The Full Wiki

Procainamide: Wikis

Advertisements
  

Note: Many of our articles have direct quotes from sources you can cite, within the Wikipedia article! This article doesn't yet, but we're working on it! See more info or our list of citable articles.

Encyclopedia

From Wikipedia, the free encyclopedia

Procainamide
Systematic (IUPAC) name
4-amino-N-(2-diethylaminoethyl) benzamide
Identifiers
CAS number 51-06-9
ATC code C01BA02
PubChem 4913
DrugBank APRD00509
Chemical data
Formula C 13H21N3O 
Mol. mass 235.325 g/mol
Pharmacokinetic data
Bioavailability 85% (oral)
Protein binding 15 to 20%
Metabolism Hepatic (CYP2D6-mediated)
Half life ~2.5 to 4.5 hours
Excretion Renal
Therapeutic considerations
Pregnancy cat. C(US)
Legal status POM (UK)
Routes IV, IM, oral
 Yes check.svgY(what is this?)  (verify)

Procainamide (INN, pronounced /proʊˈkeɪnəmaɪd/; trade names Pronestyl, Procan, Procanbid) is a pharmaceutical antiarrhythmic agent used for the medical treatment of cardiac arrhythmias, classified by the Vaughan Williams classification system as class Ia.

Contents

History

It was introduced in 1951.[1]

Procanbid will no longer be manufactured.[2]

Mechanism

It blocks open sodium (Na+) channels and prolongs the cardiac action potential (outward potassium (K+) currents may be blocked). This results in slowed conduction, and ultimately the decreased rate of rise of the action potential, which may result in widening of QRS on electrocardiogram (ECG).

Uses

This drug is used for both supraventricular and ventricular arrhythmias. For example, it can be used to convert new-onset atrial fibrillation, though it is suboptimal for this purpose. It can also be used to treat Wolf-Parkinson-White syndrome by prolonging the refractory period of the accessory pathway. Typically use is secondary to lidocaine in patients who are allergic to lidocaine or dysrhythmias that are refractory to lidocaine.

Administration

Procainamide is administered intravenously or orally. When administered intravenously, a loading dose should first be given, though care should be taken not to cause hypotension. Procainamide's active metabolite is N-acetyl procainamide, which is stronger than procainamide and excreted by the kidneys and the renal system. Loading dose is 100mg IV bolus given slowly over 5 minutes. Max dose is 17mg/kg. Use is discontinued when dysrhythmia is suppressed, or if hypotension ensues, QRS complex widens by 50% or more, or maximum dose is achieved.

Side effects

Adverse effects include rash, myalgia, hypersensitivity reactions (fever, agranulocytosis), Drug-Induced Lupus Erythematosus[3] (particularly in slow-acetylators), and proarrhythmic effects (e.g., torsades de pointes). Treatment with procainamide can cause antibody production against cellular components, accounting for the systemic lupus erythematosus-like adverse reactions.

External links

References

Advertisements

Advertisements






Got something to say? Make a comment.
Your name
Your email address
Message