Because of the first-pass effect, clients may require:
1. a larger dose of oral medication than of intravenous medication.
2. a smaller dose of oral medication than of rectal medication.
3. a smaller dose of oral medication than of intravenous medication.
4. the same oral and intravenous dosage of a medication.
Correct Answer: 1
Rationale 1: In order for medication to be available, it must first pass through the liver, where it is broken down into active and inactive molecules. Medications given by the oral route are subject to this first-pass effect; thus, oral doses must be larger than parenteral doses of the same medication.
Rationale 2: Oral and rectal dosages are typically the same.
Rationale 3: The oral dose would not typically be smaller than the intravenous dose.
Rationale 4: The oral and intravenous doses are not typically the same.
Global Rationale: In order for medication to be available, it must first pass through the liver, where it is broken down into active and inactive molecules. Medications given by the oral route are subject to this first-pass effect; thus, oral doses must be larger than parenteral doses of the same medication. Rectal medications doses are similarly affected, so doses would be the same. The oral dose would not typically be smaller than the intravenous dose. Although a drug will still eventually reach the liver by the IV route, it will have an opportunity to also reach its target tissue.
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