section name header

Pronunciation

proe-KANE-ah-mide

Classifications

Therapeutic Classification: antiarrhythmics (class IA)

Indications

REMS

Action

Therapeutic Effects:

Pharmacokinetics

Absorption: IV administration results in complete bioavailability.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Converted by the liver by N-acetyltransferase to N-acetylprocainamide (NAPA), an active antiarrhythmic compound; rate of acetylation is genetically determined (slow acetylators have procainamide levels and risk of toxicity; fast acetylators have procainamide levels and risk for treatment failure). 40–70% excreted unchanged by the kidneys.

Half-life: 2.5–4.7 hr (NAPA: 7 hr); in renal impairment.

Time/Action Profile

(antiarrhythmic effects)

ROUTEONSETPEAKDURATION
IVimmediate25–60 min3–4 hr

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: ASYSTOLE, HEART BLOCK, hypotension, VENTRICULAR ARRHYTHMIAS.

Derm: rash.

GI: diarrhea, anorexia, nausea, vomiting.

Hemat: AGRANULOCYTOSIS, eosinophilia, leukopenia, thrombocytopenia.

Neuro: confusion, dizziness, SEIZURES.
Misc: chills, drug-induced lupus, fever.

Interactions

Drug-Drug:

Route/Dosage

see Calculator

Availability

(Generic available)

Assessment

Lab Test Considerations: Toxicity and Overdose:

Implementation

IV Administration:

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Pronestyl