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Severe neutropenia consequent to sustained-release procainamide.
M Mellino1, J Hogan, H C Taylor
1Department of Medicine, Division of Cardiology, Case Western University School of Medicine, Lutheran Medical Center, Cleveland, Ohio 44113, USA.
Texas Heart Institute Journal
|March 1, 1983
Summary
A patient experienced reversible neutropenia due to sustained-release procainamide. This case highlights rare complications and discusses drug mechanisms for blood dyscrasias.
Area of Science:
- Pharmacology
- Hematology
- Clinical Toxicology
Background:
- Procainamide preparations are used for cardiac arrhythmias.
- Adverse effects of procainamide, particularly blood dyscrasias, are rarely reported.
- Sustained-release formulations may alter drug pharmacokinetics and toxicity profiles.
Purpose of the Study:
- To describe a case of severe neutropenia and eosinophilia associated with sustained-release procainamide.
- To review the pharmacokinetic properties of sustained-release procainamide.
- To discuss potential mechanisms underlying drug-induced blood dyscrasias.
Main Methods:
- Case report of a patient treated with sustained-release procainamide.
- Review of pharmacokinetic data for sustained-release procainamide.
- Literature review on procainamide-induced hematological adverse events.
Main Results:
- The patient presented with reversible severe neutropenia and relative eosinophilia.
- Sustained-release procainamide was identified as the likely causative agent.
- The case represents a rare complication of procainamide therapy.
Conclusions:
- Sustained-release procainamide can cause severe, reversible neutropenia.
- Understanding drug pharmacokinetics is crucial for managing adverse effects.
- Further investigation into mechanisms of procainamide-induced blood dyscrasias is warranted.