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Relationship between α1-acid glycoprotein and lidocaine disposition in myocardial infarction

1981; Wiley; Volume: 30; Issue: 2 Linguagem: Inglês

10.1038/clpt.1981.141

1532-6535

Philip A. Routledge, David G. Shand, Aaron Barchowsky, Galen S. Wagner, WW Stargel,

Anesthesia and Pain Management

The effects of myocardial infarction (MI) on lidocaine disposition were investigated in eight patients during a constant infusion of 2 mg/min. Plasma lidocaine binding and total plasma and free lidocaine concentrations were measured 12, 24, 36, and 48 hr after beginning therapy and were related to α1-acid glycoprotein (AAG) concentrations. By 48 hr total plasma lidocaine and AAG concentrations had risen, as had plasma lidocaine binding. Because of enhanced binding, free lidocaine concentrations did not change significantly over this time. There was a correlation between AAG and the binding ratio for lidocaine (r = 0.87) and between AAG and total plasma lidocaine concentrations (r = 0.81). The data suggest that the rise in AAG seen after MI is responsible for enhanced plasma lidocaine binding and may, at least in part, be related to lidocaine cumulation. Clinical Pharmacology and Therapeutics (1981) 30, 154–157; doi:10.1038/clpt.1981.141