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  • Title: A graphical nomogram method for predicting toxic concentrations of unbound phenytoin.
    Author: Pospisil J, Pelclová D.
    Journal: Int J Clin Pharmacol Ther; 1994 Mar; 32(3):122-5. PubMed ID: 8205372.
    Abstract:
    The graphical nomogram method to estimate the phenytoin free concentration at any selected total serum phenytoin and/or albumin concentrations was applied using Scatchard binding equation. The binding parameters were calculated by the non-linear least-squares regression analysis of the binding data collected from 96 outpatients on common anticonvulsant therapy. Free phenytoin concentration was measured by the Amicon multi-micro ultrafiltration system. The mean values of N and Kapp were found to be: N = 1.03, and Kapp = 18,500 (M-1). Correlation coefficient for relationship between measured and predicted free phenytoin concentrations was very good (r = 0.94), but the results of prediction-error analysis (MPE = 0.153, and RMSE = 0.296) show that the nomogram method overpredicts the measured free phenytoin (PHT) concentration approximately about 10% higher (15-30 mg/l) than serum phenytoin levels.
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