Contents

Search

adenosine (Adenocard, Adenoscan)

Purine nucleoside & neurotransmitter. Pharmacology: Tradename Adenocard. Indication(s): 1) paroxysmal supraventricular tachycardia (PSVT) 2) re-entrant supraventricular tachycardia susceptible to termination by AV block a) AV nodal re-entry b) orthodromic supraventricular tachycardia (WPW) 3) diagnosis of adenosine-induced AV nodal atrial flutter, atrial fibrillation, ventricular tachycardia by causing transient AV dissociation 4) diagnosis of wide complex tachycardia believed to be of supraventricular origin 5) cardiac nuclear stress test agent (Adenoscan) Contraindications: - 2nd degree AV block Dose: 1) 6 mg rapid IV 2) if no response after 1-2 min, give 12 mg 3) a 3rd dose of 12 mg may be given * use at a reduced dose in patients with a history of cardiac transplantation Pharmacokinetics: 1) immediate onset of action 2) metabolism: plasma 3) elimination 1/2 life < 10 sec Adverse effects: 1) common (> 10%) a) facial flushing (18%) b) palpitations c) transient hypotension d) dyspnea (12%) e) headache f) sweating 2) less common (1-10%) - dizziness, paresthesias/numbness, chest pain/pressure 3) uncommon (< 1%) - lightheadedness, apprehension, head pressure, metallic taste, tightness in throat, pressure in groin, heaviness in arms, neck & back, blurred vision, hypoventilation, burning sensation 4) other a) atrial standstill b) prolonged asystole in patients with sick sinus syndrome c) 2nd degree AV block or 3rd degree AV block d) rare but serious risk of myocardial infarction & death (Adenoscan) [4] Drug interactions: 1) effects antagonized by methylxanthines 2) effects potentiated by dipyridamole (blocks adenosine uptake & metabolism) 3) effects potentiated by carbamazepine 4) digitalis: rarely associated with ventricular fibrillation Mechanism of action: 1) adenosine A1 receptor agonist [6] 2) inhibition of sinus node automaticity 3) prolongation of AV node conduction time 4) prolongation of AV refractoriness 5) does not affect heart rate in fetal when used to treat supraventricular tachycardia during pregnancy [6]

Interactions

molecular events drug interactions

Related

adenosine receptor paroxysmal supraventricular tachycardia (PSVT) Wolff-Parkinson-White (WPW) syndrome

Specific

adenylosuccinate; succinyladenosine; adenylsuccinic acid N6-methyladeninosine

General

antiarrhythmic agent neurotransmitter purine nucleoside receptor agonist ribonucleoside

Properties

MISC-INFO: elimination route PLASMA 1/2life 10 SECONDS pregnancy-category C safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (ed), Companion Handbook, McGraw Hill, NY, 1994
  3. Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 163
  4. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  5. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  6. Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17. American College of Physicians, Philadelphia 2009, 2012, 2015
  7. FDA MedWatch. Nov 20, 2013 Lexiscan (regadenoson) and Adenoscan (adenosine): Drug Safety Communication - Rare but Serious Risk of Heart Attack and Death. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm375981.htm

Substructure-of

puromycin

Component-of

adenosine/nicotinamide