily for lower respiratory tract conditions and are not appropriate for treating upper respiratory issues.