Serum Phenytoin Concentrations in Uremia
Authors: Ellen D. Burgess, Patrick N. Friel, Andrew D. Blair, Vidmantas A. Raisys
Journal: Annals of Internal Medicine (1981)

Brief Reports1 January 1981Serum Phenytoin Concentrations in UremiaELLEN D. BURGESS, M.D., PATRICK N. FRIEL, B.S., ANDREW D. BLAIR Jr., Ph.D., VIDMANTAS A. RAISYS, Ph.D.ELLEN D. BURGESS, M.D.Search for more papers by this author, PATRICK N. FRIEL, B.S.Search for more papers by this author, ANDREW D. BLAIR Jr., Ph.D.Search for more papers by this author, VIDMANTAS A. RAISYS, Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-94-1-59 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSeveral techniques have been established for ascertaining serum phenytoin concentrations. The simplest technique, which is most widely used, is the enzyme-multiplied immunoassay (EMIT; Syva Corporation, Palo Alto, California), a nonradioactive immunoassay based on the enzymatic activity of a hapten-enzyme conjugate that is influenced by the hapten-antibody reaction (coefficients of variation less than 10%). Many studies have shown excellent statistical agreement between the enzyme-multiplied immunoassay and the more traditional gas-liquid chromatography and high-performance liquid chromatography methods (coefficients of variation, 5%) (1, 2). Recent isolated reports suggest that the enzyme-multiplied immunoassay is not accurate in the presence of renal failure (3, 4)....References1. CASTROIBANEZDICESAREADAMSMALKUS AJJRH. Comparative determination of phenytoin by spectrophotometry, gas chromatography, liquid chromatography, enzyme immunoassay and radioimmunoassay. Clin Chem. 1978;24:710-3. CrossrefMedlineGoogle Scholar2. KUMPSMARDENSSCHARPEVERKERK AYSR. Evaluation and comparison of enzyme-immunoassay, gas chromatography, and high-pressure liquid chromatography for the monitoring of antiepileptic drugs in serum. In: PAUL SB, ed. Enzyme Labelled Immunoassay of Hormones and Drugs. Berlin: Walter de Gruyter and Co. :1978:405-18. Google Scholar3. FLACHSRASMUSSEN HJ. Renal disease may increase apparent phenytoin in serum as measured by enzyme-multiplied immunoassay. Clin Chem. 1980;26:361. Letter. CrossrefMedlineGoogle Scholar4. MCDONALDKABRA DP. Renal disease may increase apparent phenytoin in serum as measured by enzyme-multiplied immunoassay. Clin Chem. 1980;26:361-2. Letter. CrossrefMedlineGoogle Scholar5. FRIELTROUPIN PA. Flash-heater ethylation of some antiepileptic drugs. Clin Chem. 1975;21:751-4. CrossrefMedlineGoogle Scholar6. PORTERLAYZER RR. Plasma albumin concentration and diphenylhydantoin binding in man. Arch Neurol. 1975;32:298-303. CrossrefMedlineGoogle Scholar7. LETTERIMELLKLOUISKUTTDURANTEGLAZKO JHSHPA. Diphenylhydantoin metabolism in uremia. N Engl J Med. 1971;285:648-52. CrossrefMedlineGoogle Scholar8. ODAR-CEDERLOFBORGA IO. Kinetics of diphenylhydantoin in uremic patients: consequences of decreased plasma protein binding. Eur J Clin Pharmacol. 1974;7:31-7. CrossrefMedlineGoogle Scholar9. BORGAHOPPELODAR-CEDERLOFGARLE OCIM. Plasma levels and renal excretion of phenytoin and its metabolites in patients with renal failure. Clin Pharmacol Ther. 1979;26:306-14. CrossrefMedlineGoogle Scholar10. RUBENSTEINBASTIANI KR. Renal disease may increase apparent phenytoin in serum as measured by enzyme-multiplied immunoassay. Clin Chem. 1980;26:362. Letter. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ELLEN D. BURGESS, M.D.; PATRICK N. FRIEL, B.S.; ANDREW D. BLAIRJr., Ph.D.; VIDMANTAS A. RAISYS, Ph.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPhenytoin immunoassay measurements in serum samples from patients with renal insufficiency: comparison with high-performance liquid chromatographyEndogenous Metabolic DisordersPhenytoin Overview— Metabolite Interference in Some Immunoassays Could Be Clinically ImportantDetermination of Phenytoin and Its Major Metabolites in Human Serum by High-Performance Liquid Chromatography with Fluorescence DetectionHemodialysis-related emergencies—Part IIDrug concentrationsLigand displacement immunoassay — demonstration of its use for the measurement of serum phenobarbital and phenytoinAntiepileptische TherapiePhenytoin and Phenobarbital Concentrations in Renal InsufficiencyJOHN W. TURK, M.D., PH.D., JACK H. LADENSON, PH.D.Selection of analytic methods for therapeutic drug monitoringTherapeutic Approach to the Child with Acute Renal FailureDrugs and the KidneyUse of Antiepileptic Drugs in the Presence of Liver and Kidney Diseases: A ReviewSerum Phenytoin Concentrations in UremiaLOIS ALDWIN, PH.D., DAVID S. KABAKOFF, PH.D 1 January 1981Volume 94, Issue 1Page: 59-60KeywordsAttentionChromatographyEnzyme multiplied immunoassay techniqueEpilepsyGas liquid chromatographyImmunoassaysRenal failureResearch facilities ePublished: 1 December 2008 Issue Published: 1 January 1981 PDF downloadLoading ...