Answer to Question 1
B
Decreased levels of serum albumin provide fewer binding sites for protein-bound drugs. This causes an increased amount of free drug in the plasma to bind to drug receptor sites and increases the drug's effect. Response D is incorrect. Older adults have decreased kidney function that affects their ability to excrete all drugs that are excreted by the kidney. This is not, however, the major cause of side effects from protein-bound drugs. Responses A and C are correct statements, but they do not address protein-bound drugs specifically.
Answer to Question 2
A
The aging changes in the gastrointestinal system greatly affect the absorption of drugs that are taken orally. Aging changes seem to decrease cumulatively the absorption of most medications. Response B is incorrect because even though distribution is decreased in the older adult, it is because of vascular, hydration, or decreased muscle mass and increased fat stores, not because of changes in the gastrointestinal tract. Response C is incorrect because it is an overgeneralization to say that older people have a general intolerance of oral medications. Response D is also false because most medications are excreted by the kidneys, not the bowel.
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