Adenosine

Welcome to Dwaey, specifically on Adenosine page.
This medicine contains important and useful components, as it consists of
Adenosine is available in the market in concentration.

Generic Name of Adenosine - Learn More

Adenosine

Adenosine Precaution - What You Need to Know

Adenosine requires careful consideration in certain populations and clinical scenarios:
- Pregnancy: Adenosine is classified as a Category C drug for pregnancy, meaning that there is insufficient data to confirm its safety during pregnancy. It should only be used when the potential benefit justifies the potential risk to the fetus, and it should be avoided in the first trimester unless absolutely necessary.
- Breastfeeding: While there is limited information regarding the excretion of adenosine in breast milk, it is recommended that it be used with caution in breastfeeding women. Due to its short half-life, significant systemic exposure in the infant is unlikely, but caution should still be exercised.
- Cardiac Disorders: Adenosine should be used with caution in patients with existing heart disease, particularly those with severe bradycardia, sick sinus syndrome, or second- or third-degree heart block, as it may worsen these conditions. It is contraindicated in patients with a history of arrhythmias, especially those involving the atrioventricular (AV) node.
- Asthma and Respiratory Conditions: Although adenosine is not typically contraindicated in patients with asthma, it may cause bronchoconstriction, leading to respiratory distress. Patients with a history of severe bronchospasm or reactive airway disease should be monitored closely.
- Renal and Hepatic Impairment: In patients with severe renal or hepatic impairment, adenosine should be used cautiously, as it is metabolized by the liver and excreted by the kidneys. Reduced clearance may result in prolonged effects.

Monitoring parameters include heart rate, blood pressure, and ECG to ensure the appropriate therapeutic response and to detect any adverse reactions such as arrhythmias. Regular observation is required during and after administration to monitor for side effects like transient bradycardia, hypotension, or shortness of breath.

Adenosine Indication - Uses and Benefits

Adenosine is primarily used in the treatment of supraventricular tachycardia (SVT), a condition characterized by an abnormally fast heart rate originating above the ventricles. Adenosine is effective in restoring normal sinus rhythm by temporarily blocking AV nodal conduction, thereby interrupting the reentrant circuits that cause SVT.
- FDA-approved Use: Adenosine is most commonly used in acute settings for the rapid conversion of SVT to a normal sinus rhythm. It is considered a first-line agent for SVT, especially in cases that do not respond to vagal maneuvers.
- Off-label Uses: Adenosine may also be used off-label for diagnostic purposes in certain arrhythmias, including the identification of atrial flutter or the investigation of other supraventricular arrhythmias. It can also be used in the assessment of coronary artery disease, as it induces vasodilation and increases blood flow to coronary vessels, which can be helpful during myocardial stress testing.

Adenosine Contraindications - Important Warnings

Adenosine is contraindicated in several clinical situations:
- Second- or Third-degree AV Block: Adenosine should not be used in patients with AV block (except in those with a functioning pacemaker), as it can worsen conduction and lead to complete heart block.
- Sick Sinus Syndrome: Patients with sick sinus syndrome, unless they have a functioning pacemaker, should not receive adenosine due to the risk of further bradycardia or asystole.
- Hypersensitivity: A history of hypersensitivity to adenosine or any of its components contraindicates its use.
- Bronchospastic Diseases: Adenosine is contraindicated in patients with asthma or other bronchospastic conditions, as it can induce bronchoconstriction.
- Severe Hypotension: Adenosine can cause a transient drop in blood pressure, which can be dangerous in patients with pre-existing hypotension.

