PEDIATRICS Vol. 47 No. 5 May 1971, pp. 811-817
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EFFECT OF BILIRUBIN ON DRUG CONJUGATIONS IN CHILDREN

Gerhard Levy Pharm.D.1 and Inta J. Ertel M.D.1

1 Department of Pharmaceutics, State University of New York at Buffalo, the Department of Pediatrics, Ohio State University, and the Children's Hospital Research Foundation, Columbus, Ohio

The formation of glucuronides of salicylate, salicylamide, and acetaminophen in two sisters with congenital unconjugated hyperbilirubinemia responsive to phenobarbital was normal at widely different (6 to 37 mg per 100 ml) serum bilirubin concentrations. The conjugation of salicylate with glycine, and the formation of salicylamide sulfate and acetaminophen sulfate were also normal. This shows that unconjugated hyperbilirubinemia per se does not affect the biotransformation of the three drugs tested. The clinical and pharmacokinetic characteristics of the children in this study are consistent with a recently proposed mechanism involving a deficiency in hepatic anion-binding protein (rather than glucuronyl transferase) as one cause of unconjugated hyperbilirubinemia.

Submitted on September 3, 1970
Accepted on December 7, 1970