Drug binding in the undernourished: a study of the binding of propranolol to alpha 1-acid glycoprotein.

The binding of propranolol, a drug commonly used in cardiovascular disorders, to alpha 1-acid glycoprotein (AGP) was studied in vitro in malnutrition. Compared to normal and hospital controls, the level of AGP was found to be elevated in undernourished subjects with and without infection. In the same patients the free drug percentage was significantly diminished. A significant inverse relationship was observed between the percentage of free drug and the level of AGP. The finding suggests that there may be need for an altered dosage regimen in the undernourished.