Phenytoin and albumin

Published

Can someone explain to me why we check albumin levels when a patient is on phenytoin long term? I know I must've learned this at some point but I have forgotten and can't find anything with a clear answer when googling.

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Specializes in OR, Nursing Professional Development.

From the Journal of Clinical Pharmacology

The Relationship of Serum Albumin Level to Phenytoin Toxicity

Abstract:

Phenytoin (DPH) is a commonly used anticonvulsant that can be associated with potentially serious toxicity when serum concentrations exceed 20 μg/mL. Phenytoin is also highly protein-bound and exhibits dose-dependent absorption characteristics. The therapeutic effect and the degree of toxicity are dependent on free phenytoin concentrations (free fraction), which in turn depend on the degree or percentage of binding to serum albumin. We report a case in which the effects of profound DPH toxicity were attenuated after the intravenous administration of albumin. We comment on the importance of gastric lavage in the decontamination of patients with acute drug overdose.
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Specializes in retired LTC.

Learned something new ... TY

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