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Test Code Proca G Procainamide and N-acetylprocainamide, Serum

Useful For

Monitoring therapy with procainamide

 

Assessing compliance

 

Evaluating toxicity

Profile Information

Test ID Reporting Name Available Separately Always Performed
NAPRO N-acetylprocainamide, S No Yes
PROC1 Procainamide plus NAPA, S No Yes

Method Name

Immunoassay
Includes a separate determination of N-acetylprocainamide (NAPA).

Reporting Name

Procainamide and NAPA, S

Specimen Type

Serum


Specimen Required


Container/Tube:
Preferred:
Serum gel
Acceptable: Red top
Specimen Volume: 0.5 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.


Seattle Children's Hospital Note:

Collect 1.0 mL whole blood in a red or gold top.

Specimen Minimum Volume

0.25 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 7 days
  Frozen  14 days
  Ambient  24 hours

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

NA

Icterus

NA

Other

NA

Reference Values

Procainamide

Therapeutic: 4.0-10.0 mcg/mL

Critical value: >12.0 mcg/mL

 

N-acetylprocainamide

Therapeutic: 12.0-18.0 mcg/mL

Critical value: ≥40.0 mcg/mL

Method Description

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 (the reduced form of NAD), 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.(Package insert: Roche Procainamide reagent, Roche Diagnostic Corp, Indianapolis, IN)

 

N-acetylprocainamide

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 (the reduced form of NAD), 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.(Package insert: Roche N-acetylprocainamide reagent, Roche Diagnostic Corp, Indianapolis, IN)

Day(s) and Time(s) Performed

Monday through Sunday; Continuously

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

PROC1-80190

NAPRO-80192

LOINC Code Information

Result ID Test Result Name Result LOINC Value
NAPRO N-acetylprocainamide, S 3834-9
PROCN Procainamide, S 3982-6
PRONP Procainamide + NAPA 3983-4