The binding of phenobarbitone and phenytoin to kwashiorkor serum.

The binding of phenytoin and phenobarbitone to the serum of kwashiorkor patients and normal serum has been investigated. There was no alteration in the binding of phenytoin. However, there was a decrease in the binding of phenobarbitone to kwashiorkor serum, and this was particularly striking in the presence of added phenytoin. It was confirmed that phenytoin was almost exclusively albumin-bound, while phenobarbitone was bound to albumin, alpha 1-and alpha 2-globulin in almost equal proportions.