DD Exam 1 with 100% correct answers
First Pass Effect: drug that has been absorbed by GI tract and is metabolized prior to reaching systemic circulation How are drugs eliminated from the body? 1. Metabolism → Liver (drug must be lipophilic) 2. Excretion → Kidney Blood Supply... Kidney renal artery into kidney and the renal vein out of kidney and back to inferior vena cava Blood Supply... Liver common hepatic artery and portal vein into liver and the hepatic vein back to inferior vena cava Drug Elimination... Kidney excretes unchanged drug from the systemic circulation Drug Elimination... Liver metabolizes drug from the portal circulation (leads to fast pass effect) and the systemic circulation Metabolism occurs mostly in the liver and may also occur in the small intestine, rectal, nasal, and vaginal What other factors could prevent a drug from reaching the systemic circulation? - drug is degraded in the GI tract - did not get fully absorbed First Pass Effect... Primary Location - Gut wall metabolism - liver metabolism What can bypass the first pass effect and still enter systemic circulation? - SC insulin abdomen - IV in arm
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