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Lidocaine Pharmacokinetics in Advanced Heart Failure, Liver Disease, and Renal Failure in Humans

PATE D. THOMSON, M.D.; KENNETH L. MELMON, M.D.; JAMES A. RICHARDSON, M.D., F.A.C.P.; KEITH COHN, M.D.; WALTER STEINBRUNN, M.D.; ROBERT CUDIHEE, M.D.; and MALCOLM ROWLAND, Ph.D.
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▸Requests for reprints should be addressed to Kenneth L. Melmon, M.D., 1089 Moffitt Hospital, University of California San Francisco Medical Center, San Francisco, CA 94122.


San Francisco, California


Ann Intern Med. 1973;78(4):499-508. doi:10.7326/0003-4819-78-4-499
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The pharmacokinetics of intravenously administered lidocaine were studied in 10 normal subjects, 11 patients with heart failure, 8 patients with alcoholic liver disease, and 6 chronic renal dialysis patients. In heart failure subjects, both the measured volume of distribution and plasma clearance were significantly reduced. Liver disease subjects showed a reduced plasma clearance and prolongation of the "dominant phase" half-life. Neither volume of distribution nor clearance was abnormal in renal disease subjects. The alterations in volume of distribution and clearance are related to the activity of the circulation in drug disposition. The low clearance implies the need to decrease dosage regimens or alter infusion rates in patients with advanced heart failure or liver disease.

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