Question

Hepatic first pass effect can not be avoided by administering the drug through _______ route.

• A. \( \text{Per-oral} \)
• B. \( \text{Sublingual} \)
• C. \( \text{Intramuscular} \)
• D. \( \text{Subcutaneous} \)

Hint:

Think of the oral route as the "liver's first stop" for drugs after absorption from the gut. Other routes often allow the drug to enter the bloodstream directly.

Answer 1

The Correct Option is A

The hepatic first-pass effect (or presystemic metabolism) refers to the metabolism of a drug occurring in the liver before it reaches systemic circulation. When a drug is administered per-orally (by mouth), it is absorbed from the gastrointestinal tract and enters the portal circulation, which carries it directly to the liver where it can be extensively metabolized before reaching the rest of the body. Sublingual administration bypasses the first-pass effect because the drug is absorbed directly into the systemic circulation through the blood vessels under the tongue. Similarly, intramuscular and subcutaneous routes also bypass the initial hepatic metabolism as the drug is absorbed directly into the bloodstream from the injection site.