Bisalbuminemia can lead to which clinical implication?

• A. Increased therapeutic drug levels
• B. Decreased therapeutic drug levels
• C. No effect on drug binding
• D. Altered bilirubin binding

Answer: (A)

Bisalbuminemia changes how albumin binds drugs. Albumin normally carries many drugs in the blood, and the portion that is unbound is the one that can produce therapeutic effects. If a variant albumin alters binding, less drug is held by albumin, so more remains free in the plasma. That means the pharmacologically active, free drug level rises, which can enhance effects or cause toxicity even without a big change in the total measured drug concentration. So the clinical implication is an increase in active (therapeutic) drug levels.