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Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1981 Jun;74(6):422–426. doi: 10.1177/014107688107400606

Altered drug binding to serum proteins in pregnant women: therapeutic relevance.

E Perucca, M Ruprah, A Richens
PMCID: PMC1438765  PMID: 6788952

Abstract

The binding of diazepam, phenytoin and valproic acid to serum proteins in vitro has been compared in pregnant women of different gestational ages and in controls. The unbound fraction of each of three drugs was elevated during pregnancy (particularly during the last 8 weeks) probably due, at least in part, to a fall in serum albumin concentration. These findings may provide a partial explanation for the increase in the clearance of certain drugs during pregnancy and need to be taken into account when interpreting serum drug levels in clinical practice.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Dam M., Christiansen J., Munck O., Mygind K. I. Antiepileptic drugs: metabolism in pregnancy. Clin Pharmacokinet. 1979 Jan-Feb;4(1):53–62. doi: 10.2165/00003088-197904010-00005. [DOI] [PubMed] [Google Scholar]
  2. Doumas B. T., Watson W. A., Biggs H. G. Albumin standards and the measurement of serum albumin with bromcresol green. Clin Chim Acta. 1971 Jan;31(1):87–96. doi: 10.1016/0009-8981(71)90365-2. [DOI] [PubMed] [Google Scholar]
  3. Hamar C., Levy G. Serum protein binding of drugs and bilirubin in newborn infants and their mothers. Clin Pharmacol Ther. 1980 Jul;28(1):58–63. doi: 10.1038/clpt.1980.131. [DOI] [PubMed] [Google Scholar]
  4. Hooper W. D., Bochner F., Eadie M. J., Tyrer J. H. Plasma protein binding of diphenylhydantoin. Effects of sex hormones, renal and hepatic disease. Clin Pharmacol Ther. 1974 Mar;15(3):276–282. doi: 10.1002/cpt1974153276. [DOI] [PubMed] [Google Scholar]
  5. Krauer B., Krauer F., Hytten F. E. Drug disposition and pharmacokinetics in the maternal-placental-fetal unit. Pharmacol Ther. 1980;10(2):301–328. doi: 10.1016/0163-7258(80)90085-6. [DOI] [PubMed] [Google Scholar]
  6. Lunde P. K., Rane A., Yaffe S. J., Lund L., Sjöqvist F. Plasma protein binding of diphenylhydantoin in man. Interaction with other drugs and the effect of temperature and plasma dilution. Clin Pharmacol Ther. 1970 Nov-Dec;11(6):846–855. doi: 10.1002/cpt1970116846. [DOI] [PubMed] [Google Scholar]
  7. MacGee J. Rapid determination of diphenylhydantoin in blood plasma by gas-liquid chromatography. Anal Chem. 1970 Mar;42(3):421–422. doi: 10.1021/ac60285a024. [DOI] [PubMed] [Google Scholar]
  8. Mandelli M., Tognoni G., Garattini S. Clinical pharmacokinetics of diazepam. Clin Pharmacokinet. 1978 Jan-Feb;3(1):72–91. doi: 10.2165/00003088-197803010-00005. [DOI] [PubMed] [Google Scholar]
  9. Mygind K. I., Dam M., Christiansen J. Phenytoin and phenobarbitone plasma clearance during pregnancy. Acta Neurol Scand. 1976 Aug;54(2):160–166. doi: 10.1111/j.1600-0404.1976.tb04789.x. [DOI] [PubMed] [Google Scholar]
  10. Piafsky K. M. Disease-induced changes in the plasma binding of basic drugs. Clin Pharmacokinet. 1980 May-Jun;5(3):246–262. doi: 10.2165/00003088-198005030-00004. [DOI] [PubMed] [Google Scholar]
  11. Rowland M. Plasma protein binding and therapeutic drug monitoring. Ther Drug Monit. 1980;2(1):29–37. doi: 10.1097/00007691-198001000-00005. [DOI] [PubMed] [Google Scholar]
  12. Stock B., Dean M., Levy G. Serum protein binding of drugs during and after pregnancy in rats. J Pharmacol Exp Ther. 1980 Feb;212(2):264–268. [PubMed] [Google Scholar]

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