Plasma Protein Binding of Acidic Drugs

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Reidenberg and Drayer (25) have stated that protein binding in serum from uremic patients is decreased for every acidic drug that has been studied. Most acidic drugs bind to the bilirubin binding site on albumin, but there are also different binding sites that play a role. The reduced binding that occurs when renal function is impaired has been variously attributed to reductions in serum albumin concentration, structural changes in the binding sites, or displacement of drugs from

TABLE 5.3 Effect of Impaired Renal Function on Phenytoin Kinetics

Normal subjects Uremic patients Parameter (n = 4) (n = 4)

TABLE 5.3 Effect of Impaired Renal Function on Phenytoin Kinetics

Normal subjects Uremic patients Parameter (n = 4) (n = 4)

Percentage unbound (fu)

12%

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