## Core Concept
The question tests the pharmacokinetic property of drug excretion, specifically focusing on biliary excretion. Biliary excretion is a significant route for eliminating certain drugs and their metabolites from the body. Drugs that are excreted in the bile are often lipophilic and undergo hepatic metabolism.
## Why the Correct Answer is Right
Ampicillin is primarily excreted through the kidneys into the urine. Unlike some other drugs that are significantly metabolized in the liver and excreted into the bile, ampicillin's major route of elimination is renal. This characteristic makes it stand out from drugs that are known to be excreted in the bile.
## Why Each Wrong Option is Incorrect
* **Option A:** is known for being excreted in the bile. This drug undergoes extensive hepatic metabolism, and its metabolites are excreted into the bile.
* **Option B:** is also excreted in the bile. Biliary excretion is a significant elimination pathway for this drug.
* **Option C:** is excreted in the bile as well. This drug's elimination involves both renal and biliary pathways, but biliary excretion is notable.
## Clinical Pearl / High-Yield Fact
A key point to remember is that drugs excreted in the bile can sometimes cause issues in patients with liver or biliary obstruction, as this can lead to drug accumulation and increased risk of toxicity. Ampicillin, being primarily excreted through the kidneys, does not typically accumulate to toxic levels in liver dysfunction related to biliary excretion.
## Correct Answer: D. Ampicillin.
Free Medical MCQs Β· NEET PG Β· USMLE Β· AIIMS
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