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Removal of Phenytoin by Hemodialysis in Uremic Patients

Ernst Martin, MD; John G. Gambertoglio, PharmD; David S. Adler, PharmD; Thomas N. Tozer, PhD; Lucy A. Roman; Henry Grausz, MD
JAMA. 1977;238(16):1750-1753. doi:10.1001/jama.1977.03280170044025.
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The removal of phenytoin by hemodialysis was determined in seven uremic patients. Four patients were receiving phenytoin sodium for therapeutic purposes; three received one dose each intravenously to quantitate its disposition in uremia. The drug was measured in whole blood, plasma, saliva, and dialysate. Only 2% to 4% of the intravenous dose was recovered in the dialysate. Phenytoin clearance by dialysis was 7 to 14 ml/min; plasma clearance was 53 to 133 ml/min. Since hemodialysis contributes little toward shortening the 11-to-18-hour half-life of phenytoin in the uremic patient, no supplemental dose is necessary for uremic patients undergoing hemodialysis.

(JAMA 238:1750-1753, 1977)


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