Brands, Medical Use, Clinical Data
- Vasodilator Agents
- Antiarrhythmic Agents
- Cardiac drugs
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
For controlling paroxysmal supraventricular tachycardia (PSVT). This drug can also be used diagnostically for stable, wide complex tachyardias of unknown type.
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.
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.
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.
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
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.