The patient is taking low-dose aspirin daily for his heart. The nurse knows only a portion of the medication taken actually reaches the tissue due to what process?

Distribution

First-pass effect

Reduced absorption

Gastrointestinal circulation

Answer and Explanation

The Correct Answer is B

A. Distribution refers to the movement of the drug from the bloodstream into tissues and organs, but it does not explain why only a portion of the medication reaches the tissues.

B. The first-pass effect occurs when an orally administered drug is metabolized by the liver before reaching systemic circulation. Aspirin, when taken orally, undergoes significant metabolism in the liver, reducing the amount of active drug available to exert its therapeutic effect. This explains why only a portion of the drug reaches the tissues.

C. Reduced absorption can limit drug availability, but aspirin is generally well absorbed in the gastrointestinal tract. The primary reason for reduced drug availability in this case is metabolism by the liver, not poor absorption.

D. Gastrointestinal circulation involves the enterohepatic recycling of some drugs, but it does not explain why only a portion of aspirin reaches systemic circulation. The first-pass effect is the primary factor.

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Correct Answer is C

Explanation

A. Capsules generally take longer to dissolve than liquid suspensions and thus do not provide the fastest onset of action.

B. Enteric-coated pills are designed to dissolve in the small intestine rather than the stomach, which can delay the onset of action. They are typically used to protect the drug from stomach acid or to prevent stomach irritation, not for rapid action.

C. Liquid suspensions are absorbed more quickly than solid forms of medication because they do not need to dissolve first, allowing for faster onset of action.

D. Tablets take longer to dissolve than liquid forms and may not provide as rapid an effect as a liquid suspension.

A. Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women. B. Adequate studies in pregnant women have demonstrated there is no risk to the fetus. C. There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks. D. Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant women.

Correct Answer is A

Explanation

a) Pregnancy Category B drugs are those for which animal studies have not shown harm to the fetus, but there are no well-controlled studies in pregnant women. This means that while the drug appears to be safe in animal models, its effects on human pregnancy remain uncertain.

b) This statement describes Pregnancy Category A, where adequate human studies have shown no risk to the fetus.

c) This statement describes Pregnancy Category D, where there is clear evidence of human fetal risk, but benefits may outweigh risks in certain situations.

d) This statement describes Pregnancy Category C, where animal studies have shown adverse effects, but there are no adequate human studies, and the drug may still be used if the benefits outweigh the risks.

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