# The pathological state that alters the volume of distribution of many drugs is:
A. Septicemia
B. Duodenal ulcers
C. Congestive heart failure
D. Hypertension
The correct answer is C. Congestive heart failure.
In congestive heart failure the volume distribution is often decreased by 40% and loading doses of drugs should be appropriately reduced. Drug clearance may also be diminished due to decreased blood flow to the liver and kidneys.