Effect of decreased metabolism on duration of action
Water-soluble drugs, such as rocuronium, will be distributed into a larger volume of distribution because of the volume-overloaded nature of many liver disease patients. This accounts for the need for a larger initial dose to obtain the desired clinical effect despite the prolonged duration of action.
Ester local anesthetics are metabolized by psuedocholinesterase and may have a prolonged duration of action. Amide local anesthetics are metabolized by the liver so they may also have a prolonged duration of action. With either class, care should be taken to avoid toxicity and large volume blocks probably should be approached with caution or avoided.
21.3 Questions and Answers
Questions (Choose the Most Appropriate Answer)
Bile helps emulsify what substance in the GI tract?
Gastrin is secreted by which cells in the GI tract?
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