0100488741

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THE EFFECT OF DRUGS ON BILIRUBIN-ALBUMIN BINDING CAPACITY

English (英語)

The Kobe journal of the medical sciences

32(5)

163-169

1986-10

Displacement of bilirubin-bound to human serum albumin by 14 commonly used drugs were studied quantitatively using a model of competitive binding of bilirubin and drug to one site on serum albumin. The rate of bilirubin displacement by certain concentrations of drugs were measured by peroxidase oxidation method. The clinically potent bilirubin-displacer, sulfisoxazole was applied as control. A linear plot of relative increase of the unbound bilirubin levels after addition of certain levels of drugs were obtained. The constant binding of sulfisoxazole was 1. 72 x 10^ 4 M-l and the maximal displacing factor (MDF) in treated babies was estimated at 2.29. Taking the MDF 1.2 as the upper limit for significant danger of displacement, latamoxef (LMOX - 1.63) belonged to this group. Cefalotin (CET - 1.13) had a moderate displacing effect and slight effects were shown by cefotaxime (CTX - 1.07), acetyl salicylic acid (1.08), aminophylline (1.06). No displacing effects were recorded on furosemide, diazepam, phenobarbital, doxapram, digoxin, ampicillin, gentamicin, amikacin and kanamycin. It is concluded that caution should be taken in giving latamoxef to jaundiced infants with infection for the increasing risk of kernicterus.

neonate

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