Active ingredient: Adenosine - Brands, Medical Use, Clinical Data

Brands, Medical Use, Clinical Data

Drug Category

• Vasodilator Agents
• Antiarrhythmic Agents
• Analgesics
• Cardiac drugs

Dosage Forms

• Liquid

Brands / Synonyms

2'-Deoxyadenosine; Adenine Deoxy Nucleoside; Adenine Deoxyribonucleoside; Adenine Deoxyribose; Adenine Nucleoside; Adenine Riboside; Adenocard; Adenocor; Adenoscan; Adenosin; Adenosine; Adensoine; Adenyldeoxyriboside; Boniton; Deoxyadenosine; Desoxyadenosine; Myocol; Nucleocardyl; Sandesin; USAF CB-10

Indications

For controlling paroxysmal supraventricular tachycardia (PSVT). This drug can also be used diagnostically for stable, wide complex tachyardias of unknown type.

Pharmacology

Adenosine is an endogenous nucleoside occurring in all cells of the body and is not chemically related to other antiarrhythmic drugs. Adenosine is indicated for the conversion to sinus rhythm of paroxysmal supraventricular tachycardia (PSVT), including that associated with accessory bypass tracts (Wolff-Parkinson-White Syndrome). Adenosine is antagonized competitively by methylxanthines such as caffeine and theophylline, and potentiated by blockers of nucleoside transport such as dipyridamole. Adenosine is not blocked by atropine.

Mechanism of Action

Adenosine slows conduction time through the A-V node, can interrupt the reentry pathways through the A-V node, and can restore normal sinus rhythm in patients with paroxysmal supraventricular tachycardia (PSVT), including PSVT associated with Wolff-Parkinson-White Syndrome.

Absorption

Not Available

Toxicity

Not Available

Biotrnasformation / Drug Metabolism

Intracellular adenosine is rapidly metabolized either via phosphorylation to adenosine monophosphate by adenosine kinase, or via deamination to inosine by adenosine deaminase in the cytosol.

Contraindications

Intravenous Adenocard (adenosine) is contraindicated in:

1. Second- or third-degree A-V block (except in patients with a functioning artificial pacemaker).

2. Sinus node disease, such as sick sinus syndrome or symptomatic bradycardia (except in patients with a functioning artificial pacemaker).

3. Known hypersensitivity to adenosine.

Drug Interactions

Intravenous Adenocard (adenosine) has been effectively administered in the presence of other cardioactive drugs, such as quinidine, beta-adrenergic blocking agents, calcium channel blocking agents, and angiotensin converting enzyme inhibitors, without any change in the adverse reaction profile. Digoxin and verapamil use may be rarely associated with ventricular fibrillation when combined with Adenocard. Because of the potential for additive or synergistic depressant effects on the SA and AV nodes, however, Adenocard should be used with caution in the presence of these agents. The use of Adenocard in patients receiving digitalis may be rarely associated with ventricular fibrillation.

The effects of adenosine are antagonized by methylxanthines such as caffeine and theophylline. In the presence of these methylxanthines, larger doses of adenosine may be required or adenosine may not be effective. Adenosine effects are potentiated by dipyridamole. Thus, smaller doses of adenosine may be effective in the presence of dipyridamole. Carbamazepine has been reported to increase the degree of heart block produced by other agents. As the primary effect of adenosine is to decrease conduction through the A-V node, higher degrees of heart block may be produced in the presence of carbamazepine.