Ontario Registered Pharmacy Technician (RphT) Practice Exam

Which route(s) of administration completely bypasses the first pass effect?

1. Transdermal and sublingual

2. Rectal and oral

3. Rectal, transdermal, sublingual

4. Oral

The correct answer is: Transdermal and sublingual

Transdermal and sublingual routes completely bypass the first pass effect because they do not involve going through the digestive system or the liver. The other options listed all involve the oral route, which means the medication must pass through the stomach and liver before reaching the bloodstream. This process can result in the breakdown or metabolism of the medication, reducing its effectiveness. Rectal administration also involves passing through the liver, while sublingual administration involves the medication being absorbed through the mucous membranes under the tongue. Therefore, these options do not completely bypass the first pass effect like transdermal and sublingual routes do.