Procainamide, Serum or Plasma

CPT: 80192
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Test Details

Synonyms

  • Pronestyl®

Test Includes

Procainamide; N-acetyl procainamide (NAPA)

Methodology

Immunoassay

Reference Interval

Therapeutic: procainamide: 4.0−10.0 μg/mL, procainamide + NAPA: 10.0−30.0 μg/mL

Additional Information

The cardiac actions of this drug are similar to those of quinidine. It is used in a variety of arrhythmias. Procainamide usually is rapidly absorbed from the gastrointestinal tract. Peak blood levels are reached within one hour. Optimal plasma sampling time after oral dosage is one to two hours. Optimal sampling time after I.V. administration of dose is 30 minutes. The drug is converted by the liver to its active metabolite, N-acetyl procainamide (NAPA). The half-life of procainamide is two to six hours and for NAPA is eight hours. Rate of metabolism is genetically determined (slow and fast acetylator types) contributing to significant interindividual variability. Impairment of renal function has pronounced effect on drug disposition, especially for NAPA. Patients with severe renal dysfunction generally have prolonged and highly variable half-life characteristics. Elimination half-life may be prolonged in geriatric subjects.1

Specimen Requirements

Specimen

Serum or plasma

Volume

1 mL

Minimum Volume

0.3 mL

Container

Red-top tube or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant.

Collection

Transfer separated serum or plasma to a plastic transport tube. Oral treatment: peak: 75 minutes after dose; trough: immediately before next dose. I.V. treatment: immediately after loading dose; 2, 6, 12, and 24 hours after starting I.V. maintenance.

Storage Instructions

Refrigerate

Stability Requirements

Temperature

Period

Room temperature

2 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Gel-barrier tube; severe hemolysis; lipemia; icteric specimen

Clinical Information

Footnotes

1. Montamat SC, Cusack BJ, Vestal RE. Management of drug therapy in the elderly. N Engl J Med., 1989 Aug 3; 321(5):303-309. 2664519

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
007252 Procainamide, Serum 018666 Procainamide, Serum ug/mL 3982-6
007252 Procainamide, Serum 018459 NAPA, Serum ug/mL 3834-9
007252 Procainamide, Serum 022287 Total PA+NAPA ug/mL 3983-4

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