A 65-year-old female is hospitalized after a diagnosis of acute myocardial infar

Question

A 65-year-old female is hospitalized after a diagnosis of acute myocardial infarction complicated by recurrent episodes of ventricular tachycardia while being monitored in the critical care unit. The patient also has a history of congestive heart failure (CHF) and physical examination revealed peripheral edema and a congested mildly tender liver. The patients weighs 70 kg, and treatment is instituted with an initial 70 mg dose of intravenous lidocaine infused slowly over 2 minutes. Estimated lidocaine distribution volume (Vd) is 1.0 L/kg. Due to the diagnosis of CHF the elimination half-life (T1/2) is estimated at 4 hours (approximately twice normal). What maintenance infusion rate will provide a steady-state plasma lidocaine level of 5 micrograms/mL in this patient? a. 1.0 mg/min b. 2.5 mg/min c. 5.0 mg/min d. 10.0 mg/min

Explanation / Answer

b. 2.5mg/min

As the patient weight 70 kg and the volume distribution is half time hence 2.5 mg/ml is the maintenance infusion rate required to maintain the steady plasma lidocaine level

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