Plasma protein binding of phenylbutazone during recovery from acute renal failure

Mussche, M. M.; Belpaire, F. M.; Bogaert, Marc G.

doi:10.1007/bf00613431

Cited by 19 publications

(3 citation statements)

References 8 publications

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“…Only 2 of the patients studied had albumin levels below the normal range, whereas all had reduced binding (Table 11). Other investigators': 15,16,19 have also noted this lack of correlation between albumin levels and drug binding in uremic patients.…”

Section: Discussionmentioning

confidence: 94%

Alteration of plasma albumin in relation to decreased drug binding in uremia

Soobis

1977

Clin Pharma and Therapeutics

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The binding of sulfadiazine in the plasma of normal and uremic subjects was measured by means of an ultrafiltration technique. Patients with uremia had reduced binding of sulfadiazine due to decreased albumin-binding capacity. No conclusive evidence was found to suggest that reduced drug binding in uremia is caused by competing metabolites. Studies of purified normal and uremic albumin revealed differences in amino acid composition and variations in the protein content of the two albumin bands found on isoelectric focusing. It is suggested that decreased drug binding in uremia may be at least partly due to altered albumin composition.

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Section: Discussionmentioning

confidence: 94%

Alteration of plasma albumin in relation to decreased drug binding in uremia

Soobis

1977

Clin Pharma and Therapeutics

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“…There are, however, situations in which the proteinbinding of a drug may change. For example, we know, from observations in adult patients that chronic liver diseases, and acute and chronic renal insufficiency, may reduce protein binding [1,2,3,4,7,10,11,13,20,21,22,23,24,25,26,27,30]. It is at present not known whether other diseases exert a similar effect.…”

Section: Zusammenfassung Die Wirkung Eines Medikamentes Ist Unter Anmentioning

confidence: 91%

Investigations on salicylate protein binding in newborns and infants

et al. 1978

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Abstract. The non protein-bound portion of a drug is mainly responsible for the effect of a drug. If this free portion is changed for any reason, drug reactions varying from the normal may occur. Using sodium salicylate as an example, we have investigated this question in newborn children and in infants. It was shown that the newborns had significantly less salicylate protein-binding than the infants had. There was no significant difference of the binding constants between newborns with and without jaundice. In the 75 infants examined, 12 (15%) showed a significant reduction in salicylate protein-binding, but no definite relation to a specific disease could be established. A primary reduction in protein-binding, as well as a secondary reduction because of the disease, must be considered in these children.The importance of this reduced protein-binding should not be underestimated. In patients with restricted renal function or lowered hepatic metabolic capacity, it may lead to a delayed excretion of the drug which has increased penetration into the tissues.

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“…However, as renal function improves, gradual normalization of protein-binding capacity is observed in patients with AKI. 58,59…”

Section: Pharmacokinetic Alterations In Critically Ill Patients With Akimentioning

confidence: 99%

Antibiotic Dosing in Patients With Acute Kidney Injury

Lewis

Mueller

2014

J Intensive Care Med

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Increasing evidence suggests that antibiotic dosing in critically ill patients with acute kidney injury (AKI) often does not achieve pharmacodynamic goals, and the continued high mortality rate due to infectious causes appears to confirm these findings. Although there are compelling reasons why clinicians should use more aggressive antibiotic dosing, particularly in patients receiving aggressive renal replacement therapies, concerns for toxicity associated with higher doses are real. The presence of multisystem organ failure and polypharmacy predispose these patients to drug toxicity. This article examines the pharmacokinetic and pharmacodynamic consequences of critical illness, AKI, and renal replacement therapy and describes potential solutions to help clinicians give "enough but not too much" in these very complicated patients.

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Plasma protein binding of phenylbutazone during recovery from acute renal failure

Cited by 19 publications

References 8 publications

Alteration of plasma albumin in relation to decreased drug binding in uremia

Alteration of plasma albumin in relation to decreased drug binding in uremia

Investigations on salicylate protein binding in newborns and infants

Antibiotic Dosing in Patients With Acute Kidney Injury

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