Total, unbound plasma and salivary phenytoin levels in critically ill patients
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Journal of epilepsy and clinical neurophysiology (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-26492010000200006 |
Resumo: | OBJECTIVE: To assess the reliability of salivary phenytoin (PHT) concentrations and predicted free PHT levels by Sheiner-Tozer equation in order to substitute measured free PHT concentrations in critically ill patients. METHODOLOGY: Twenty-four neurocritically ill adult patients receiving intravenous PHT were included in the study. Analyses of total, free plasma and saliva PHT concentrations were performed by fluorescence polarization immunoassay. Plasma albumin levels were also determined. RESULTS: Free PHT concentrations as well as salivary levels better correlate to clinical effect than total drug concentrations. Linear regression analysis showed a strong correlation between estimated free PHT concentrations by Sheiner-Tozer and measured free PHT levels (r=0.835; p<0.001) and salivary PHT concentrations and measured free PHT concentrations (r=0.964; p<0.001). Sheiner-Tozer equation could be misleading in the presence of displacing drugs. CONCLUSIONS: Saliva may serve as a feasible fluid to plasma in order to be used as a surrogate for free concentration monitoring of PHT in this population. |
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Journal of epilepsy and clinical neurophysiology (Online) |
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Total, unbound plasma and salivary phenytoin levels in critically ill patientsPhenytoinunbound concentrationsaliva concentrationSheiner-Tozer equationOBJECTIVE: To assess the reliability of salivary phenytoin (PHT) concentrations and predicted free PHT levels by Sheiner-Tozer equation in order to substitute measured free PHT concentrations in critically ill patients. METHODOLOGY: Twenty-four neurocritically ill adult patients receiving intravenous PHT were included in the study. Analyses of total, free plasma and saliva PHT concentrations were performed by fluorescence polarization immunoassay. Plasma albumin levels were also determined. RESULTS: Free PHT concentrations as well as salivary levels better correlate to clinical effect than total drug concentrations. Linear regression analysis showed a strong correlation between estimated free PHT concentrations by Sheiner-Tozer and measured free PHT levels (r=0.835; p<0.001) and salivary PHT concentrations and measured free PHT concentrations (r=0.964; p<0.001). Sheiner-Tozer equation could be misleading in the presence of displacing drugs. CONCLUSIONS: Saliva may serve as a feasible fluid to plasma in order to be used as a surrogate for free concentration monitoring of PHT in this population.Liga Brasileira de Epilepsia (LBE)2010-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-26492010000200006Journal of Epilepsy and Clinical Neurophysiology v.16 n.2 2010reponame:Journal of epilepsy and clinical neurophysiology (Online)instname:Liga Brasileira de Epilepsia (LBE)instacron:LBE10.1590/S1676-26492010000200006info:eu-repo/semantics/openAccessIbarra,M.Vázquez,MartaFagiolino,P.Mutilva,F.Canale,A.eng2010-09-16T00:00:00Zoai:scielo:S1676-26492010000200006Revistahttp://epilepsia.org.br/publicacoes/ONGhttps://old.scielo.br/oai/scielo-oai.php||jecnpoa@terra.com.br1980-53651676-2649opendoar:2010-09-16T00:00Journal of epilepsy and clinical neurophysiology (Online) - Liga Brasileira de Epilepsia (LBE)false |
dc.title.none.fl_str_mv |
Total, unbound plasma and salivary phenytoin levels in critically ill patients |
title |
Total, unbound plasma and salivary phenytoin levels in critically ill patients |
spellingShingle |
Total, unbound plasma and salivary phenytoin levels in critically ill patients Ibarra,M. Phenytoin unbound concentration saliva concentration Sheiner-Tozer equation |
title_short |
Total, unbound plasma and salivary phenytoin levels in critically ill patients |
title_full |
Total, unbound plasma and salivary phenytoin levels in critically ill patients |
title_fullStr |
Total, unbound plasma and salivary phenytoin levels in critically ill patients |
title_full_unstemmed |
Total, unbound plasma and salivary phenytoin levels in critically ill patients |
title_sort |
Total, unbound plasma and salivary phenytoin levels in critically ill patients |
author |
Ibarra,M. |
author_facet |
Ibarra,M. Vázquez,Marta Fagiolino,P. Mutilva,F. Canale,A. |
author_role |
author |
author2 |
Vázquez,Marta Fagiolino,P. Mutilva,F. Canale,A. |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Ibarra,M. Vázquez,Marta Fagiolino,P. Mutilva,F. Canale,A. |
dc.subject.por.fl_str_mv |
Phenytoin unbound concentration saliva concentration Sheiner-Tozer equation |
topic |
Phenytoin unbound concentration saliva concentration Sheiner-Tozer equation |
description |
OBJECTIVE: To assess the reliability of salivary phenytoin (PHT) concentrations and predicted free PHT levels by Sheiner-Tozer equation in order to substitute measured free PHT concentrations in critically ill patients. METHODOLOGY: Twenty-four neurocritically ill adult patients receiving intravenous PHT were included in the study. Analyses of total, free plasma and saliva PHT concentrations were performed by fluorescence polarization immunoassay. Plasma albumin levels were also determined. RESULTS: Free PHT concentrations as well as salivary levels better correlate to clinical effect than total drug concentrations. Linear regression analysis showed a strong correlation between estimated free PHT concentrations by Sheiner-Tozer and measured free PHT levels (r=0.835; p<0.001) and salivary PHT concentrations and measured free PHT concentrations (r=0.964; p<0.001). Sheiner-Tozer equation could be misleading in the presence of displacing drugs. CONCLUSIONS: Saliva may serve as a feasible fluid to plasma in order to be used as a surrogate for free concentration monitoring of PHT in this population. |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-26492010000200006 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-26492010000200006 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1676-26492010000200006 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Liga Brasileira de Epilepsia (LBE) |
publisher.none.fl_str_mv |
Liga Brasileira de Epilepsia (LBE) |
dc.source.none.fl_str_mv |
Journal of Epilepsy and Clinical Neurophysiology v.16 n.2 2010 reponame:Journal of epilepsy and clinical neurophysiology (Online) instname:Liga Brasileira de Epilepsia (LBE) instacron:LBE |
instname_str |
Liga Brasileira de Epilepsia (LBE) |
instacron_str |
LBE |
institution |
LBE |
reponame_str |
Journal of epilepsy and clinical neurophysiology (Online) |
collection |
Journal of epilepsy and clinical neurophysiology (Online) |
repository.name.fl_str_mv |
Journal of epilepsy and clinical neurophysiology (Online) - Liga Brasileira de Epilepsia (LBE) |
repository.mail.fl_str_mv |
||jecnpoa@terra.com.br |
_version_ |
1754734659598548992 |