Which of the following local anesthetics is metabolized in the lungs and liver?

Prilocaine is a local anesthetic that is metabolized primarily in the lungs and liver. This characteristic is important because it influences how the drug behaves in the body, including its onset, duration, and potential for toxicity. Prilocaine undergoes biotransformation via hepatic enzymes and is also metabolized by non-specific plasma esterases, which can occur in various tissues, including the lungs.

Understanding the metabolism of local anesthetics is crucial for the safe and effective use of these agents in clinical settings. For example, when administering prilocaine, one must be cautious of the risk of systemic toxicity, especially in patients with compromised liver function or those with circulatory disturbances that might affect drug metabolism. The other local anesthetics listed have different metabolic pathways: lidocaine is primarily metabolized in the liver, bupivacaine has a longer half-life and is also metabolized in the liver, and articaine is unique in that it is metabolized both in the liver and by plasma esterases, but not primarily in the lungs. Understanding these distinctions helps in choosing the appropriate local anesthetic for various clinical situations.