Adenosine

Adenosine is an anti-arrhythmic medicine used to treat life-threatening arrhythmia (abnormal heart rhythm). It restores normal heart rhythm by blocking abnormal electrical signals in the heart. Adenosine is also used to carry out diagnostic stress tests of the heart. It is administered under the supervision of a doctor. Your doctor will decide the dose and duration of the medicine for you. Doctor may closely monitor your blood pressure, heart rate and ECG till you became stable. You should continue all your other medicines that are advised by the doctor for your long-term treatment even after this injection. Common side effects of this medicine include flushing (sense of warmth in the face, ears, neck, and trunk), headache, chest pain, dizziness, and nausea. Consult your doctor if these effects bother you. This medicine is used with caution for some people. Thus, you must inform doctor if you are suffering from any kidney or liver disease. Also, let your doctor know if you are pregnant or breastfeeding and about all the other medications that you are taking regularly. Adenosine is an anti-arrhythmic medication. It regulates heart beat by blocking abnormal electrical signals in the heart.

Used for the treatment of Paroxysmal Supraventricular Tachycardia (PSVT), including that associated with accessory bypass tracts (Wolff-Parkinson-White Syndrome) . Adenosine does not convert atrial flutter, atrial fibrillation, or ventricular tachycardia to normal sinus rhythm .

Anti-arrhythmic (Class V), Endogenous Nucleoside

Adenosine injection slows conduction time through the A-V node, interrupts reentry pathways through the A-V node, and restores normal sinus rhythm in patients with PSVT . It slows conduction at the AV node via A1 receptors and mediates peripheral and coronary vasodilation via A2 receptors . Plasma half-life is <10 seconds, allowing rapid dose titration .

IV Administration Adenocard: given as a rapid injection (1-3 sec) by peripheral IV route directly into vein or into IV line close (proximal) to patient & is followed by rapid NS flush after each inj (20 mL for adults, 5 mL or more for peds) Place pt in mild reverse Trendelenburg position before giving drug.

Adult Dose: Pregnancy; heart transplant patients; patients on dipyridamole (lower initial dose of adenosine 0.5-1 mg); atrial fibrillation or flutter with accessory pathway (conduction along anomalous pathway may increase). Lactation: Potential for serious adverse reactions in nursing infants; decision to interrupt nursing after administration of adenosine or not should take into account importance of drug to mother. Renal Dose: Adenosine acts rapidly to slow down conduction through the AV node via the A1 receptors. It also mediates peripheral and coronary vasodilatation by stimulating the A2 receptors. Extremely short plasma half-life (<10 sec) permits dosage titration during IV use every 1-2 min and causes no concern of cumulative effect through repeated dosing.

Your doctor or nurse will give you this medicine. Kindly do not self administer.

If you miss a dose of Adenosine, please consult your doctor.

Common: • Flushing (sense of warmth in the face, ears, neck and trunk) • Dizziness • Lightheadedness • Nausea • Numbness • Tingling • Chest pain

[NOT RELEVANT] Not relevant, as Adenosine is intended for use in hospitalised patients. Food and drinks containing caffeine such as chocolate, coffee, and tea must be avoided for at least 12 hours before medicine use. Stop taking medication and inform your doctor immediately if you experience a slow heartbeat, severe chest pain, and very low blood pressure. Inform your doctor if you have a history of fits or problems with your heart. Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.

Intravenous Differential diagnosis of supraventricular tachycardias Child: Initially, 50-100 mcg/kg; if necessary, may increase dose by 50-100 mcg/kg increments at 1-2 minute intervals or until arrhythmia is controlled. Max dose: 300 mcg/kg. Paroxysmal supraventricular tachycardia Child: Initially, 50-100 mcg/kg; if necessary, may increase dose by 50-100 mcg/kg increments at 1-2 minute intervals or until arrhythmia is controlled. Max dose: 300 mcg/kg. Myocardial imaging Adult: 140 mcg/kg/minute by infusion for 6 minutes. Inject radionuclide 3 minute after infusion.

2nd or 3rd degree AV block and sick sinus syndrome (unless pacemaker fitted), asthma, hypersensitivity.

[CONSULT YOUR DOCTOR] It is not known whether it is safe to consume alcohol with Adenosine. Please consult your doctor.

[CONSULT YOUR DOCTOR] Adenosine may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[SAFE IF PRESCRIBED] Adenosine is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

Adenosine IV has been used for the treatment of PSVT in neonates, children, and adolescents. Dosing is weight-based (<50 kg: initial dose of 0.05–0.1 mg/kg). Controlled studies have not been conducted.

Caution is required in elderly patients because they may have reduced cardiac function, nodal dysfunction, or concomitant diseases/medications that can cause severe bradycardia or AV block.

[SAFE IF PRESCRIBED] Adenosine is safe to use in patients with kidney disease. No dose adjustment of Adenosine is recommended. [SAFE IF PRESCRIBED] Adenosine is probably safe to use in patients with liver disease. Limited data available suggests that dose adjustment of Adenosine may not be needed in these patients. Please consult your doctor.

Adenosine has a half-life of less than 10 seconds, so adverse effects are generally brief and self-limiting. Treatment of prolonged effects is symptomatic. Methylxanthines (caffeine, theophylline) are competitive antagonists of adenosine.

Store in a cool, dry place protected from light. Do not refrigerate, as crystallization may occur. If crystallization occurs, warm the solution to room temperature until the crystals dissolve. The solution must be clear at the time of use. Keep out of reach of children.