PEBC Evaluating Exam Practice Questions - PEBC Pharmacist Evaluating Examination Exam

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Warfarin is highly protein-bound (~99%). A patient is started on a second drug that displaces warfarin from albumin. What is the most accurate description of the clinical consequence at new steady state for a low-extraction drug?

A sustained large increase in total warfarin concentration and toxicity No pharmacokinetic interaction is possible with protein binding Immediate permanent loss of anticoagulant effect A transient rise in free fraction, but total clearance of free drug increases so free concentration tends to return toward baseline

Correct Answer:

A transient rise in free fraction, but total clearance of free drug increases so free concentration tends to return toward baseline

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