QUESTION 2 Mrs. Simpson is a 56-year-old female who has coronary artery disease,
ID: 238571 • Letter: Q
Question
QUESTION 2 Mrs. Simpson is a 56-year-old female who has coronary artery disease, hypertension, type II diabetes mellitus and rheumatoid arthritis. Her medication list is as follows: Prinizil ( lisinopril and hydrochlorothiazide) 10/12.5 mg), po, daily, glyburide (Diabeta), 10 mg, po, daily, enteric-coated aspirin, 325 mg, po, every 12 hours, and Nitrostat (nitroglycerin), 0.3 mg, sublingually, as needed for chest pain. She has also been taking codeine solution, 30 mg, po, as needed for nightly chronic cough. Which of this patient's medications is not subject to the first-pass effect? a. glyburide b. nitroglycerin c. aspirin d. codeine
Explanation / Answer
Ans:Nitroglycerine
First pass metabolism reduces the concentration of drug greatly before it reaches to systemic circulation.It occurs in gut and liver.
Nitroglycerine is taken by sublingual route for chest pain.Sublingual route avoids first pass affect because this route allows drug to be absorbed directly into the systemic circulation.Therefore nitroglycerine is not subjected to first-pass effect.