April 1984

Clinical Studies With Computer-Assisted Initial Lidocaine Therapy

Author Affiliations

From the Laboratory of Applied Pharmacokinetics and the Sections of Clinical Pharmacy (Dr Rodman), Clinical Pharmacology (Drs Jelliffe and Tuey), Cardiology (Drs de Guzman and Haywood), and Intensive Care (Dr Wagers), the University of Southern California Schools of Medicine and Pharmacy, and the Community Hospital of the Monterey Peninsula, Carmel, Calif (Dr Kolb). Dr Tuey is now with the Pharmacontrol Corp, Englewood Cliffs, NJ; Dr Rodman is now with the Department of Pharmaceutical Services, University of Minnesota Hospitals, Minneapolis.

Arch Intern Med. 1984;144(4):703-709. doi:10.1001/archinte.1984.00350160051009

• A randomized prospective study compared achievement and maintenance of therapeutic plasma concentrations in patients receiving computer-assisted (CA) initial lidocaine hydrochloride therapy, designed pharmacokinetically to achieve and maintain a chosen plasma concentration, v conventional lidocaine therapy (CT). A separate audit of outcome was also conducted. The CA regimens provided more effective concentrations in the first hour than did CT, 2.65 v 1.5 μg/mL average. In the audit, ventricular fibrillation occurred in two of 78 CA v eight of 78 CT patients. Dosage adjustments were required in two CA patients v 33 CT patients. The CA therapy improved therapeutic precision, reduced dosage adjustments, and may have improved safety during initial lidocaine therapy before fitting to plasma concentration data for subsequent feedback. An improved clinical computer program now also fits to plasma concentration data. It is accessed and used routinely by hospitals over an international timesharing network.

(Arch Intern Med 1984;144:703-709)