In neonates, the number of protein-binding sites is limited. What is the danger of competitive medication binding?
a. kernicterus or bilirubin encephalopathy
b. Wernicke-Korsakoff syndrome
c. bilirubinuria
d. xanthoendothelioma or pantanencephaly
A
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A Correct. In neonates, the number of protein-binding sites is limited. Consequently, competitive drug binding may lead to increased concentrations of unbound, unconjugated bilirubin leading to Kernicterus or bilirubin encephalopathy. Lower drug doses or higher levels of endogenous substances, such as free fatty acids, bilirubin, or steroids to provide increase binding potential are indicated.
B Incorrect. Wernicke-Korsakoff syndrome is the coexistence of Wernicke's encephalopathy (inflammatory, hemorrhagic, degeneration of the brain) and Korsakoff's psychosis (a form of amnesia often seen in chronic alcoholics), totally unrelated to the danger of competitive medication binding in the neonate.
C Incorrect. Bilirubinuria is the presence of bilirubin in the urine, may be present as a symptom, but is not the primary danger of competitive medication binding.
D Incorrect. Xanthoendothelioma (yellow interior tumor, not actually real) or the pantanencephaly (congenital absence of all or nearly all brain tissue) have nothing to do with the danger of competitive medication binding.
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