Which organ is primarily responsible for excretion of a medication?

Choice A reason: This is correct. The liver is the main organ responsible for drug metabolism. The enzymes that the body uses to metabolize drugs are present throughout the body but are most abundant in the liver. The liver can transform drugs into more polar and water-soluble compounds, which can then be excreted by the kidneys or the biliary system.

Choice B reason: This is incorrect. The lungs are not primarily responsible for drug metabolism, although they can play a minor role in some cases. The lungs can metabolize some drugs that are inhaled, such as anesthetics, or drugs that circulate through the pulmonary blood vessels, such as propranolol. However, the lungs have a lower capacity and a lower variety of enzymes than the liver.

Choice C reason: This is incorrect. The heart is not responsible for drug metabolism, although it can be affected by it. The heart is the organ that pumps blood throughout the body, delivering oxygen and nutrients to the tissues and organs. The heart can be influenced by the pharmacokinetics and pharmacodynamics of drugs, which are the processes of drug absorption, distribution, metabolism, and excretion, and the effects of drugs on the body, respectively.

Choice D reason: This is incorrect. The kidney is not primarily responsible for drug metabolism, although it is important for drug excretion. The kidney is the organ that filters the blood and removes waste products and excess fluid as urine. The kidney can excrete drugs that are water-soluble or that are not reabsorbed by the tubules. The kidney can also metabolize some drugs, such as aspirin, but to a lesser extent than the liver.

Choice A reason: Past medical history of benign prostatic hyperplasia (BPH) is not a contraindication or a concern for administering Reglan, which is a medication that stimulates the motility of the upper gastrointestinal tract and treats nausea, heartburn, and gastroparesis¹. Reglan does not affect the prostate or urinary function.

Choice B reason: Blood pressure of 132/82 is slightly above the normal range of 120/80, but it is not a cause for concern or a reason to withhold Reglan. Reglan can lower the blood pressure by reducing the fluid volume and preventing sodium retention¹. The nurse should monitor the blood pressure regularly, but does not need to notify the health care provider about this finding.

Choice C reason: Allergy to corn is a concern for administering Reglan, as some formulations of Reglan may contain corn starch as an inactive ingredient. Corn starch can trigger an allergic reaction in people who are sensitive to corn, causing symptoms such as rash, itching, swelling, or anaphylaxis. The nurse should check the label of the Reglan product and avoid using it if it contains corn starch. The nurse should also notify the health care provider and the pharmacy about the patient's allergy and request an alternative medication or formulation.

Choice D reason: Past medical history of gout is not a contraindication or a concern for administering Reglan, which is a medication that stimulates the motility of the upper gastrointestinal tract and treats nausea, heartburn, and gastroparesis¹. Reglan does not affect the uric acid levels or the joints.