Dear Mailbase,

 

We have had an enquiry from a pharmacist to see if we can provide phenytoin results that have been corrected for albumin concentration.

 

The rationale being that there was a recent case where the phenytoin concentration was 10 mg/L and the albumin concentration was 24 g/L.  The corrected phenytoin concentration was 20 mg/L, but the dose of phenytoin was increased because the clinician used the uncorrected value of 10 mg/L. It resulted in the patient becoming toxic. Our pharmacist feels patient safety would be improved if corrected phenytoin concentrations were reported and has provided us with the equation to do this.

 

Does anybody have experience of correcting phenytoin concentrations? Are there any risks in doing this? Finally, what equations, to correct for albumin concentration, are being used?

 

Thoughts and comments welcome.

 

Regards,

Susan.

 

Dr Susan Vickery

Department of Laboratory Medicine

East Kent Hospitals University NHS Foundation Trust


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