Adenosine

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Adenoscan; Belgium: Adenocor; Cyprus: Adenocor; Czech Republic: Adenocor; Denmark: Adenocor, Adenosin; Estonia: Adenocor; Finland: Adenocor; France: Adenoscan, Adenyl, Ampecyclal, Krenosin; Germany: Adenosin; Greece: Adenocor, Adenoscan; Hungary: Adenocor; Ireland: Adenocor; Italy: Adenoscan, Krenosin; Luxembourg: Adenocor, Krenosin; Malta: Adenocor; Netherlands: Adenocor, Adenoscan; Poland: Adenocor; Portugal: Adenocor, Adenoscan; Slovakia: Adenocor; Spain: Adenocor, Adenoscan, Atepodin; Sweden: Adenosin; UK: Adenocor, Adenoscan.

North America

Canada: Adenocard, Adenosine; USA: Adenocard, Adenoscan, Adenosine.

Latin America

Argentina: Adenosina; Brazil: Adenocard; Mexico: Krenosin, Pisdeno.

Asia

Japan: Adenoscan.

Drug combinations

Adenosine: Ascorbic Acid (Vitamin C); Dexpanthenol

Chemistry

Adenosine: C~10~H~13~N~5~O~4~. Mw: 267.24. (1) 6-Amino-9-β-D-ribofuranosyl-9H-purine; (2) 9-β-D-Ribofuranosyladenine. CAS-58-61-7 (1988).

Adenosine Phosphate: C~10~H~14~N~5~O~7~P. Mw: 347.22. (1) 5′-Adenylic acid; (2) Adenosine 5′-(dihydrogen phosphate). CAS-61-19-8 (1963).

Pharmacologic Category

Class IV Antiarrhythmics. Other Miscellaneous Therapeutic Agents. Diagnostic Agents. (ATC-Code: C01EB10).

Mechanism of action

Slows conduction time through the AV node, interrupting the re-entry pathways through the AV node, restoring normal sinus rhythm.

Therapeutic use

Treatment of paroxysmal supraventricular tachycardia (PSVT), including that associated with accessory bypass tracts (Wolff-Parkinson-White syndrome).

Pregnancy and lactiation implications

Reports of administration during pregnancy have indicated no adverse effects on fetus or newborn.

Unlabeled use

Acute vasodilator testing in pulmonary artery hypertension.

Contraindications

Hypersensitivity to adenosine or any component of the formulation. Second- or third-degree AV block or sick sinus syndrome (except in patients with a functioning artificial pacemaker). Atrial flutter. Atrial fibrillation. Ventricular tachycardia. Avoid use in bronchoconstrictive or bronchospastic lung disease.

Warnings and precautions

Atrial fibrillation/flutter in PSVT associated with accessory conduction pathways after adenosine has been reported. Risk of serious arrhythmias/hypotension. Not for use in atrial fibrillation/flutter associated with Wolff-Parkinson-White syndrome. May produce first-, second-, or third-degree heart block (decreases conduction through the AV node). Hypotension. Possible proarrhythmic effects. May cause bronchoconstriction in asthma. Electrolyte imbalance may occur. Use caution with other drugs which slow AV conduction (e.g. digoxin, verapamil). Dietary caffeine should be avoided for 12-24 hours prior to pharmacologic stress testing. Transient AV block may occur. Use with caution in the elderly. Antiarrhythmic agents should be reserved for patients with life-threatening ventricular arrhythmias.

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