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Differences between the measured and calculated free serum phenytoin concentrations in epileptic patients

Authors
 Ji-Man Hong  ;  Young-Chul Choi  ;  Won-Joo Kim 
Citation
 YONSEI MEDICAL JOURNAL, Vol.50(4) : 517-520, 2009 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2009
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticonvulsants/blood* ; Anticonvulsants/pharmacokinetics ; Anticonvulsants/therapeutic use ; Epilepsy/blood* ; Epilepsy/drug therapy ; Female ; Humans ; Male ; Middle Aged ; Phenytoin/blood* ; Phenytoin/pharmacokinetics ; Phenytoin/therapeutic use ; Young Adult
Keywords
Phenytoin ; epilepsy ; hypoalbuminemia
Abstract
PURPOSE: The pharmacokinetics of phenytoin is complicated by genetic and environmental differences. It is, therefore, important to monitor the serum concentrations in patients who receive phenytoin. Because most of the phenytoin in serum is bound to proteins, the level of serum albumin influences the amount of free phenytoin. MATERIALS AND METHODS: We compared the measured and calculated free phenytoin levels in epileptic patients who were taking phenytoin monotherapy, using the Sheiner-Tozer equation. A total of 49 patients (30 men and 19 women; age range, 15 - 87 years) were included in the study and their trough serum phenytoin and albumin concentrations were analyzed. RESULTS: The linear correlation between free and total phenytoin concentrations was moderate (r = 0.822, p < 0.001). The mean difference between measured and calculated free phenytoin was large (0.65 +/- 0.88 microg/mL; 95% confidence interval (CI), -1.11 to 2.41). After dividing the patients into groups by albumin concentration, hypoalbuminemic patients (< 3.5 g/dL) more often had a greater percent difference (> or = 20%) than observed in the normoalbuminemic (> or = 3.5 g/dL) group. CONCLUSION: In hypoalbuminemic patients, the measurement of free phenytoin level is necessary to properly evaluate the phenytoin level than that calculated from total phenytoin level.
Files in This Item:
T200902462.pdf Download
DOI
10.3349/ymj.2009.50.4.517
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Joo(김원주) ORCID logo https://orcid.org/0000-0002-5850-010X
Choi, Young Chul(최영철) ORCID logo https://orcid.org/0000-0001-5525-6861
Hong, Ji Man(홍지만) ORCID logo https://orcid.org/0000-0002-0696-8448
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104210
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