Zusammenfassung
Bei 45 Kindern und 7 Erwachsenen wurde Phenytoin im Plasma oder Serum, Plasma-oder Serumdialysat und Speichel gaschromatographisch bestimmt. Zur Dialyse wurden 200 µl Plasma benötigt. Zwischen den in den verschiedenen Flüssigkeiten gefundenen Werten bestanden enge Korrelationen (r≧0,95). In einigen Fällen wurden im Speichel im Vergleich zu Plasma und Dialysat exterm hohe Konzentrationen gemessen. Bei Verwendung von Speichelanalysen für therapeutische Entscheidungen ist daher Vorsicht geboten. Bei 15 Kindern mit hohen Phenytoinspiegeln ergaben die Werte für das freie Medikament keine bessere Übereinstimmung mit dem klinischen Bild als die Gesamtkonzentration im Plasma.
Summary
Phenytoin was determined in plasma or serum, dialysate from plasma or serum and saliva in 45 children and 7 adults by gas chromatography. 200 µl of plasma were necessary for dialysis. Close correlations were found between phenytoin concentrations in the different media (r≧0.95). Since in some cases the levels in saliva were extremely high in comparison to plasma and dialysate, precautions are advisable when using phenytoin determinations in saliva for therapeutic decisions. Clinical data from 15 children with high phenytoin levels suggest that there is no advantage in determining the unbound fraction of the drug in plasma for the control of antiepileptic therapy.
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Brügmann, G., Kleinau, E., Nolte, R. et al. Comparison of phenytoin determinations in plasma, plasma dialysate and saliva for control of antiepileptic therapy in children. Klin Wochenschr 57, 93–94 (1979). https://doi.org/10.1007/BF01491341
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DOI: https://doi.org/10.1007/BF01491341