A patient presents with nephrotic syndrome and hypoalbuminemia. Protein binding of which drug is not affected:
Ans. is 'b' Morphine Nephrotic syndrome leads to loss of proteins so the drugs which are highly bound to protein will be affectednow, have a look at the protein binding of the drugs given in the optionsTolbutamide - 90% (page 277, K.D.T, 4/e)Morphine -30%(p435, K.D.T., 4/e)Diazepam -99% (p-435, K.D. T, 4/e)Valproate -90% (p 388, K.D. T, 4/e)So the drug which is least bound to protein i.e. morphine will be least affected.
Tolbutamide
Morphine
Diazepam
Valproate
Pharmacokinetics