A patient is taking a drug that does not bind to albumin. Which aspect of renal drug excretion is affected by this characteristic?
a. Active tubular secretion
b. Glomerular filtration
c. Passive tubular reabsorption
d. pH-dependent ionization
B
As blood flows through the glomerular capillaries, fluids and small molecules are forced through the pores of the capillary wall. Large molecules, such as drugs bound to albumin, remain behind in the blood. Active tubular secretion requires active transport systems to pump molecules from one side of the membrane to another. Passive tubular reabsorption allows substances in high concentrations in the tubule to be reabsorbed into the blood, and lipid-soluble drugs readily cross this membrane by passive reabsorption. pH-dependent ionization affects drugs that ionize in ei-ther acid or alkaline environments.
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