Advanced Emergency Medical Technician (AEMT) Practice Test

When a drug is given through a route that requires the drug to be absorbed through the hepatic portal system prior to reaching the systemic circulation, that drug has been given by the __________ route.

1. Transdermal

2. Sublingual

3. Enteral

4. Parenteral

The correct answer is: Enteral

The correct answer is that the drug has been given by the enteral route. This route includes any method of delivering medications that involves the gastrointestinal tract. When a drug is administered enterally, it typically enters the stomach or intestines, where it is then absorbed into the bloodstream through the portal circulation. This means that the drug is first processed by the liver before it reaches the systemic circulation, which can significantly affect its bioavailability and overall effect in the body. In contrast, other routes like transdermal and sublingual bypass the hepatic portal system. Transdermal administration delivers drugs through the skin directly into the bloodstream, avoiding the digestive system entirely. Sublingual administration involves placing the drug under the tongue, allowing it to dissolve and enter the systemic circulation directly, also circumventing the hepatic portal system. Parenteral routes, such as intravenous or intramuscular, deliver drugs directly into the bloodstream without passing through the gastrointestinal tract, thus avoiding hepatic metabolism before systemic distribution.