Two nurses are discussing drugs that are affected by the first-pass effect. The nurses understand that a prime example of a drug affected by the first-pass effect is _____ given _____
a. morphine; intravenously
b. nitroglycerin; sublingually
c. insulin; sublingually
d. nitroglycerin; orally
D
Nitroglycerin given orally is subject to the first-pass effect because most of it is destroyed by the liver; therefore, this medication should not be given orally.
An intravenous medication cannot be subject to the first-pass effect.
Nitroglycerin given sublingually is not subject to the first-pass effect, therefore the most effective route for administration of nitroglycerin is the sublingual route.
A drug given sublingually is not subject to the first-pass effect.
DIF: Cognitive Level: Application REF: p. 39
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies
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