Phenytoin and plasmapheresis : importance of sampling times and impact of obesity
The effect of plasmapheresis (PP) on total and free phenytoin clearance is reported. An obese patient with the diagnosis of thrombotic thrombocytopenic purpura (TTP) was treated with PP. Twelve episodes of PP, having exchange volumes of 1.5-2.25 times the plasma volume with a mean +/- SD 7.7 +/- 0.8...
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| Veröffentlicht in: | Therapeutic drug monitoring 1994-12, Vol.16 (6), p.624-628 |
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| container_title | Therapeutic drug monitoring |
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| creator | OLSEN, K. M MARX, M. A MONAGHAN, M. S BARNES, E ACKERMAN, B. H PAPPAS, A. A |
| description | The effect of plasmapheresis (PP) on total and free phenytoin clearance is reported. An obese patient with the diagnosis of thrombotic thrombocytopenic purpura (TTP) was treated with PP. Twelve episodes of PP, having exchange volumes of 1.5-2.25 times the plasma volume with a mean +/- SD 7.7 +/- 0.8 L of plasma removed, were studied. A significant (p < 0.05) difference was observed with a mean change in plasma phenytoin concentrations from pre- to end-PP of 7.32 +/- 2.5 mg/L compared to 1.98 +/- 0.7 mg/L observed pre-PP to 1 h post-PP. These values corresponded to 48.4 +/- 11.6 and 15.0 +/- 6.7% decreases in phenytoin concentrations at the two aforementioned time periods. To prevent misinterpretation of plasma phenytoin concentrations, samples should not be obtained for at least 2 h after PP. |
| doi_str_mv | 10.1097/00007691-199412000-00017 |
| format | Article |
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These values corresponded to 48.4 +/- 11.6 and 15.0 +/- 6.7% decreases in phenytoin concentrations at the two aforementioned time periods. To prevent misinterpretation of plasma phenytoin concentrations, samples should not be obtained for at least 2 h after PP.</description><subject>Anticonvulsants. Antiepileptics. Antiparkinson agents</subject><subject>Biological and medical sciences</subject><subject>Blood Specimen Collection</subject><subject>Epilepsy, Tonic-Clonic - drug therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neuropharmacology</subject><subject>Obesity, Morbid - complications</subject><subject>Obesity, Morbid - metabolism</subject><subject>Pharmacology. Drug treatments</subject><subject>Phenytoin - blood</subject><subject>Phenytoin - pharmacokinetics</subject><subject>Phenytoin - therapeutic use</subject><subject>Plasmapheresis</subject><subject>Purpura, Thrombocytopenic - blood</subject><subject>Purpura, Thrombocytopenic - complications</subject><subject>Purpura, Thrombocytopenic - therapy</subject><subject>Time Factors</subject><issn>0163-4356</issn><issn>1536-3694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kFtLBCEYhiWKbdv6CYEX0d2Unzo6dhfRCRYqqGtxHG0n5pTOXuy_z92dVhGR93k_4UEIA7kBouQtSUsKBRkoxYGmV5YOyCM0h5yJjAnFj9GcgGAZZ7k4RWcx_iSCF4TM0EwWaRMxRx_vK9dtxr7usOkqPDQmtmZYueBiHfEdrtuhD6PprMO9x9G0Q1N333isWxd3jQQYO27DvkydcXOOTrxporuY7gX6enr8fHjJlm_Prw_3y8zSgo-Z5cQZlYNTvhKiBAU-56VxlnnOpWUCSskZVbnxlBgPFVRlzph1VNHCWMoW6Ho_dwj979rFUbd1tK5pTOf6ddRSSpEcsQQWe9CGPsbgvB5C3Zqw0UD01qb-t6kPNvXOZqpeTn-sy9ZVh-KkL-VXU26iNY0PSVQdDxhjEhQl7A9h93zy</recordid><startdate>19941201</startdate><enddate>19941201</enddate><creator>OLSEN, K. 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Antiparkinson agents</topic><topic>Biological and medical sciences</topic><topic>Blood Specimen Collection</topic><topic>Epilepsy, Tonic-Clonic - drug therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neuropharmacology</topic><topic>Obesity, Morbid - complications</topic><topic>Obesity, Morbid - metabolism</topic><topic>Pharmacology. Drug treatments</topic><topic>Phenytoin - blood</topic><topic>Phenytoin - pharmacokinetics</topic><topic>Phenytoin - therapeutic use</topic><topic>Plasmapheresis</topic><topic>Purpura, Thrombocytopenic - blood</topic><topic>Purpura, Thrombocytopenic - complications</topic><topic>Purpura, Thrombocytopenic - therapy</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>OLSEN, K. M</creatorcontrib><creatorcontrib>MARX, M. A</creatorcontrib><creatorcontrib>MONAGHAN, M. 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A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Phenytoin and plasmapheresis : importance of sampling times and impact of obesity</atitle><jtitle>Therapeutic drug monitoring</jtitle><addtitle>Ther Drug Monit</addtitle><date>1994-12-01</date><risdate>1994</risdate><volume>16</volume><issue>6</issue><spage>624</spage><epage>628</epage><pages>624-628</pages><issn>0163-4356</issn><eissn>1536-3694</eissn><coden>TDMODV</coden><abstract>The effect of plasmapheresis (PP) on total and free phenytoin clearance is reported. An obese patient with the diagnosis of thrombotic thrombocytopenic purpura (TTP) was treated with PP. Twelve episodes of PP, having exchange volumes of 1.5-2.25 times the plasma volume with a mean +/- SD 7.7 +/- 0.8 L of plasma removed, were studied. A significant (p < 0.05) difference was observed with a mean change in plasma phenytoin concentrations from pre- to end-PP of 7.32 +/- 2.5 mg/L compared to 1.98 +/- 0.7 mg/L observed pre-PP to 1 h post-PP. These values corresponded to 48.4 +/- 11.6 and 15.0 +/- 6.7% decreases in phenytoin concentrations at the two aforementioned time periods. To prevent misinterpretation of plasma phenytoin concentrations, samples should not be obtained for at least 2 h after PP.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>7878706</pmid><doi>10.1097/00007691-199412000-00017</doi><tpages>5</tpages></addata></record> |
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| ispartof | Therapeutic drug monitoring, 1994-12, Vol.16 (6), p.624-628 |
| issn | 0163-4356 1536-3694 |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Anticonvulsants. Antiepileptics. Antiparkinson agents Biological and medical sciences Blood Specimen Collection Epilepsy, Tonic-Clonic - drug therapy Humans Male Medical sciences Middle Aged Neuropharmacology Obesity, Morbid - complications Obesity, Morbid - metabolism Pharmacology. Drug treatments Phenytoin - blood Phenytoin - pharmacokinetics Phenytoin - therapeutic use Plasmapheresis Purpura, Thrombocytopenic - blood Purpura, Thrombocytopenic - complications Purpura, Thrombocytopenic - therapy Time Factors |
| title | Phenytoin and plasmapheresis : importance of sampling times and impact of obesity |
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