A Group of Investigators Is Currently Conducting a Phase I

A group of investigators is currently conducting a phase I clinical trial for a newly developed synthetic opioid that has twice the analgesic capability of morphine.  After oral ingestion of a fixed dose by several volunteers, the plasma concentration of the drug is measured and determined to be subtherapeutic.  Rectal administration of the same dose of the drug shows a plasma concentration well within the therapeutic range, almost double the level measured after oral intake.  Which of the following best accounts for the observed difference in drug concentration following rectal administration when compared to oral administration?

A) Decreased drug delivery to the liver
B) Greater blood flow to this region of the intestine
C) Increased absorption rate of the drug
D) Larger mucosal surface area
E) Reduced renal blood flow

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