Drugs bind to plasma proteins such as albumin, which is responsible for binding acidic drugs. Basic drugs bind to alpha-1-acid glycoprotein. Drugs that bind to albumin do not appear
to be altered in obese patients, but alterations in binding to alpha-1-acid glycoprotein was
noted.Obese individuals have an increased amount of alpha-1-acid glycoprotein, which
increases the amount of total drug bound. However, increased binding did not appear to
alter the free drug fractions, which is the active available drug to bind to the receptor and
produce the pharmacologic effect.