Which of the following is metabolized in the liver?

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Multiple Choice

Which of the following is metabolized in the liver?

Explanation:
Lidocaine is primarily metabolized in the liver. It undergoes extensive hepatic processing by cytochrome P450 enzymes, mainly N-deethylation, to active and then inactive metabolites (monoethylglycinexylidide and glycinexylidide). This hepatic pathway is responsible for most of its clearance, and impaired liver function can markedly prolong its effects. In contrast, the other options are mainly broken down outside the liver: esters like procaine and cocaine are rapidly hydrolyzed by plasma esterases, while epinephrine is inactivated by catechol-O-methyltransferase and monoamine oxidase in various tissues, including the liver but not predominantly via hepatic metabolism.

Lidocaine is primarily metabolized in the liver. It undergoes extensive hepatic processing by cytochrome P450 enzymes, mainly N-deethylation, to active and then inactive metabolites (monoethylglycinexylidide and glycinexylidide). This hepatic pathway is responsible for most of its clearance, and impaired liver function can markedly prolong its effects. In contrast, the other options are mainly broken down outside the liver: esters like procaine and cocaine are rapidly hydrolyzed by plasma esterases, while epinephrine is inactivated by catechol-O-methyltransferase and monoamine oxidase in various tissues, including the liver but not predominantly via hepatic metabolism.

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