What occur in patients with acute inflammatory diseases regarding protein binding?

In patients with acute inflammatory diseases, the levels of proteins available for drug binding are altered due to physiological changes that occur in response to inflammation. During an acute inflammatory response, the liver increases the synthesis of certain proteins, such as acute-phase reactants, while reducing the production of others, including albumin. This results in a dynamic shift in protein levels that can significantly impact drug binding.

Since many drugs bind to plasma proteins such as albumin, a decrease in albumin levels can lead to an increase in the free (unbound) concentration of drugs, which can enhance their pharmacological effects and toxicity. Furthermore, inflammatory conditions may also affect the binding affinity of drugs to proteins, further complicating the pharmacokinetics of medications in these patients.

This alteration in protein levels and binding capabilities is crucial for adjusting drug dosages to ensure efficacy and minimize adverse effects, making it a key consideration in the management of patients with acute inflammatory diseases.