Which one of the following drugs does not undergo the first-pass effect?
Correct Answer: Insulin
Description: Insulin bypasses hepatic effect. Pg.no. 260 KD TRIPATHI Seventh edition Drugs that undergo first-pass elimination are opioids, beta-adrenergic blockers, progesterone, isosorbide dinitrate etc. Subcutaneous administration of insulin delivered into the peripheral circulation can lead to near-normal glycemia but differs from the physiological secretion of insulin in two major ways: * The absorption kinetics do not reproduce the rapid rise and decline of endogenous insulin in response to changes in blood glucose. * Injected insulin is delivered into the peripheral circulation instead of being released into the poal circulation. Thus, the poal/peripheral insulin concentration is not physiological, and this may alter the influence of insulin on hepatic metabolism. Pg no 1248 Goodman and Gillmann 12th edition Pg no 17 sathoskar 25th edition
Category:
Pharmacology
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