This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: General anatomy, Subject name: Anatomy
Drug with high plasma protein binding have 
Select and explain. 
A. Sho duration of action, B. Less drug interaction, C. Lower volume of distribution, D. All of the above
C: Lower volume of distribution
Answer: C: Lower volume of distribution 
Explanation: Ref-KDT 6/e p22 Plasma protein binding causes restriction of drugs in the vascular compament and thus lower volume of distribution. Longer duration of action - as the protein-bound fraction is not available for metabolism ofexcretion. Plasma protein bound drugs tend to have more drug internactions due to displacement of a drug with lower affnity by a drug ywith higher affinity for plasma proteins. Hypoalbuminemia can lead to high concentration of free drug and thus drug toxity.