Hemoperfusion for Treatment of N-Acetylprocainamide Intoxication
Authors: GREGORY L. BRADEN
Journal: Annals of Internal Medicine (1986)

Brief Reports1 July 1986Hemoperfusion for Treatment of N-Acetylprocainamide IntoxicationGREGORY L. BRADEN, M.D., JOHN P. FITZGIBBONS, M.D., MICHAEL J. GERMAIN, M.D., HOWARD M. LEDEWITZ, M.D.GREGORY L. BRADEN, M.D.Search for more papers by this author, JOHN P. FITZGIBBONS, M.D.Search for more papers by this author, MICHAEL J. GERMAIN, M.D.Search for more papers by this author, HOWARD M. LEDEWITZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-1-64 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe pharmacokinetics of procainamide and its major metabolite,N-acetylprocainamide, are significantly altered in patients with chronic renal failure (1-4). BecauseN-acetylprocainamide is normally eliminated through renal excretion, it tends to accumulate in patients with renal failure and may reach toxic levels in patients on chronic dialysis despite adequate dialytic therapy (1-4). In addition, recent reports ofN-acetylprocainamide intoxication in dialysis patients have shown that therapy either by peritoneal dialysis (5) or hemodialysis (6) is of questionable benefit. We report the case of a patient on chronic hemodialysis who developedN-acetylprocainamide intoxication and show the superiority of hemoperfusion over hemodialysis in...References1. GIBSONMATUSIKBRIGGS TEW. N-acetylprocainamide levels in patients with end-stage renal failure. Clin Pharmacol Ther. 1976; 19:206-12. CrossrefMedlineGoogle Scholar2. DRAYERLOWENTHALWOOSLEYNIESSCHWARTZREIDENBERG DDRAAM. Cumulation of N-acetylprocainamide, an active metabolite of procainamide, in patients with impaired renal function. Clin Pharmacol Ther. 1977;22:63-9. CrossrefMedlineGoogle Scholar3. GIBSONATKINSONMATUSIKNELSONBRIGGS TAELW. Kinetics of procainamide and N-acetylprocainamide in renal failure. Kidney Int. 1977;12:422-9. CrossrefMedlineGoogle Scholar4. STECATKINSONNEVIN GAM. N-acetylprocainamide pharmacokinetics in functionally anephric patients before and after Pertubation by hemodialysis. Clin Pharmacol Ther. 1979;26:618-28. CrossrefMedlineGoogle Scholar5. VILLALBA-PIMENTALEPSTEINSELLERS LLE. Survival after massive procainamide ingestion. Am J Cardiol. 1973;32:727-30. CrossrefMedlineGoogle Scholar6. ATKINSONKRUMLOVSKYHUANGDEL GRECO AFCF. Hemodialysis for severe procainamide toxicity: clinical and pharmacokinetic observations. Clin Pharmacol Ther. 1976;20:585-92. CrossrefMedlineGoogle Scholar7. LEWISLEEADAMS LCK. An evaluation of the procainamide and N-acetylprocainamide methods for the DuPont ACA discrete clinical analyzer. Wilmington, Delaware: DuPont Company; 1983. Google Scholar8. CHOWPIERGIESBOWSHER MAD. Torsade de pointes induced by N-acetylprocainamide. J Am Coll Cardiol. 1984;4:621-4. CrossrefMedlineGoogle Scholar9. GIBSONMATUSIKNELSONBRIGGS TELW. Artificial kidneys and clearance calculations. Clin Pharmacol Ther. 1976;30:720-6. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Baystate Medical Center Springfield Tufts University School of Medicine Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHemoperfusion for the Treatment of Poisoning: Technology, Determinants of Poison Clearance, and Application in Clinical PracticeClass IA Antiarrhythmics: Quinidine, Procainamide, and DisopyramideThe case of the slandered Halloween cupcake: Survival after massive pediatric procainamide overdosePediatric toxicologic concernsTherapeutic drug monitoring: antiarrhythmic drugsAntiarrhythmicsN-acetylprocainamide intoxication with torsade de pointes treated by high dialysate flow rate continuous arteriovenous hemodiafiltrationEpuration extrarénale en toxicologieCombined High-Efficiency Hemodialysis and Charcoal Hemoperfusion in Severe N-Acetylprocainamide IntoxicationPAntiarrhythmic MedicationsRemoval of Digoxin from the Circulation Using Immobilized Monoclonal AntibodiesConsiderations in the Diagnosis and Treatment of Arrhythmias in Patients with End-Stage Renal DiseaseDrugs and the KidneyExtracorporeal techniques in the treatment of exogenous intoxicationsHemoperfusion for N-Acetylprocainamide IntoxicationSTEVEN C. BORKAN, M.D. 1 July 1986Volume 105, Issue 1Page: 64-65KeywordsExcretionHemoperfusionIntoxicationMedical dialysisMetabolitesPeritoneal dialysisPharmacokineticsRenal failure Issue Published: 1 July 1986 PDF downloadLoading ...