Alterations of phenytoin protein binding with in vivo haemodialysis in dialysis encephalopathy.

Abstract:

:Protein binding of phenytoin was assesed in one patient with dialysis encephalopathy before and after haemodialysis. Phenytoin concentrations were measured by radioimmunoassay and continuous ultrafiltration was used to assess phenytoin binding. At a serum concentration of 60 micromol.1-1 the percentage of phenytoin bound to serum albumin was considerably lower in the patient serum (79.95% predialysis; 92.09% postdialysis) than that in three normal sera (97.90 +/- 0.17%). Analysis of Scatchard plots indicated two classes of binding sites. In class I both the affinity and capacity for binding phenytoin were reduced in the pre and post-dialysis serum, whereas in class II the capacity of the uraemic serum was increased although the intrinsic association constant was greatly reduced. It was concluded that in vivo haemodialysis is associated with large fluctuations in the protein binding of phenytoin, in which the concentration of endogenous dialysible metabolites are strongly implicated.

journal_name

Eur J Clin Pharmacol

authors

Steele WH,Lawrence JR,Elliott HL,Whiting B

doi

10.1007/BF00563560

subject

Has Abstract

pub_date

1979-02-19 00:00:00

pages

69-71

issue

1

eissn

0031-6970

issn

1432-1041

journal_volume

15

pub_type

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