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A patient requires a high dose of his new antihypertensive medication because the new medication has a significant first-pass effect. This means that the drug
A)must pass through the patient's bloodstream several times to generate a therapeutic effect.
B)passes through the renal tubules and is excreted in large amounts.
C)is extensively metabolized in the patient's liver.
D)is ineffective following the first dose and increasingly effective with each subsequent dose.
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Abrams' Clinical Drug Therapy: Rationales for Nursing Practice
Edition: 10th
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Some drugs are extensively metabolized in the liver, with only part of a drug dose reaching the systemic circulation for distribution to sites of action. This is called the first-pass effect or presystemic metabolism. The first-pass effect is not related to renal function or the need to pass through the bloodstream multiple times.

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