Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sirgo, M. A.
Right arrow Articles by Vlasses, P. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sirgo, M. A.
Right arrow Articles by Vlasses, P. H.
NEUROLOGY 1984;34:1250
© 1984 American Academy of Neurology

Interpretation of serum phenytoin concentrations in uremia is assay-dependent

Mark A. Sirgo, PharmD, Paul J. Green, PhD, Mario L. Rocci, Jr, PhD and Peter H. Vlasses, PharmD

From the Division of Clinical Pharmacology, Department of Medicine and Clinical Laboratories, and Department of Pathology, Jefferson Medical College, Thomas Jefferson University; and the Department of Pharmacy Practice, Philadelphia College of Pharmacy and Science, Philadelphia, PA.

A 25-year-old man with sickle cell disease and chronic renal insufficiency had tonic-clonic seizures treated with phenytoin. Serum phenytoin concentrations, total and free, measured by two homogenous enzyme immunoassays (EMIT®, ACA®) were reported to be within the therapeutic range, yet the patient experienced seizures. Values on discharge exceeded the therapeutic range but were not associated with signs or symptoms of toxicity. Reanalysis of serum samples by a more specific, high performance liquid chromatographic (HPLC) method revealed the previous values were spurious, apparently due to phenytoin metabolite cross-reactivity. Values by fluorescence polarization immunoassay (TDX®,) correlated well with those by HPLC, as well as with the patient's clinical course.

Address correspondence and reprint requests to Mark A. Sirgo, PharmD, c/o Clinical Pharmacology (M-502), Thomas Jefferson University Hospital, 11th and Walnut Streets, Philadelphia, PA 19107.

Accepted for publication January 30, 1984.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1984 by AAN Enterprises, Inc.