NPLEX II Minor Surgery Practice Test

Amide local anesthetics are primarily metabolized in which organ?

Liver Lungs Kidneys Spleen

Correct Answer:

Liver

Explanation:

Amide local anesthetics are inactivated mainly by the liver. They are metabolized by hepatic enzymes—primarily amidases and parts of the cytochrome P450 system—into inactive metabolites, with the kidneys responsible for excreting those metabolites. The lungs and spleen don’t play a significant role in their metabolism, and this is in contrast to ester local anesthetics, which are rapidly hydrolyzed by plasma cholinesterases. Clinically, impaired liver function slows this metabolism, prolonging effects and raising toxicity risk, which reinforces why the liver is the primary organ involved.

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