Which phase of pharmacokinetics is affected by the first pass effect?
Excretion
Metabolism
Distribution
Absorption
The Correct Answer is D
Choice A: Excretion
Excretion is the process by which drugs and their metabolites are eliminated from the body, primarily through the kidneys (urine), but also via bile, sweat, saliva, and other routes. While excretion is a crucial phase of pharmacokinetics, it is not directly impacted by the first pass effect. The first pass effect primarily involves the metabolism of a drug before it reaches systemic circulation, which occurs prior to the excretion phase.
Choice B: Metabolism
The first pass effect, also known as first-pass metabolism or presystemic metabolism, significantly impacts the metabolism phase of pharmacokinetics. This phenomenon occurs when a drug is metabolized at a specific location in the body, such as the liver or gut wall, before it reaches systemic circulation. As a result, the concentration of the active drug is reduced, affecting its bioavailability. The liver is the primary site for this metabolic process, where enzymes break down the drug, potentially leading to a significant reduction in its therapeutic effect.
Choice C: Distribution
Distribution refers to the process by which a drug is transported from the bloodstream to various tissues and organs in the body. This phase is influenced by factors such as blood flow, tissue permeability, and binding to plasma proteins. However, the first pass effect does not directly alter the distribution phase. Instead, it affects the amount of drug that enters systemic circulation, which in turn can influence the extent of distribution.
Choice D: Absorption
Absorption is the process by which a drug enters the bloodstream from its site of administration. This phase is crucial for determining the onset of a drug’s action. While the first pass effect occurs after absorption, it does not directly change the absorption phase itself. Instead, it affects the drug’s concentration after it has been absorbed and before it reaches systemic circulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Disease treatment refers to the management and care of a patient to combat a disease or condition. This includes interventions aimed at curing the disease, alleviating symptoms, or preventing complications. While physical therapy can be part of disease treatment, in the context of a heart attack, it is more accurately described as a form of tertiary prevention.
Choice B Reason:
Tertiary prevention involves measures taken to reduce the impact of an ongoing illness or injury that has lasting effects. This includes rehabilitation and efforts to prevent further complications or deterioration. Physical therapy after a heart attack is a classic example of tertiary prevention, as it aims to improve the patient’s quality of life, enhance physical function, and prevent further cardiac events.
Choice C Reason:
Secondary prevention focuses on early detection and prompt intervention to prevent the progression of a disease. This includes screening tests and early treatment of conditions to halt or slow their progression. In the case of heart disease, secondary prevention might involve regular monitoring of blood pressure and cholesterol levels to detect and manage risk factors early.
Choice D Reason:
Primary prevention aims to prevent the onset of disease before it occurs by reducing risk factors and promoting healthy behaviors. This includes lifestyle changes such as a healthy diet, regular exercise, and smoking cessation to prevent the development of heart disease in the first place. Physical therapy after a heart attack does not fall under primary prevention, as it is an intervention after the disease has already occurred.
Correct Answer is C
Explanation
Choice A Reason:
While it is true that women often experience more adverse drug reactions than men, this is not because drugs inherently have more toxic effects in women. The higher incidence of side effects in women is largely due to the fact that drug dosages and effects have historically been studied primarily in men. This has led to a lack of understanding of how drugs specifically affect women.
Choice B Reason:
Women do not necessarily metabolize drugs more slowly than men. Drug metabolism can vary widely depending on the specific medication and individual differences. However, the lack of female representation in clinical trials has resulted in less data on how women metabolize certain drugs, leading to unpredictable effects.
Choice C Reason:
Most known drug effects are indeed based on drug trials conducted predominantly in men. Historically, women were excluded from clinical trials due to concerns about hormonal fluctuations and potential risks to fetuses. This has resulted in a significant gap in knowledge about how drugs affect women, leading to more unpredictable and often adverse effects when these drugs are used by women.
Choice D Reason:
While hormonal fluctuations during menstrual cycles can affect drug metabolism and efficacy, this is not the primary reason for the unpredictable effects of drugs in women. The main issue is the historical exclusion of women from clinical trials, which has led to a lack of data on how drugs affect women differently from men.
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