An older adult client is taking phenytoin (Dilantin), an anticonvulsant, for seizure disorder. She has come to the gerontologist with complaints of double vision (diplopia). The physician orders a blood test for albumin. Why would the physician test the albumin level?
a. Phenytoin responds to drops in plasma albumin levels by allowing more of the drug to reach the receptor sites.
b. A drop in plasma albumin indicates a rapid clearance rate.
c. Elevated albumin plasma represents an allergic reaction to phenytoin.
d. An elevated albumin level may initially present with symptoms of diplopia.
a. Phenytoin responds to drops in plasma albumin levels by allowing more of the drug to reach the receptor sites.
FEEDBACK:
a. Albumin is the principal protein used to bind drugs. As we age, the liver produces less albumin, allowing more of the drug to reach the receptor sites. This causes a greater than expected response.
b. A drop in albumin plasma level allows more unbound (free) drug to reach the receptor sites. .
c. As we age, the liver produces less albumin. A drop in plasma albumin is suspected. .
d. The symptom of diplopia is most likely an adverse reaction related to too much phenytoin reaching the receptor sites. .
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