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Postburn serum drug binding and serum protein concentrations


Journal of Clinical Pharmacology 26(2): 147-151
Postburn serum drug binding and serum protein concentrations
The free fractions of diazepam, imipramine, lidocaine, meperidine, phenytoin, propranolol, and salicyclic acid were determined in the serum of seven burn patients (25% to 80% of their skin surface burned) about one week after the burn and in the three of the patients at about four weeks following the injury. Serum protein fractions were measured by electrophoresis, and alpha-1 acid glycoprotein levels were determined. For the drugs that bind predominantly to albumin, the serum free fractions were greater in patients one week after the burn incident than in control subjects (diazepam, 0.055 vs. 0.017; phenytoin, 0.24 vs. 0.16; and salicyclic acid, 0.69 vs. 0.32). The increase in free fraction for these drugs was attributed to the postburn decrease in serum albumin levels (2.2 vs. 4.4 g/dL, control). Imipramine, lidocaine, meperidine, and prprnaolol bind primarily to alpha-1 acid glycoprotein. The free fractions for these drugs decreased one week following the burn (imipramine, 0.074 vs. 0.095; lidocaine, 0.17 vs. 0.35; meperidine, 0.37 vs. 0.48; and propranolol, 0.045 vs. 0.107], presumably in response to the increased alpha-1 acid glycoprotein concentration (222 vs. 83 mg/kL, control). Diazepam, lidocaine, propranolol, and salicyclic acid free fractions were still different from control values at four weeks after the accident.


Accession: 006153909

PMID: 3950058

DOI: 10.1002/j.1552-4604.1986.tb02923.x



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