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Adenosine

CARDIOVASCULAR SYSTEM

ANTIARRHYTHMICS - [ CARDIOVASCULAR SYSTEM ]

Adenosine is an anti-arrhythmic drug. Adenosine activates the potassium channels on atrium and sinus and AV nodes. This results in hyperpolarization, and slowing of normal automaticity of the heart. This decreases the conduction velocity of the sinus node and the atrioventricular node.

Conversion to sinus rhythm of paroxysmal supraventricular tachycardia (PSVT), including that associated with accessory bypass tracts (Wolff-Parkinson-White Syndrome).

Second- or third-degree A-V block except in patients with a functioning artificial pacemaker. Sinus node disease, such as sick sinus syndrome or symptomatic bradycardia except in patients with a functioning artificial pacemaker. Hypersensitivity to adenosine

Facial flushing, headache, sweating, palpitations, chest pain, hypotension Shortness of breath/dyspnea, chest pressure, hyperventilation, head pressure Lightheadedness, dizziness, tingling in arms, numbness, apprehension, blurred vision, burning sensation, heaviness in arms, neck and back pain Nausea, metallic taste, tightness in throat, pressure in groin Heart block, arrhythmias at time of conversion, bronchoconstriction

Digoxin, verapamil: Ventricular fibrillation Caffeine, theophylline: antagonism of adenosine effects Dipyridamole: potentiation of effects of adenosine Carbamazepine: increased incidence of heart blocks

Should be used with caution in elderly because they may have a diminished cardiac function, nodal dysfunction, concomitant diseases or drug therapy that may alter hemodynamic function and produce severe bradycardia or AV block.

Oral: 40 to 80 mg, 3 to 4 times daily (Max. 480 mg/day). Rapid intravenous injection: 3 mg every 2 seconds with regular cardiac monitoring, if necessary, followed by 6 mg every 1 to 2 min. Increment should not be given if higher level AV block occurs at any particular dose.

1. Sampson KJ, Kass RS. Anti-arrhythmic drugs. In: Brunton L, Chabner B, Knollmann B eds. Goodman & Gilman’s The Pharmacological basis of Therapeutics. 12th ed. USA: McGraw Hill; 2011:815-48. 2. ADENOCARD [cited 2013 sept 9]. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/019937s026lbl.pdf 3. National Formulary of India. 4 th ed. Government of India, Ministry of Health and Family Welfare. India: Indian Pharmacopoeia Commission; 2011.