Pharmacology Quiz
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PRINCIPLES OF PHARMACOLOGY
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A patient with severe cirrhosis and resultant hypoalbuminemia requires a loading dose of phenytoin. Phenytoin is an acidic drug, normally 90% bound to albumin, with a typical Vd of 0.7 L/kg. The goal is to achieve a therapeutic free plasma concentration of 1.5 mg/L. In this patient, the unbound fraction (fu) is double that of a healthy individual. How should the loading dose be adjusted for this patient compared to a patient with normal albumin levels to achieve the target free concentration?
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