Adenosine Side Effects - What to Expect

The side effects of adenosine are typically transient and dose-dependent, but they can be severe in certain cases:
- Common Side Effects:
- Bradycardia: A significant but temporary decrease in heart rate, typically lasting less than 10 seconds, is common. However, this can be problematic in patients with underlying heart disease or pacemaker dependency.
- Hypotension: A transient drop in blood pressure often occurs immediately after administration of adenosine. This is usually brief but can cause dizziness or fainting.
- Flushing and Chest Discomfort: Flushing, a sensation of warmth, and chest pressure are common following adenosine administration. These effects are generally short-lived.
- Severe Side Effects:
- Prolonged Asystole: Although rare, adenosine can cause a brief period of asystole, particularly in patients with certain pre-existing heart conditions. This should resolve spontaneously.
- Respiratory Effects: Adenosine can cause bronchoconstriction, especially in patients with asthma, leading to wheezing, shortness of breath, or other signs of respiratory distress.
- Severe Hypotension: In patients with underlying hypotension or those already receiving antihypertensive therapy, adenosine may exacerbate hypotension.
- Management of Side Effects: Most side effects of adenosine are transient and self-limited. In cases of prolonged bradycardia or asystole, resuscitation measures, such as the use of atropine or pacing, may be necessary. In patients with asthma or respiratory distress, bronchodilators should be administered.

Adenosine Pregnancy Category ID - Safety Information

3

Adenosine Mode of Action - How It Works

Adenosine works primarily by affecting the electrical conduction system of the heart. It acts on specific purinergic receptors (A1 receptors) located in the AV node and other cardiac tissues:
- AV Node Conduction Block: By binding to A1 receptors in the AV node, adenosine reduces the speed of electrical conduction, effectively slowing the heart rate. This results in the interruption of reentrant circuits that cause supraventricular tachycardia (SVT).
- Vasodilation: Adenosine also induces coronary vasodilation, which improves blood flow to the heart muscle. This can be beneficial during myocardial stress testing or in diagnosing coronary artery disease.
- Short Half-Life: Adenosine has an extremely short half-life of around 10 seconds, which allows it to exert rapid, transient effects on the heart and makes it ideal for emergency use in acute arrhythmia management.

Adenosine’s effects are reversed quickly once the drug is discontinued due to its rapid metabolism by the enzyme adenosine deaminase, which is widely present in tissues and the liver.

Adenosine Drug Interactions - What to Avoid

Adenosine has several important drug-drug interactions that should be carefully managed:
- Theophylline and Caffeine: Both of these substances antagonize the effects of adenosine, and patients taking these medications may require higher doses of adenosine to achieve the desired therapeutic effect.
- Adenosine Reuptake Inhibitors: Medications such as dipyridamole and certain antidepressants can inhibit the reuptake of adenosine, leading to prolonged effects of the drug. This interaction can increase the risk of side effects, such as prolonged bradycardia or hypotension.
- Antiarrhythmic Agents: Drugs like verapamil and diltiazem, which block calcium channels, may potentiate the effects of adenosine and increase the likelihood of side effects such as bradycardia, hypotension, or asystole.
- Digoxin: There may be an increased risk of bradycardia and heart block when adenosine is used in combination with digoxin. Close monitoring is necessary.
- Other Antihypertensive Medications: Adenosine can lower blood pressure transiently, which could enhance the effects of antihypertensive medications and lead to hypotension.

Food and alcohol interactions are minimal but should be monitored. Alcohol, by influencing the cardiovascular system, may increase the risk of hypotension when used in conjunction with adenosine.

Adenosine Adult Dose - Recommended Dosage

For the treatment of SVT in adults, adenosine is typically administered as an intravenous (IV) bolus:
- Initial Dose: 6 mg IV push, administered rapidly over 1-2 seconds, followed by a saline flush.
- Second Dose: If the first dose is ineffective within 1-2 minutes, a second dose of 12 mg IV push can be administered, again followed by a saline flush.
- Maximum Dose: The maximum recommended dose is 12 mg. Doses higher than this are not typically used due to the risk of excessive side effects.

Adenosine Child Dose - Dosage for Children

For pediatric patients, the dosing is based on weight and age:
- Initial Dose: 0.1 mg/kg (up to a maximum of 6 mg) administered IV push, followed by a saline flush.
- Second Dose: If necessary, a second dose of 0.2 mg/kg (up to a maximum of 12 mg) can be administered after 1-2 minutes.
- Maximum Dose: The maximum single dose is 12 mg for pediatric patients.

Pediatric dosing should be closely monitored, especially for signs of bradycardia, hypotension, or respiratory distress.

Adenosine Renal Dose - Dosage for Kidney Conditions

No specific dose adjustment is needed for patients with renal impairment. However, caution should be exercised in patients with severe renal disease as the clearance of adenosine may be affected, leading to prolonged effects.