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Procainamide



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 C13H21N3O 
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

Procainamide (proe-KANE-a-mide) (INN, 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. Procanbid® will no longer be manufactured.1

Additional recommended knowledge

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). 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.

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 excreted by the kidneys and the renal system.

Adverse effects include rash, myalgia, hypersensitivity reactions (fever, agranulocytosis), Drug-Induced Lupus Erythematosus (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.


References

1. http://www.fda.gov/cder/drug/shortages/procanletter.pdf


 
This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Procainamide". A list of authors is available in Wikipedia.
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