Elevated serum phenytoin concentrations in a uremic patient when measured by enzyme-multiplied immunoassay

Drug Intelligence & Clinical Pharmacy
G R Matzke, R J Sawchuk

Abstract

A patient with chronic renal failure did not respond to "therapeutic" serum phenytoin concentrations as measured by enzyme-multiplied immunoassay (EMIT). Her seizure disorder was not controlled despite phenytoin concentrations of 25-35 micrograms/ml. When her serum samples were reassayed by high pressure liquid chromatography and gas-liquid chromatography, the phenytoin serum concentrations were found to be approximately 1/2 of the previously reported values, that is, 16.0 micrograms/ml vs. 33 micrograms/ml. The precise reason for this discrepancy is currently unknown. Our findings suggest that the EMIT assay may yield falsely elevated serum phenytoin concentrations in uremic subjects.

References

Nov 1, 1974·Archives of Neurology·H Kutt, J K Penry
Feb 1, 1971·Journal of Pharmaceutical Sciences·R H HammerA Mayersdorf

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Citations

Jan 12, 2000·The Annals of Pharmacotherapy·P F Smith, G D Morse

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