A nurse is preparing to administer a medication that is highly protein bound.What should be considered when administering this drug to a client with hypoalbuminemia?

The client may have an increased free fraction of the drug

The client may have a decreased free fraction of the drug

The client may have an increased volume of distribution for the drug

The client’s albumin levels do not affect pharmacokinetics

Answer and Explanation

The Correct Answer is A

Medications that are highly protein bound bind to plasma proteins such as albumin, reducing their free fraction and potentially reducing their therapeutic effect.A client with hypoalbuminemia may have an increased free fraction of a highly protein-bound medication due to reduced protein binding, potentially increasing its therapeutic effect.

b.The client may have an increased, not decreased, free fraction of the drug due to reduced protein binding.

c.An increased volume of distribution may occur if protein binding is reduced, but this is not directly related to hypoalbuminemia.

d.The client’s albumin levels can affect pharmacokinetics by altering protein binding of highly protein-bound medications.

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Correct Answer is A

Explanation

P-glycoprotein is a membrane protein that pumps certain drugs out of cells and can affect their absorption, distribution, and elimination. Inhibition of P-glycoprotein can increase the concentration of other medications that are substrates for this protein, potentially increasing their therapeutic effect and the risk of drug interactions.

b. There is an increased, not decreased, risk of drug interactions due to increased concentration of other medications that are substrates for P-glycoprotein.

c. There is an increased risk of drug interactions due to increased concentration of other medications that are substrates for P-glycoprotein.

d. P-glycoprotein inhibition can affect pharmacokinetics by altering absorption, distribution, and elimination of other medications that are substrates for this protein.

A. Oral B. Intravenous C. Subcutaneous D. Intramuscular

Correct Answer is B

Explanation

First-pass metabolism refers to the metabolism of a drug by the liver before it reaches systemic circulation. Drugs that undergo extensive first-pass metabolism have a lower bioavailability when administered orally because a significant portion of the drug is metabolized before it reaches systemic circulation. Intravenous administration bypasses first-pass metabolism and delivers the drug directly into systemic circulation.

a. Oral administration would result in lower bioavailability due to first-pass metabolism.

c. Subcutaneous administration may also be subject to first-pass metabolism.

d. Intramuscular administration may also be subject to first-pass metabolism.

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A nurse is preparing to administer a medication that is highly protein bound.What should be considered when administering this drug to a client with hypoalbuminemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer a medication that inhibits P-glycoprotein.What should be considered when administering this drug with other medications?

Correct Answer is A

Explanation

A nurse is preparing to administer a medication that undergoes extensive first-pass metabolism. What route of administration should be used?

Correct Answer is B

Explanation

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