Hemoperfusion for N-Acetylprocainamide Intoxication
Authors: STEVEN C. BORKAN
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 December 1986Hemoperfusion for N-Acetylprocainamide IntoxicationSTEVEN C. BORKAN, M.D.STEVEN C. BORKAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-6-965 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The data presented by Braden, and coworkers (1) do not show the clear superiority of hemoperfusion over hemodialysis for treatment of severeN-acetylprocainamide intoxication. The evidence is circumstantial that a markedly elevated level of this metabolite was responsible for precipitating thetorsade de pointesbecause two separate episodes of ventricular arrhythmia occurred before any procainamide was administered, because thetorsade de pointesoccurred 3 days after intravenous procainamide therapy was discontinued, and because theN-acetylprocainamide level had already fallen from 56 to 49.5 /µg/mL. Although hemoperfusion produced an impressive 38% decrement in the plasma 7V-acetylprocainamide level (to...References1. BRADENFITZGIBBONSGERMAINLEDEWITZ GJMH. Hemoperfusion for treatment of N-acetylprocainamide intoxication. Ann Intern Med. 1986;105:64-5. LinkGoogle Scholar2. CHOWPIERGIESBOWSHER MAD. Torsade de pointes induced by N-acetylprocainamide. J Am Coll Cardiol. 1984;4:621-4. CrossrefMedlineGoogle Scholar3. MCEVOY G ed. Drug Information. Bethesda, Maryland: American Hospital Formulary Services; 1986:706. Google Scholar4. GARELLALORCH SJ. Use of dialysis and hemoperfusion in drug overdose-an overview. In: ANDERSON RJ, SCHRIER RW, eds. Clinical Use of Drugs in Patients with Kidney and Liver Disease. Philadelphia: W. B. Saunders Company; 1981. Google Scholar5. ATKINSONKRUMLOVSKYHUANGDEL GRECO AFCF. Hemodialysis for severe procainamide toxicity: clinical and pharmacokinetic observations. Clin Pharmacol Ther. 1976;20:585-92. CrossrefMedlineGoogle Scholar1. OLSHANSKYMARTINSHUNT BJS. N-acetylprocainamide causing torsades de pointes. Am J Cardiol. 1982;50:1439-41. CrossrefMedlineGoogle Scholar2. NGUYENTHOMSENLIEMSWERDLOWFRANZ KGBCM. N-acetylprocainamide, torsades de pointes, and hemodialysis [Letter]. Ann Intern Med. 1986;104:283-4. LinkGoogle Scholar3. VLASSESFERGUSONROCCIRAJAPORTERGREENSPAN PRMRRA. Lethal accumulation of procainamide metabolite in severe renal insufficiency. Am J Nephrol. 1986;6:112-6. CrossrefMedlineGoogle Scholar4. STECATKINSONNEVIN GAM. N-acetylprocainamide pharmacokinetics in functionally anephric patients before and after perturbation by hemodialysis. Clin Pharm Ther. 1979;26:618-28. CrossrefMedlineGoogle Scholar5. ROSANSKYBRADY SM. Procainamide toxicity in a patient with acute renal failure. Am J Kidney Dis. 1986;7:502-6. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: STEVEN C. BORKAN, M.D.Affiliations: Boston University Medical Center Boston, MA 02118 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCombined High-Efficiency Hemodialysis and Charcoal Hemoperfusion in Severe N-Acetylprocainamide IntoxicationBibliographyExtracorporeal techniques in the treatment of exogenous intoxications 1 December 1986Volume 105, Issue 6Page: 965-966KeywordsArrhythmiaBlood plasmaHemoperfusionIntoxicationMetabolites ePublished: 1 December 2008 Issue Published: 1 December 1986 PDF downloadLoading ...