Comparisons of Four Protein-Binding Models Characterizing the Pharmacokinetics of Unbound Phenytoin in Adult Patients Using Non-Linear Mixed-Effects Modeling

• Published in: Drugs in R&D Vol. 20; no. 4; pp. 343 - 358
• Main Authors: Jun, Heajin, Rong, Yan, Yih, Catharina, Ho, Jordan, Cheng, Wendy, Kiang, Tony K. L.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2020; Springer Nature B.V; Adis, Springer Healthcare
• Subjects: Adult; Aged; Aged, 80 and over; Anticoagulants; Anticonvulsants - administration & dosage; Anticonvulsants - blood; Anticonvulsants - pharmacokinetics; Binding sites; Critical care; Drug dosages; Drug interactions; Drug Monitoring; Enzymes; Female; Humans; Internal Medicine; Male; Medical laboratories; Medicine; Medicine & Public Health; Middle Aged; Models, Biological; Nonlinear Dynamics; Original; Original Research Article; Pharmacokinetics; Pharmacology/Toxicology; Pharmacotherapy; Phenytoin - administration & dosage; Phenytoin - blood; Phenytoin - pharmacokinetics; Plasma; Protein Binding; Proteins; Retrospective Studies; Serum Albumin - metabolism; Software; Therapeutic drug monitoring; Young Adult

Background and objective Phenytoin is extensively protein bound with a narrow therapeutic range. The unbound phenytoin is pharmacologically active, but total concentrations are routinely measured in clinical practice. The relationship between free and total phenytoin has been described by various bi...