This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: CHF, Angina Pectoris and Myocardial Infarction, Subject name: Pharmacology
Glyceryl trinitrate is given by sublingual route, because it has 
Select and explain. 
A. High absorption, B. High first pass metabolism, C. Low volume of distribution, D. High plasma protein bound
B: High first pass metabolism
Answer: B: High first pass metabolism 
Explanation: Glyceryl trinitrate (GTN) has high first pass metabolism. So preferred route is sublingual to bypass the metabolism liver Advantage of sublingual route Fast acting No first pass metabolism Self administration is possible After action drug can be spitted out