A patient with decompensated cirrhosis and low cardiac output receives a prolonged intravenous lidocaine infusion. Perioral paraesthesia and

Question

A patient with decompensated cirrhosis and low cardiac output receives a prolonged intravenous lidocaine infusion. Perioral paraesthesia and confusion develop despite a previously acceptable rate. Which paired pharmacokinetic change is most likely?

Accepted Answer

Reduced hepatic clearance with prolonged active-metabolite exposure

Answer

Enhanced plasma-esterase hydrolysis with shortened elimination half-life

Answer

Accelerated Hofmann degradation with reduced parent-drug exposure

Answer

Reduced oral bioavailability from greater first-pass metabolism

Answer

Increased renal excretion of unchanged lidocaine with metabolite depletion

Lidocaine hepatic metabolism — FRCA Primary MCQ

A patient with decompensated cirrhosis and low cardiac output receives a prolonged intravenous lidocaine infusion. Perioral paraesthesia and confusion develop despite a previously acceptable rate. Which paired pharmacokinetic change is most likely?