Simultaneous quantification of procainamide and N-acetylprocainamide with high-performance liquid chromatography

Area of Science:

• Pharmacokinetics and Analytical Chemistry

Background:

• Procainamide is an antiarrhythmic drug with variable metabolism.
• N-acetylprocainamide (NAPA) is the primary active metabolite of procainamide.
• Determining a patient's acetylator phenotype is crucial for optimizing procainamide therapy.

Purpose of the Study:

• To develop and validate a rapid, precise, and specific analytical method for simultaneous determination of procainamide and NAPA in human plasma.
• To assess the utility of this method for rapid acetylator phenotype determination in clinical settings.

Main Methods:

• High-performance liquid chromatography (HPLC) was employed for the simultaneous quantification of procainamide and NAPA.
• N-Formylprocainamide was used as the internal standard.
• Plasma samples were analyzed to determine method accuracy and precision.

Main Results:

• The developed HPLC method demonstrated high precision and specificity for both procainamide and NAPA.
• Coefficients of variation were 3.6% for both analytes within the clinically relevant plasma concentration range.
• The method allows for rapid analysis, facilitating timely clinical decisions.

Conclusions:

• A validated, rapid, and precise HPLC method for simultaneous procainamide and NAPA measurement in plasma has been established.
• This method is suitable for routine clinical use, particularly for rapid acetylator phenotype determination in patients treated with procainamide.
• Efficient monitoring of procainamide and NAPA levels can improve therapeutic outcomes in patients with arrhythmias.