Decreased albumin levels during pregnancy affect lipophilic drug binding by causing:

• A. Increased plasma protein binding
• B. Decreased binding and higher tissue distribution
• C. Increased plasma concentration
• D. Decreased tissue distribution

Answer: (B)

When albumin levels fall in pregnancy, the binding capacity for lipophilic drugs declines because albumin is the main protein that binds these medications in plasma. With less albumin available, a larger fraction of the drug remains unbound (free), which can readily diffuse into tissues. This increases tissue distribution and can enhance pharmacologic effects or toxicity, since the active free drug concentration rises. The other options don’t fit because binding would not increase with lower albumin, tissue distribution would not decrease, and total plasma concentration isn’t the primary change driving this effect.