4.8
血液成分への薬物の結合
When drugs enter the systemic circulation, they interact with blood components like human serum albumin or HSA, α1-acid glycoprotein or AAG, lipoproteins, globulins, and red blood cells or RBCs.
HSA, the most abundant plasma protein, has distinct drug-binding sites. For example, warfarin, certain NSAIDs, and sodium valproate bind to site I. Site II binds benzodiazepines, ibuprofen, and cloxacillin. Few drugs bind to sites III and IV.
AAG binds drugs like imipramine, lidocaine, and propranolol.
Lipophilic drugs, like cyclosporine and amiodarone, bind to lipoproteins, and this binding is influenced by the drug's lipid content.
Steroids like cortisone and prednisone can bind to plasma globulins such as α1-globulin.
Lipophilic drugs exhibit a higher affinity for RBCs than hydrophilic drugs. Specific RBC components, such as hemoglobin, carbonic anhydrase, and cell membranes, can bind distinct drugs.
Drugs like phenytoin bind to hemoglobin, while acetazolamide binds to carbonic anhydrase. Imipramine can bind to the RBC membrane.
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