Phenytoin level in renally dialyzed pts

[BME103]

Just wondering if you can help me. The therapeutic level of total phenytoin should be around 10-20. However, what should the therapeutic level of total phenytoin be in a patient who receives dialysis 3x/wk? Should the free phenytoin level be taken instead?

Any help or references would be greatly appreciated!

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[PharmDstudent]

I'm just waiting for BMBiology to save the day.

http://forums.studentdoctor.net/showpost.php?p=4866030&postcount=1
http://forums.studentdoctor.net/showpost.php?p=4867045&postcount=10

http://forums.studentdoctor.net/showpost.php?p=6224860&postcount=1
http://forums.studentdoctor.net/showpost.php?p=6242445&postcount=66

I don't know who you are, but what you do is creepy.

So which is it, BMBiology or BME103? My guess is it's both.

 

[BME103]

WTH? Don't hijack my thread please.

 

[PharmDstudent]

I just so happened to stumble upon this thread, because I'm interested in medical school. I rarely follow members' posts, but I found it odd that someone would post something like this in the allopathic forum instead of the pharmacy forum. Well... what do you know? It just so happens to be BME103.

If I wasn't active in the pharmacy forum, I would have fallen for it too.

 

[BME103]

I am not following you. Again, don't hijack my thread. If anybody know the answer to my question, I would be grateful. Thank you.

 

[PharmDstudent]

Don't play clueless. You can't beat Alicia Silverstone's acting.

Since this is one of the only decent threads that you've posted under this log on ID, I would be happy to provide you with a small catch that you're fishing for.

phenytoin
Dilantin ®
Renal failure: Cadjusted = Cmeasured / [ (0.1 x albumin) + 0.1) ]
(http://www.globalrph.com/anticonvulsants.htm)

3) Renal Failure (<10mL/min, dialysis)
In patients with renal failure, uremia increases the unbound fraction of phenytoin. These patients also tend to have low serum albumin. In general, aim for therapeutic levels between 20-40 umol/L.
(http://www.vhpharmsci.com/VHFormulary/Tools/Phenytoin-Kinetic-Monitoring.htm)

 

[LadyWolverine]

I just so happened to stumble upon this thread, because I'm interested in medical school. I rarely follow members' posts, but I found it odd that someone would post something like this in the allopathic forum instead of the pharmacy forum.

Why? You do realize that physicians are expected to understand drug dosing, right? Regardless of what the OP's purpose is in asking this question, why wouldn't a medical student choose to post a question so that his/her peers might answer?

 

[MonkeyNuts!]

I'm just waiting for BMBiology to save the day.

http://forums.studentdoctor.net/showpost.php?p=4866030&postcount=1
http://forums.studentdoctor.net/showpost.php?p=4867045&postcount=10

http://forums.studentdoctor.net/showpost.php?p=6224860&postcount=1
http://forums.studentdoctor.net/showpost.php?p=6242445&postcount=66

I don't know who you are, but what you do is creepy.

So which is it, BMBiology or BME103? My guess is it's both.

I don't think admins allow you to have multiple accounts?

If not, I'm surprised this forum isn't trolled more often than it already is.

Also if not, that means BME103 is a major toolbag.

 

[PharmDstudent]

Why? You do realize that physicians are expected to understand drug dosing, right? Regardless of what the OP's purpose is in asking this question, why wouldn't a medical student choose to post a question so that his/her peers might answer?

I understand that 100%, and I agree with every point that you've raised.

Here's the back story: I've been following BME103 for a couple of months now, because I think it's another poster's trash account. Basically, I think he's using this second account to start controversial threads or as a means to back himself up when someone disagrees with his other logon ID's posts.
It's a little MPD if you will... and it's creepy.