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Journal ArticleDOI

Valproic acid binding to human serum albumin and human plasma: effects of pH variation and buffer composition in equilibrium dialysis

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TLDR
The binding of valproic acid to human serum albumin (HSA) and to pooled human plasma has been investigated by using equilibrium dialysis with three different dialysis solutions: phosphate buffer, phosphate buffer with NaCl, and Krebs solution.
Abstract
The binding of valproic acid (VPA) to human serum albumin (HSA) and to pooled human plasma has been investigated by using equilibrium dialysis with three different dialysis solutions: phosphate buffer (solution I), Krebs solution (solution II), and Krebs solution without calcium (solution III). The effect of pH variation from 6.4 to 8.2 has been also investigated. VPA free fraction increased by increasing pH with all the dialysis solutions (from 4.1% at pH 6.4 to 9.4% at pH 8.2 with solution I, from 8.1% to 11.3% with solution II, and from 10.6% to 14.3% with solution III, in plasma). At each pH value, free fraction obtained with solution III was the highest and that obtained with solution I was the lowest. Data in plasma and HSA solution were similar. In a separate experiment we compared (at pH 7.4, with plasma) the three more frequently used dialysis solutions: phosphate buffer, phosphate buffer with NaCl, and Krebs solution. They gave, respectively, a mean VPA free fraction of 7.8, 10.3, and 12.7%. These findings can explain the wide range of VPA free fraction values reported in the literature. Researchers intending to determine VPA free concentration by equilibrium dialysis should take into account these methodological aspects.

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Journal ArticleDOI

An update on sodium valproate.

TL;DR: Most adverse reactions to sodium valproate are mild and reversible, but with increasing experience, the drug's rare, idiosyncratic, adverse effects are becoming apparent, particularly hepatotoxicity and teratogenicity.
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The pH dependency of the binding of drugs to plasma proteins in man.

TL;DR: There was clear evidence indicating that pH-induced changes in the plasma proteins are also involved in the observed pH-dependent interaction with ligands, and these changes in fu could be clinically relevant with narrow-therapeutic-range drugs.
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Unbound valproate fraction in plasma and subcutaneous microdialysate in steady state and after a single dose in humans.

TL;DR: The results of the current study show that unbound plasma fractions of VPA are consistently higher in steady state compared with single dose, providing indirect evidence of displacement of Vpa from plasma proteins by product(s) of V PA biotransformation.
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Effects of Pre-analytical Variables in Therapeutic Drug Monitoring

TL;DR: This chapter will discuss sources of errors in therapeutic drug monitoring during the pre-analytical phase, including in vivo patient variables; the effects of blood collection techniques and materials; specimen processing and transport; and specimen type.
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State of the Art: Measurement of Drug Concentrations for Therapeutic Drug Monitoring

TL;DR: The goals of this review are to provide the reader with an understanding of current analytical procedures, the ability to interpret analytical results more accurately, and to solve clinical problems more readily.
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