Protein-bound medications frequently cause side effects in older adults because
a. Older adults are more susceptible to adverse drug reactions
b. Older adults often have a decreased serum albumin level that increases the amount of free drug
c. Older adults take many drugs, and adverse drug reactions are primarily caused by polypharmacy
d. Older adults do not have adequate kidney function to excrete protein-bound drugs
B
Decreased levels of serum albumin provide fewer binding sites for protein-bound drugs. This causes an increased amount of free drug in the plasma to bind to drug receptor sites and increases the drug's effect. Response D is incorrect. Older adults have decreased kidney function that affects their ability to excrete all drugs that are excreted by the kidney. This is not, however, the major cause of side effects from protein-bound drugs. Responses A and C are correct statements, but they do not address protein-bound drugs specifically.
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