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Angiology Feb 1982In summary, procainamide is a useful agent for suppressing premature depolarization frequency. Its short half-life of elimination requires a dosing frequency of every 3... (Review)
Review
In summary, procainamide is a useful agent for suppressing premature depolarization frequency. Its short half-life of elimination requires a dosing frequency of every 3 hours with regular dosage forms or every 6-8 hours with a sustained action dosage. Because of the extreme unpredictability of plasma concentration, the dosage must be titrated in each patient with electrocardiographic monitoring serving as the most useful method of evaluating efficacy. Maximum and minimum plasma concentrations are helpful in monitoring the achievement of therapeutic plasma levels and adjusting the frequency of dosing, especially in the presence of impaired renal function or low cardiac output. Adverse effects of procainamide include anorexia, nausea, vomiting, fatigue, insomnia, visual hallucinations, and disorientation; these are minor and cease with discontinuation of the drug. Agranulocytosis has rarely been reported. Long-term treatment has resulted in the occurrence of a lupus-like syndrome that is reversible when the drug is stopped. Procainamide is excreted in breast milk and infants of mothers receiving procainamide should not be nursed.
Topics: Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Creatinine; Delayed-Action Preparations; Dose-Response Relationship, Drug; Electrocardiography; Humans; Procainamide; Therapeutic Equivalency
PubMed: 7039427
DOI: 10.1177/000331978203300201 -
Journal of Veterinary Pharmacology and... Dec 1986Procainamide hydrochloride was administered to ouabain-intoxicated dogs to determine an antiarrhythmic plasma concentration of procainamide. Ventricular arrhythmias were...
Procainamide hydrochloride was administered to ouabain-intoxicated dogs to determine an antiarrhythmic plasma concentration of procainamide. Ventricular arrhythmias were produced in dogs following intravenous injections of ouabain. After a sustained ventricular tachycardia was achieved, procainamide was administered and plasma samples collected for assay. Plasma procainamide was assayed by fluorescence polarization immunoassay. Procainamide was administered at increasingly higher constant rate infusions in order to achieve intermittent, steady-state plasma concentrations. Infusion rates were calculated on the basis of previous pharmacokinetic information. All six dogs that received procainamide converted to a normal sinus cardiac rhythm after attaining a mean plasma concentration of 33.8 micrograms/ml with a range of 48.5 micrograms/ml-25.0 micrograms/ml. It was observed that the computer-generated prediction of plasma concentrations based upon previous pharmacokinetic data produced an underestimate of the actual plasma concentrations. These data may suggest that plasma concentrations of procainamide for controlling some cardiac arrhythmias in dogs may be higher than plasma concentrations cited for human patients.
Topics: Animals; Arrhythmias, Cardiac; Computer Simulation; Dog Diseases; Dogs; Electrocardiography; Female; Infusions, Intravenous; Injections, Intravenous; Kinetics; Male; Ouabain; Procainamide
PubMed: 3806778
DOI: 10.1111/j.1365-2885.1986.tb00056.x -
The Journal of Pediatrics Apr 1983
Topics: Acecainide; Adult; Arrhythmias, Cardiac; Female; Humans; Infant, Newborn; Male; Milk, Human; Postpartum Period; Pregnancy; Pregnancy Complications, Cardiovascular; Procainamide
PubMed: 6187910
DOI: 10.1016/s0022-3476(83)80210-8 -
Clinical Therapeutics 1985Hemodynamic and electrophysiologic effects of procainamide, the pharmacokinetic properties of conventional and sustained-release forms of the drug, guidelines for its... (Review)
Review
Hemodynamic and electrophysiologic effects of procainamide, the pharmacokinetic properties of conventional and sustained-release forms of the drug, guidelines for its administration and dosage, and contraindications for and adverse effects of its use are outlined. A review of clinical studies of procainamide therapy concludes that in the treatment of ventricular arrhythmia it is comparable to other class IA drugs and generally superior to beta-blockers and to class IB drugs. For atrial arrhythmias, procainamide is usually the drug of choice when intravenous therapy is indicated; for oral prophylaxis, quinidine or the sustained-release form of procainamide is more effective than conventional formulation oral procainamide. Because procainamide is the only class I antiarrhythmic drug currently available that is commonly administered intravenously and orally, it is frequently the drug of choice for patients requiring both immediate and intermediate periods of arrhythmia control. It is often the drug of choice for initial testing with programmed electrical stimulation.
