Drugs that are highly bound to albumin
Plasma protein binding 1) Highly plasma protein bound drugs are largely restricted to the vascular compament because protein bound drug does not cross membranes,thus they tend to have smaller volumes of distribution. 2)High degree of protein binding generally makes the drug long acting, because bound fraction is not available for metabolism or excretion, unless it is actively extracted by liver or by kidney tubules. 3) One drug can bind to many sites on the albumin molecule. Conversely, more than one drug can bind to the same site. This can give rise to displacement interactions among drugs bound to the same site(s). The drug bound with higher affinity will displace that bound with lower affinity. Some clinically impoant displacement interactions are: * Aspirin displaces sulfonylureas. * Indomethacin, phenytoin displace warfarin. Ref:- kd tripathi; pg num:-19,20
Effectively cross the BBB
Have a large Volume of distribution
Are easily filtered at the glomerulus
Can undergo competition with other drugs for albumin binding sites
General pharmacology