Difficulty: Medium
Average Score: 83%
Simulated
The nurse is preparing to administer medications to a 54-year-old client. Which medications taken would be affected by the first-pass effect? (Select All that Apply.)
Correct answer
B,C,F
Rationale
The correct answer is B, C, and F. These medications are affected by the first-pass effect as they are taken orally and undergo metabolism in the liver before reaching systemic circulation. Morphine administered intravenously (A) bypasses the liver and first-pass effect. Nitroglycerin sublingual tablets (D, E) are absorbed directly into the bloodstream through the oral mucosa, avoiding the liver. Acetaminophen (F) can be affected by the first-pass effect as it is taken orally. Famotidine (C) and Diphenhydramine (B) are also orally administered and metabolized in the liver, making them susceptible to the first-pass effect.