Alpha 1-Acid Glycoprotein and Plasma Lidocaine Binding
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The relationship between the degree of plasma binding of lidocaine (lignocaine) and the concentration of the acute phase reactant, alpha 1-acid glycoprotein (AAG), is reviewed. Studies in normal subjects and patients with myocardial infarction, renal disease, hepatic failure and receiving antiepileptic drug therapy have all shown a remarkably good relationship between AAG concentration and the binding ratio for lidocaine. In situations where AAG is altered, particularly myocardial infarction, the usual therapeutic range for total plasma lidocaine concentrations may not apply and must be interpreted appropriately. This provides the strongest rationale for monitoring free rather than total drug concentration as an aid in lidocaine therapy.
Letson H, Morris J, Dobson G Pharmacol Res Perspect. 2023; 11(5):e01133.
PMID: 37643751 PMC: 10465298. DOI: 10.1002/prp2.1133.
Sadou Yaye H, Faucheron A, Dupont L, El Kouari F, Fekkar A, Bellanger A Eur J Hosp Pharm. 2020; 27(3):162-167.
PMID: 32419937 PMC: 7223286. DOI: 10.1136/ejhpharm-2018-001680.
Practical Regional Anesthesia Guide for Elderly Patients.
Lin C, Darling C, Tsui B Drugs Aging. 2019; 36(3):213-234.
PMID: 30680678 DOI: 10.1007/s40266-018-00631-y.
Central nervous system toxicity following topical skin application of lidocaine.
Brosh-Nissimov T, Ingbir M, Weintal I, Fried M, Porat R Eur J Clin Pharmacol. 2004; 60(9):683-4.
PMID: 15568142 DOI: 10.1007/s00228-004-0814-4.
Regional anaesthesia in the elderly: a clinical guide.
Tsui B, Wagner A, Finucane B Drugs Aging. 2004; 21(14):895-910.
PMID: 15554749 DOI: 10.2165/00002512-200421140-00001.