A Theoretical Method for Normalizing Total Serum Valproic Acid Concentration in Hypoalbuminemic Patients
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- Hermida Jesús
- Central Laboratory, University Hospital Clinic, Santiago de Compostela
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- Tutor J. Carlos
- Central Laboratory, University Hospital Clinic, Santiago de Compostela
書誌事項
- タイトル別名
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- Theoretical Method for Normalizing Total Serum Valproic Acid Concentration in Hypoalbuminemic Patients
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In patients with hypoalbuminemia, the total serum concentration of valproic acid may offer poor clinical information; however, very few clinical laboratories routinely analyze the free concentration of the drug. The aim of this study was to design a procedure to normalize the total concentration of valproic acid according to the level of serum albumin and using previously published free fraction values. In 121 adult patients, with albumin levels of 18 – 41 g/L, the total concentration of valproic acid was normalized using the derived equation: CN = αHCH/6.5, where αH is the free fraction of the drug corresponding to the patient’s particular albuminemia and CH is the total concentration of valproic acid. The value of 6.5 corresponds to the free fraction of the drug for a serum albumin of 42 g/L (percentile 50 of the reference range). For total concentrations lower than 75 mg/L, the predicted normalized valproic acid concentrations were reasonably concordant with the observed normalized concentrations calculated using the data from a protein-binding study. In a significant number of cases, subtherapeutic concentrations of the drug became therapeutic and even supratherapeutic when corrected according to the albumin levels. Furthermore, cases with therapeutic drug concentrations frequently became supratherapeutic when normalized. The limitations and clinical aplications of the proposed formula for normalizing the total concentration of valproic acid are presented. It is concluded that it may be useful for the posological management of hypoalbuminemic patients when the free concentration of the drug is not available, and decisions have to be made based on the total serum concentration.<br>
収録刊行物
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- Journal of Pharmacological Sciences
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Journal of Pharmacological Sciences 97 (4), 489-493, 2005
公益社団法人 日本薬理学会
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詳細情報 詳細情報について
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- CRID
- 1390001205176121728
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- NII論文ID
- 10025727438
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- NII書誌ID
- AA11806667
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- ISSN
- 13478648
- 13478613
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- NDL書誌ID
- 7301003
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- PubMed
- 15840952
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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- 使用不可