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. Estrogen blockers can increase the risk of thromboembolic events, including deep vein thrombosis and pulmonary embolism, which the nurse should caution the client about.
B. Tendon rupture is more commonly associated with certain antibiotics and corticosteroids, not typically with estrogen blockers.
C. Photosensitivity is not a common side effect associated with estrogen blockers; it is more related to specific antibiotics or other medications.
D. While some malignancies can be linked to immunosuppressive therapies, the direct risk of lymphomas is not typically associated with estrogen blockers.
Correct Answer is C
Explanation
A. Phenazopyridine does not typically cause an increase in blood pressure; this effect is not associated with the medication.
B. While gastrointestinal upset can occur, vomiting is not a primary or expected side effect of phenazopyridine.
C. A well-known side effect of phenazopyridine is orange or reddish urine, which results from the drug's dye properties.
D. Dizziness is not a common side effect; while it can occur, it is less specific to phenazopyridine compared to the characteristic orange urine.