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Pathway Description
Procainamide Mechanism of Action
Homo sapiens
Drug Action Pathway
Procainamide is a class 1A antidysrythmIc as well as an anesthetic that is used to treat ventricular dysrhythmias, tachycardia and atrial fibrillation. Procainamide mainly inhibits sodium channels protein type 5 subunit alpha but also inhibits the potassium voltage gated channel subfamily H member 2. The main antidysrythmIc effect is mediated through the sodium channel blockage though. Phenytoin slows the rate of rise in the pacemaker potential and shortens the plateau phase of atrial and ventricular myocytes as well as purkinje fibre cells as they have 'fast' action potential. This converts a one way block into a two block effectively stopping the circus rhythm irregularity. Procainamide works through use-dependent blockage meaning that it preferentially binds to the inactivate state of the sodium channel. The more active the channel the more chances procainamide can bind to the channel and block it. Procainamide can be administered through either oral or intravenous routes with both having a relatively short half-life of 2.5 to 4.5 hours
References
Procainamide Mechanism of Action References
Karlsson E: Clinical pharmacokinetics of procainamide. Clin Pharmacokinet. 1978 Mar-Apr;3(2):97-107. doi: 10.2165/00003088-197803020-00001.
Pubmed: 346289
Giardina EG: Procainamide: clinical pharmacology and efficacy against ventricular arrhythmias. Ann N Y Acad Sci. 1984;432:177-88. doi: 10.1111/j.1749-6632.1984.tb14519.x.
Pubmed: 6084435
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