Notable drugs that experience a significant first-pass effect are imipramine, morphine, propranolol, buprenorphine, diazepam, midazolam, pethidine, tetrahydrocannabinol (THC), ethanol (drinking alcohol), cimetidine, lidocaine, chlorpromazine, and nitroglycerin (NTG).
Which drug routes would be affected by the first-pass effect?
Drugs that are administered orally (as opposed to intravenously, intramuscularly, sublingually, or transdermally) must first pass from the intestine to the liver before reaching the general circulation.
Which organ is most responsible for the first-pass effect?
Since some drugs are metabolized by gut flora or digestive enzymes, the first-pass effect refers to the combined effect of metabolism by the liver and in the gut.
Does nitroglycerin undergo first-pass effect?
Drug: Nitroglycerin- is typically taken sublingually (buccal cavity) where it enters the circulation and is rapidly delivered directly to the heart (without having to go through the liver first), thus avoiding the First Pass Effect.
How can we avoid first pass effect?
Alternative routes of administration, such as suppository, intravenous, intramuscular, inhalational aerosol, transdermal, or sublingual, avoid the first-pass effect because they allow drugs to be absorbed directly into the systemic circulation.
Can you drink water after sublingual?
If this is uncomfortable, place 2 tablets at a time under the tongue and repeat the process until all the tablets have been taken. Do not eat or drink anything until the tablets are completely dissolved.
What is the first-pass effect?
The first pass effect is a phenomenon in which a drug gets metabolized at a specific location in the body that results in a reduced concentration of the active drug upon reaching its site of action or the systemic circulation.