What happens if you give two drugs together that are highly protein bound?

The drugs will compete for receptor sites

The client will have increased effects of both drugs

The client will have decreased effects of both drugs

Both drugs are equally bound to protein

Answer and Explanation

The Correct Answer is B

A) The drugs will compete for receptor sites: While it's true that highly protein-bound drugs can compete for binding sites on proteins (like albumin), the main issue with highly protein-bound drugs interacting is not related to competition for receptor sites. The primary concern is how the drugs displace each other from the protein-binding sites, which can increase the free (active) drug levels in the bloodstream. This can lead to a higher pharmacological effect, especially if the unbound drug concentration rises to a therapeutic or toxic level.

B) The client will have increased effects of both drugs: This is the correct answer. When two highly protein-bound drugs are administered together, they can displace each other from protein-binding sites. This displacement increases the amount of free (active) drug in circulation, which may intensify the pharmacologic effects of both drugs. For example, if one drug displaces the other from its protein-binding site, more of the free drug will be available to exert its effects. This can increase the risk of side effects, toxicity, or both.

C) The client will have decreased effects of both drugs: This is incorrect. The opposite is true—when two highly protein-bound drugs are given together, the displacement of one drug increases the amount of the free drug available, leading to a stronger effect, not a weaker one. Decreased effects would occur if the drug had no access to the target receptor or if it were metabolized or eliminated too quickly, which isn't the case in this scenario.

D) Both drugs are equally bound to protein: While both drugs may bind to protein, they do not necessarily bind equally. One drug might bind more strongly or more selectively to the protein than the other, which could lead to displacement of the weaker-bound drug. The important point is that their competition for protein-binding sites can lead to an increase in free (active) drug concentrations.

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Correct Answer is B

Explanation

Here's the process for calculating the drug concentration after multiple half-lives:

First half-life: After 1 half-life, 50% of the original dose remains in the body.

200 mg x 0.50 = 100 mg remains after 1 half-life.

Second half-life: After 2 half-lives, 50% of the remaining drug will be eliminated.

100 mg x 0.50 = 50 mg remains after 2 half-lives.

Third half-life: After 3 half-lives, 50% of the remaining drug will be eliminated again.

50 mg x 0.50 = 25 mg remains after 3 half-lives.

Fourth half-life: After 4 half-lives, 50% of the remaining drug will be eliminated once more.

25 mg x 0.50 = 12.5 mg remains after 4 half-lives.

Now, we need to sum up the amount of drug remaining in the body at each half-life:

After 4 half-lives, there are 12.5 mg left from the original dose.

Total drug in the body after 4 half-lives = 200 mg - 12.5 mg = 375 mg.

Correct Answer is ["250"]

Explanation

Identify the total volume:

The client is ordered to receive 1000 mL of 0.9% saline.

Identify the infusion time:

The infusion time is 4 hours.

Set up the calculation:

We need to find out the IV pump rate in mL/hr. We can use the following formula:

(Total volume) / (Infusion time) = IV pump rate

4. Plug in the values and calculate:

(1000 mL) / (4 hours) = 250 mL/hr

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What happens if you give two drugs together that are highly protein bound?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client receives 200 mg of a medication on a consistent schedule. How much drug is in the body at 4 half-lives?

Correct Answer is B

Explanation

A client is ordered to receive 1000ml of 0.9% saline over 4 hours. At what rate will the nurse set the IV pump in mL/hr? (Enter a number only).

Correct Answer is ["250"]

Explanation

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