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Problem 5 (Lidocaine)
R.I., a 65-year-old, 70-kg man (non-obese), was admitted with a diagnosis of cirrhosis. On the
fourth day, he developed ventricular arrhythmias, and lidocaine was ordered. He received an
initial 60-mg bolus dose at 10am followed by 120-mg administered over the next 15 minutes
(8 mg/min). At 11am he was to be given a 2 mg/min constant infusion. Calculate his
anticipated lidocaine concentration at the start of his maintenance infusion and at steady state.
Evaluate this dosing regimen based on therapy recommendations for lidocaine. (Hint: A graph
of the anticipated concentration time profile might be helpful to answer this problem) Use VD in to calculate plasma concentration at the beginning of the maintenance
infusion because the distribution should be complete 45 minutes after the end of the
infusion. Page 4 of 5 Lidocaine plasma concentrations of 1-5 mg/mL are usually associated with therapeutic
control of ventricular arrhythmias. Thus, anticipated plasma levels are in the
therapeutic range. Page 5 of 5...
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- Spring '08