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Procainamide and N-Acetylprocainamide , Serum

Lab area
Clinical Biochemistry - General
Method and equipment

Equipment : Roche Cobas Pro c503

Method : Procainamide : The assay is based on a homogeneous enzyme immunoassay technique used for the quantitative analysis of procainamide in human serum or plasma. The assay is based on competition between drug in the sample and drug labeled with the enzyme glucose‑6‑phosphate dehydrogenase
(G6PDH) for antibody binding sites. Enzyme activity decreases upon binding to the antibody, so the drug concentration in the sample can be measured in terms of enzyme activity. Active enzyme converts oxidized nicotinamide adenine dinucleotide (NAD) to NADH, resulting in an absorbance change that is measured spectrophotometrically. Endogenous serum G6PDH does not interfere because the coenzyme functions only with the bacterial (Leuconostoc mesenteroides) enzyme employed in the assay.

Method : NAPA : The assay is based on a homogeneous enzyme immunoassay technique used for the quantitative analysis of N‑acetylprocainamide in human serum or plasma. The assay is based on competition between drug in the sample and drug labeled with the enzyme glucose‑6‑phosphate dehydrogenase (G6PDH) for antibody binding sites. Enzyme activity decreases upon binding to the antibody, so the drug concentration in the sample can be measured in terms of enzyme activity. Active enzyme converts oxidized nicotinamide adenine dinucleotide (NAD) to NADH, resulting in an absorbance change that is measured spectrophotometrically. Endogenous serum G6PDH does not interfere because the coenzyme functions only with the bacterial (Leuconostoc mesenteroides) enzyme employed in the assay.

 

Expected turn-around time
STAT: 1 hour Urgent : 3 hours Routine: 3 hours
Specimen type

Serum or Plasma Lithium Heparin

Specimen requirements

Serum (red/gold top) and plasma heparin (green/mint green top) tubes

Storage and transportation

Blood should be centrifuged within 2 hours of collection. After centrifugation, immediately aliquot plasma/serum. Store the plasma/serum at 2-8°C and ship at -20°C within 2 weeks.

Special requirements

Grossly hemolyzed samples should not be analyzed.

Shipping information
The Hospital for Sick Children
Rapid Response Laboratory
555 University Avenue, Room 3642
Toronto, ON
Canada
M5G 1X8
Phone: 416-813-7200
Toll Free: 1-855-381-3212
Hours: 7 days/week, 24 hours/day
Background and clinical significance

Procainamide is a cardiac drug commonly used in combination with digoxin, beta-blockers, or amiodarone for supraventricular tachycardia. Procainamide and its active metabolite N-acetyl procainamide (NAPA) have significant antiarrhythmic activity. Therapeutic drug monitoring for procainamide is required because of its dose-dependent toxicity, narrow therapeutic index, and wide inter-individual variability in metabolism and renal function.

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