Clinical pharmacokinetics of lignocaine.

摘要: Lignocaine is widely used as a local anaesthetic and antiarrhythmic drug. It commonly administered to patients with acute myocardial infarction prophylaxis for ventricular fibrillation, although its efficacy in preventing primary fibrillation still debated. Toxicity, sometimes serious clinical consequence, not uncommom usually related overdosage. Blood lignocaine concentrations correlate roughly toxic effects might be useful an end point monitoring prophylactic therapy. Administration of may result blood concentration the or even ranges. Expected peak levels various routes anaesthesia are tabulated so that 'safe' total doses can calculated. Intramuscular injection high results sustained therapeutic but often associated early minor toxicity. eliminated primarily by hepatic metabolism, which appears limited liver perfusion. Active metabolites contribute and/or effects. Disease states such cardiac failure drugs alter flow significantly affect clearance. Pharmacokinetic studies man show wide variability drug disposition between patients, when status considered, making specific dosing recommendations problem. With intravenous injection, multicompartment kinetics observed, initial rapid decline phase activity due redistribution. constant infusion, steady state seen after 3 4 hours normal subjects 8 10 without circulatory insufficiency. In failure, continue rise 24 48 hours. presence decreased volumes distribution clearance require reduction loading maintenance doses. reduced disease sensitive index dysfunction. A algorithm treatment presented.