Adenosine

Aka: Adenosine

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II. Mechanism

  1. Endogenous purine nucleoside
  2. Slows AV Node conduction
  3. Interrupts AV Nodal Reentry pathways

III. Pharmacokinetics

  1. Rapidly sequestered by Red Blood Cells
  2. Half-life: under 10 seconds

IV. Indications

  1. Chemical conversion of AV Node re-entry Tachycardias
    1. Paroxysmal Supraventricular Tachycardia (PSVT)
    2. Wolff-Parkinson-White Syndrome (WPW Syndrome)
  2. Diagnosis in non-reentry Tachycardias
    1. Atrial Flutter
    2. Atrial Fibrillation
    3. Ventricular Tachycardia

V. Dose

  1. General
    1. Rapid IV bolus over 1-3 seconds
    2. Expect brief period of Asystole (under 15 seconds)
    3. Follow dose immediately with saline flush (15-20 cc Normal Saline in adults)
      1. May also combine Adenosine with Normal Saline (15 cc in adults) and push the combined solution
      2. Choi (2003) J Korean Soc Emerg Med 14(3): 224-7 [PubMed]
  2. Children
    1. 0.1-0.2 mg/kg rapid IV push (Max: 12 mg)
  3. Adults
    1. Initial: 6 mg rapid IV push
    2. Next: 12 mg rapid IV push
  4. Higher starting dose indications (12 mg in adults)
    1. Caffeine within the last 4 hours
    2. Theophylline
  5. Lower starting dose indications (3 mg in adults)
    1. Carbamazepine
    2. Dipyridamole (Persantine)
    3. Heart Transplant status
    4. Central Line administration (risk of severe Bradycardia and Asystole)

VI. Adverse effects

  1. Transient effects (resolve within 2 minutes)
    1. Flushing
    2. Dyspnea
    3. Chest Pain
  2. Transient arrhythmias following PSVT conversion
    1. Sinus Bradycardia
    2. Ventricular ectopy

VII. Drug Interactions

  1. Reduced effect of Adenosine
    1. Theophylline
    2. Methylxanthine (Caffeine, Theobromine)
  2. Potentiated effect of Adenosine
    1. Dipyridamole

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Ontology: Adenosine (C0001443)

Definition (CHV) a kind of nucleic acid
Definition (NCI) A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. (MeSH)
Definition (MSH) A nucleoside that is composed of ADENINE and D-RIBOSE. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter.
Definition (CSP) nucleoside that is composed of adenine and d-ribose; adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA; adenosine itself is a neurotransmitter.
Concepts Nucleic Acid, Nucleoside, or Nucleotide (T114) , Pharmacologic Substance (T121) , Neuroreactive Substance or Biogenic Amine (T124)
MSH D000241
SnomedCT 108502004, 386857003, 391720004, 371177000, 35431001
LNC LP35677-1, LP35683-9, LP35974-2, MTHU047710
English Adenosine, adenosine, ADENOSINE, adenosine (medication), Adenosine [Chemical/Ingredient], Adenosine preparation (substance), Adenosine - chemical (substance), Adenosine agent, Adenosine agent (product), Adenosine - chemical, Adenosine product, Adenosine (substance), Adenosine preparation (product), Adenosine preparation
Swedish Adenosin
Czech adenosin
Finnish Adenosiini
Russian ADENOZIN, АДЕНОЗИН
Spanish preparado con adenosina (producto), adenosina (producto), preparado con adenosina, preparado de adenosina, agente con adenosina, preparado de adenosina (sustancia), agente con adenosina (producto), adenosina (sustancia), adenosina, preparado de adenosina (producto), Adenosina
Croatian ADENOZIN
Polish Adenozyna
Japanese アデニンリボシド, アデノシン
French Adénosine
German Adenosin
Italian Adenosina
Portuguese Adenosina
Derived from the NIH UMLS (Unified Medical Language System)

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