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Tobramycin is indeed a medication cleared by plasmapheresis. Plasmapheresis is a process that removes plasma from the blood, and any substances dissolved in the plasma, such as certain medications, can also be removed. Tobramycin, an aminoglycoside antibiotic, is known to be cleared from circulation via this procedure due to its solubility in plasma and has a volume of distribution that allows significant clearance during plasmapheresis.

In contrast, the other medications listed have different properties that limit their clearance through plasmapheresis. Enalapril is an angiotensin-converting enzyme (ACE) inhibitor primarily eliminated by the liver and kidneys, and while some may be removed, it is less effectively cleared by plasmapheresis. Prednisone is a corticosteroid that binds to proteins in the plasma and has a longer half-life, which also makes it less amenable to being cleared effectively by this method. Digoxin, a cardiac glycoside, is also cleared via renal mechanisms and has significant tissue binding; thus, it is not as readily removed in significant amounts through plasmapheresis.

Understanding the pharmacokinetics and mechanisms of elimination for these drugs illustrates why tobramycin is