Dental OSCE (Objective Structured Clinical Examination) Practice Exam

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What drug is known to increase blood levels of lidocaine?

Aspirin
Propranolol
Ibuprofen
Lisinopril

The correct answer is: Propranolol

Propranolol, a non-selective beta-blocker, is known to increase blood levels of lidocaine due to its effects on liver metabolism. Lidocaine is primarily metabolized in the liver via cytochrome P450 enzymes, and propranolol can inhibit these enzymes, leading to decreased clearance of lidocaine from the bloodstream. As a result, patients taking propranolol may experience elevated levels of lidocaine, increasing the risk of toxicity. In contrast, aspirin, ibuprofen, and lisinopril do not have the same impact on the hepatic metabolism of lidocaine and, therefore, do not significantly affect its blood levels. Aspirin and ibuprofen are nonsteroidal anti-inflammatory drugs (NSAIDs) that primarily affect inflammation and pain, while lisinopril is an ACE inhibitor used for controlling blood pressure and managing heart conditions. None of these medications are known to interfere with the metabolic pathways of lidocaine in the same manner as propranolol.