The effect of hyperlipidemia on metabolism, distribution and secretion of lidocaine in patients with primary hyperlipidemia
Rózański, J.
Annales Academiae Medicae Stetinensis 46: 177-187
2000
ISSN/ISBN: 1427-440X PMID: 11712303 Document Number: 518212
High prevalence and coexistence of lipid disturbances and ischaemic heart disease (IHD) presents a new challenge to safe and effective pharmacotherapy in this group of patients. Ventricular arrhythmias are common in patients with IHD and lidocaine is the principal drug for their management. The aim of this study was to analyze the pharmacokinetics and pharmacodynamics of lidocaine in primary hyperlipidemia, depending on the type of hyperlipidemia, and to draw conclusions concerning therapeutic safety. The study was performed in 31 subjects, aged 25-58 years (mean 43.5 years), divided into four groups. The control group included 8 subjects aged 28-52 years. Group 2 included 8 patients aged 29-54 years with hypercholesterolemia. Group 3 included 8 patients aged 25-58 years with hypertriglyceridemia, and group 4 included 7 patients aged 38-58 years with mixed hyperlipidemia. The concentration of lidocaine and its main metabolite, monoethylglycinexylidide (MEGX), was measured. A single dose of lidocaine was administered intravenously during 2 minutes. Blood was sampled from the cubital vein before (0) and 5', 15', 30', 60', 120', 240', 360' and 600' after injection. The concentrations of lidocaine and MEGX were established using high-pressure liquid chromatography (HPLC)--Tab. 1-5. It was found that hyperlipidemia influences the pharmacokinetics and pharmacodynamics of lidocaine. The pattern depends on the type of hyperlipidemia. The main difference in the pharmacokinetics of lidocaine in patients with hypercholesterolemia is a greater volume of distribution and longer terminal half-life of the drug. In conclusion, dosage modification is necessary in hypercholesterolemia.