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Decreased quinidine plasma protein binding during hemodialysis
Author(s) -
Kessler Kenneth M,
Perez Guido O
Publication year - 1981
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1981.136
Subject(s) - quinidine , hemodialysis , chemistry , albumin , fatty acid , pharmacology , ultrafiltration (renal) , toxicity , medicine , endocrinology , biochemistry
Quinidine binding to serum proteins was quantitated in 10 regularly dialyzed patients with end‐stage renal disease, both under baseline conditions and after heparin during a single hemodialysis. Quinidine binding was determined in vitro, after the addition of 2 μg/ml quinidine sulfate, by ultrafiltration combined with spectrophotofluorometry. The baseline percent unbound quinidine concentration in our patients was 6.5 ± 2.3% (mean ± SD), a value lower than in normal subjects (9.9 ± 3.0%, n = 18, p < 0.005). Binding correlated with both serum albumin (r = 0.72, p < 0.02) and free fatty acid (r = 0.65, p < 0.05) concentrations. After heparin there was a rise in percent unbound quinidine (12.2 ± 5.6%, p < 0.025) and in free fatty acid concentration (1111 ± 1202 μEq/1, p = 0.004) in each subject. After heparin the relationship between quinidine binding and free fatty acid concentration was again evident (r = 0.97, p < 0.001). Dynamic changes in the levels of free quinidine, as well as other drugs during hemodialysis, may require adjustments to avoid toxicity and adverse interactions. Clinical Pharmacology and Therapeutics (1981) 30, 121–126; doi: 10.1038/clpt.1981.136