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  • Title: Differential effects of hepatic cirrhosis on the plasma protein binding of drugs.
    Author: García-Morillas M, Gil-Extremera B, Caracuel-Ruiz MD.
    Journal: Int J Clin Pharmacol Res; 1984; 4(5):327-33. PubMed ID: 6519849.
    Abstract:
    The binding of sulfisoxazole (sulfafurazole-INN) (100 micrograms/ml), diazepam (3 micrograms/ml) and digitoxin (0.025 micrograms/ml) has been studied in plasma from normal volunteers and from patients with hepatic cirrhosis. The free fraction of sulfisoxazole and diazepam in plasma was increased in these patients (22.9 +/- 3.0% and 6.5 +/- 0.7%) vs 6.6 +/- 0.6% and 3.1 +/- 0.2% in normal subjects, respectively), but binding of digitoxin did not greatly change (13.7 +/- 3.95% vs 13.9 +/- 2.27% in the control group). The increase in the free fraction of sulfisoxazole and diazepam correlated well with decreased serum albumin levels; but a change in albumin affinity, perhaps due to increased bilirubin levels, should also to be taken in consideration to explain this decreased drug binding in hepatic cirrhosis.
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