Gastrointestinal Tract into the Blood - Oral Medications Undergo the First Pass Effect - Nursing Assignment Help

Assignment Task:

(1) Which of the following are FALSE regarding the stomach

1. The acid of the stomach may trigger the ionization of oral drugs.
2. Antacids may alter drug absorption from the stomach.
3. Enteric coatings allow for the safe transmission of drugs from the stomach to the small intestine.
4. Most drugs absorb to the bloodstream from the stomach.

(2) The majority of medications are taken orally and absorbed from the gastrointestinal tract into the blood. From a chemistry perspective, which of the following statements would, therefore, be TRUE for these medications? 

1. Oral medications require facilitated transport to cross the gastrointestinal tract.
2. Most oral medications are designed to be more water-soluble than fat-soluble.
3. Oral medications are tiny molecules, as larger molecules are always absorbed to the lymph.
4. Most oral medications are more fat-soluble than water-soluble to help them cross the gastrointestinal tract.

(3) Oral medications undergo the first pass effect - Why? 

1. The blood carries the drug through the liver which metabolizes 50% before it can benefit the body.
2. The blood carries the drug through the liver which metabolizes a portion before it can benefit the body.
3. Not all of the drug is absorbed, leaving a portion 'passing' to the waste.
4. The 'first pass' describes the movement of the drug via the stomach to the intestine.

(4) How would the first pass effect be affected in a person with liver damage?

1. Less drugs would be metabolized and more would reach the tissues.
2. More drugs would be metabolized and less would reach the tissues.
3. The dose of the drug would need to be increased as fewer drugs would reach the circulation.
4. The liver has no influence over the first-pass effect.

(5) In clinical settings, it's important that we use the generic name for a drug because: 

A. It conveys simply the type of medication the patient requires.
B. It allows a patient to choose a cheaper brand with the same active ingredient.
C. The statement is incorrect - brand names should always be used.
D. A and B are correct.

(6) Two key concepts in pharmacology are pharmacokinetics (PK) and pharmacodynamics (PD). Pharmacokinetics refers to:

1. The action of a drug at the compatible receptors.
2. The strength of binding of a drug at the receptors.
3. The quality of a response of the body to a drug.
4. The movement of the drug through the body, and what the body does to it.

(7) Why is it important to establish the therapeutic range of a drug?

1. It tells us how many different conditions can be treated by the same medication.
2. It tells us how much of a drug we can give to a patient that allows it to be both effective but with minimal risk.
3. It tells us how much time we should have between doses.
4. It informs us about how the dose will need to be varied according to the height and weight of the patient.

(8) If a patient was advised to take their next dose of paracetamol 4 hours after their first dose, what does it mean their plasma concentration has reached?
A. The threshold of efficacy.
B. The minimum effective concentration.
C. A sub-therapeutic dose.
D. B and C are correct.

(9) Which of the following statements is/are CORRECT:
 A. All drugs are metabolized at different rates.
B. Each drug is metabolized by a different liver pathway.
C. Each metabolic pathway is used by multiple substances including food and drugs.
D. A and C are correct.

(10) After a half-life has occurred, what happens to the remaining active drug?

1. It is eliminated by the kidneys.
2. It undergoes the first-pass effect.
3. It travels from the liver back through the bloodstream to the target tissues.
4. The statement is false - all of the drugs is turned into waste.

(11) Drug targets are bound because the drug (ligand) shape matches the receptor shape like a lock and key.
What is this process known as, and what happens if there's more that one receptor that the drug can bind to?

1. Affinity; specificity of responses
2. Tight binding; desirable effects
3. Adsorption; many benefits
4. Pharmacodynamics; side effects

(12) Agonists bind to receptors and _______________.
Antagonists bind to receptors and _______________.

1. Trigger the receptor into action; Stop the receptor from functioning
2. Increase the cell's function; Decrease the cell's function
3. Stop the receptor from functioning; Trigger the receptor into action
4. Decrease the cell's function; Increase the cell's function

(13) Drugs that need to have an effect on the brain or unborn baby must be specially designed. Why?

1. Both membranes have a specialised waxy surface that excludes medications.
2. The immune system is more active in these special areas, and the drug needs to be protected from those attacks.
3. The barriers contain pumps that exclude most medications.

(14) This is false - most medications can cross these barriers, which is why pregnant women for example must be careful with their medications and have them assessed by a specialist for safety.

(15) Morphine produces a better pain relief response than codeine at their safe and appropriate doses, and less morphine is required for pain relief to be achieved. This tells us that morphine has a better ______ and _____ for pain relief than codeine.
potency; strength
efficacy; potency
analgesic antagonism; potency
anesthetic activity; indication
Paracetamol metabolism

(16) What happens to the remaining 1% of paracetamol that doesn't pass through the major or minor pathways.

1. It uses another metabolic pathway.
2. It is excreted unchanged in the urine.
3. It is excreted in the bile and then faeces.
4. It is lost via upper lip sweat.

(17) The minor pathway produces a toxic waste as part of the metabolic process, which may damage the liver. Why does liver damage NOT occur in people who are careful to keep within the maximum daily dose of paracetamol?

A. A fixed amount of glutathione is produced per day by the liver to remove the toxin so the waste can be safely excreted.

B. The toxin is fast tracked to the kidneys for excretion before damage can occur.

C. The major pathway can process the toxic waste produced so that it can be safely excreted.

D. B and C are correct.

(18) Which of the following is CORRECT regarding the rate of absorption of a drug?

A. Oral drugs will always reach the bloodstream faster than IV administered drugs.

B. Smaller drug molecules will absorb more completely.

C. Water soluble oral drugs will absorb the fastest.

D. A and C are correct.
 

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