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Indications for Direct Measurement of the Free (Unbound) Serum Phenytoin Concentration

Specialty:

Clinical Pharmacology & Toxicology
Emergency Medicine & Critical Care
Emergency Medicine & Critical Care
Neurology, Psychiatry, Ophthalmology & Otolaryngology

Objective:

ICD-10:

Description:

While predictive equations can serve to estimate the free phenytoin concentration in stable outpatients, they may be inaccurate under certain circumstances. A number of conditions may either reduce albumin affinity, decrease albumin concentration or displace phenytoin from protein binding sites. Direct measurement of the free level should be performed whenever protein binding is likely to be altered or unpredictable.

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