Topics: Administration, Oral; Arrhythmias, Cardiac; Delayed-Action Preparations; Drug Interactions; Electrocardiography; Heart Conduction System; Humans; Infusions, Parenteral; Injections, Intramuscular; Injections, Intravenous; Kidney Diseases; Kinetics; Procainamide
PubMed: 3902240
DOI: No ID Found -
Angiology Jul 1988Although procainamide (PA) has been widely used to treat patients with both ventricular and supraventricular arrhythmias since 1951, more than twenty years elapsed... (Comparative Study)
Comparative Study Review
Although procainamide (PA) has been widely used to treat patients with both ventricular and supraventricular arrhythmias since 1951, more than twenty years elapsed before N-acetylprocainamide (NAPA) was identified as a major PA metabolite and shown in PA-treated patients to have plasma concentrations generally equaling or being 2 to 3 times greater than those of the parent drug. Numerous investigations have been conducted since then to characterize the pharmacokinetics and pharmacodynamics of NAPA and to compare these properties with those of PA. Salient differences have been that the elimination half-life of NAPA is 2.5 times that of PA, even when renal function is normal; that NAPA has a spectrum of electrophysiologic action that differs from PA in that NAPA only prolongs action potential duration; and that NAPA is less likely than PA to cause a syndrome resembling systemic lupus erythematosus. Although these properties have provided an impetus for the development of NAPA as an antiarrhythmic drug in its own right, emphasis is placed in this review on the implications of these findings for individualizing PA therapy.
Topics: Acecainide; Arrhythmias, Cardiac; Electrophysiology; Hemodynamics; Humans; Procainamide
PubMed: 2457345
DOI: No ID Found -
Archives of Internal Medicine Feb 1979Procainamide therapy has frequently been reported as a cause of agranulocytosis, but severe thrombocytopenia associated with the use of this drug has been noted only...
Procainamide therapy has frequently been reported as a cause of agranulocytosis, but severe thrombocytopenia associated with the use of this drug has been noted only once. We report a case of simultaneously occurring agranulocytosis and profound thrombocytopenia in a patient receiving procainamide hydrochloride. Different mechanisms appeared to be responsible for the two cytopenias.
Topics: Aged; Agranulocytosis; Arteriosclerosis; Humans; Male; Procainamide; Thrombocytopenia
PubMed: 434983
DOI: No ID Found -
Carbohydrate Polymers May 2015
Topics: Nanostructures; Nanotechnology; Procainamide; beta-Cyclodextrins
PubMed: 25988204
DOI: No ID Found -
The Annals of Pharmacotherapy Oct 1994To report a case of thrombocytopenia associated with the use of extended-release procainamide hydrochloride in a geriatric patient. (Review)
Review
OBJECTIVE
To report a case of thrombocytopenia associated with the use of extended-release procainamide hydrochloride in a geriatric patient.
CASE SUMMARY
A 77-year-old man was admitted to the hospital for four-vessel coronary artery bypass surgery. He subsequently developed new onset atrial fibrillation and was started on extended-release procainamide on hospital day 7. The patient's platelet count on admission was 229 x 10(9)/L. The platelet count began to decrease on hospital day 22 and was 79 x 10(9)/L by day 30 and 13 x 10(9)/L by hospital day 37. The patient exhibited gross hematuria and lower extremity petechiae. There were no signs of splenic sequestration and other hematologic indices were normal. Procainamide was discontinued on hospital day 32. There was full recovery of the platelet count to baseline 33 days after procainamide was discontinued.
DISCUSSION
Other possible medical and drug-related causes of thrombocytopenia are reviewed and ruled out. Previous reports of procainamide-associated thrombocytopenia describe an immune-mediated peripheral destruction of platelets with platelet recovery within three to eight days after drug discontinuation. However, the prolonged recovery period and the presence of antiplatelet antibodies suggest an immune-mediated process in the bone marrow of this patient.
CONCLUSIONS
Clinicians should be aware of the possible adverse hematologic effects of procainamide in the elderly.
Topics: Aged; Atrial Fibrillation; Delayed-Action Preparations; Humans; Male; Procainamide; Thrombocytopenia; Time Factors
PubMed: 7841573
DOI: 10.1177/106002809402801008 -
South Dakota Journal of Medicine Mar 1974
Topics: Aged; Arrhythmias, Cardiac; Female; Humans; Lupus Erythematosus, Systemic; Male; Middle Aged; Procainamide; Radiography
PubMed: 4522250
DOI: No ID Found -
The New England Journal of Medicine Mar 1970
Topics: Arrhythmias, Cardiac; Costs and Cost Analysis; Humans; Myocardial Infarction; Procainamide
PubMed: 5413110
DOI: No ID Found