SEVERITY OF CIRRHOSIS AND THE RELATIONSHIP OF ALPHA-1-ACID GLYCOPROTEIN CONCENTRATION TO PLASMA-PROTEIN BINDING OF LIDOCAINE

The concentration of al-acid glycoprotein, the major determinant of the plasma protein binding of basic drugs, and the extent of lidocaine protein binding was related to the severity of liver disease in 30 cirrhotic patients. In comparison with matched control subjects, α1-acid glycoprotein concentration (77 ± 7 versus 37 ± 3 mg/dl; mean ± SEM; p < 0.01) and lidocaine binding (69% ± 2% versus 35% ± 2%; p < 0.01) was markedly reduced. There was a significant negative correlation (r = 0.78; p < 0.01) between free lidocaine and a,-acid glycoprotein concentration. Furthermore, both were significantly related to the severity of liver disease, as assessed by use of the Child Turcotte classification. © 1990.