Acecainide

A medication used in the treatment of cardiac arrhythmias

Acecainide, also known as N-acetylprocainamide (NAPA), is a pharmaceutical drug used primarily in the management of certain types of cardiac arrhythmias. It is a metabolite of the antiarrhythmic drug procainamide.

Pharmacology

Acecainide is classified as a Class III antiarrhythmic agent. It works by blocking potassium channels in the heart, which prolongs the action potential and refractory period of cardiac cells. This action helps to stabilize the heart rhythm and prevent abnormal electrical activity.

Metabolism

Acecainide is formed in the body from procainamide through the action of the enzyme N-acetyltransferase 2 (NAT2). This enzyme acetylates procainamide, converting it into acecainide. The rate of this conversion can vary among individuals due to genetic differences in NAT2 activity.

File:N-Acetyl procainamide.png

Chemical structure of Acecainide

File:Nacetyltransferase2.png

N-acetyltransferase 2 enzyme

Clinical Use

Acecainide is used in the treatment of ventricular arrhythmias, such as ventricular tachycardia and ventricular fibrillation. It is particularly useful in patients who have developed arrhythmias following a myocardial infarction.

Electrophysiological Effects

Acecainide affects the electrical conduction system of the heart by prolonging the QT interval on the electrocardiogram (ECG). This can be visualized in the EKG complex.

File:EKG Complex en.svg

Electrocardiogram complex showing the QT interval

Adverse Effects

The use of acecainide can lead to several side effects, including hypotension, bradycardia, and proarrhythmia. It is important to monitor patients closely for these effects, especially in those with pre-existing heart conditions.

Related pages

• Procainamide
• Cardiac arrhythmia
• Antiarrhythmic agent
• Electrocardiogram

Gallery

• Metabolic pathway of procainamide to acecainide
  Metabolic pathway of procainamide to acecainide

• N-Acetyl procainamide structure
  N-Acetyl procainamide structure
• N-acetyltransferase 2 enzyme
  N-acetyltransferase 2 enzyme
• EKG Complex
  EKG Complex
• Acecainide
  Acecainide