Adenosine

N/A

Intravenous Adenosine is indicated for the following: Conversion to sinus rhythm of paroxysmal supraventricular tachycardia (PSVT), including that associated with accessory bypass tracts (Wolff-Parkinson-White Syndrome).

N/A

Intravenous Adenosine is contraindicated in: 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). Known hypersensitivity to Adenosine.

This preparation is a sterile, nonpyrogenic solution for rapid bolus intravenous injection. Adenosine injection 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.

Intravenous Adenosine injection 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 Adenosine. Because of the potential for additive or synergistic depressant effects on the SA and AV nodes, however, Adenosine should be used with caution in the presence of these agents. The use of Adenosine in patients receiving Digitalis may be rarely associated with ventricular fibrillation. The effects of Adenosine are antagonized by Methylxanthines, such as, Caffeine and Theophylline.

Cardiovascular: Facial flushing, headache, sweating, palpitations, chest pain, hypotension. Respiratory: Shortness of breath/dyspnea, chest pressure, hyperventilation, head pressure. Central Nervous System: Lightheadedness, dizziness, tingling in arms, numbness, apprehension, blurred vision, burning sensation, heaviness in arms, neck and back pain. Gastrointestinal: Nausea, metallic taste, tightness in throat, pressure in groin. In post-market clinical experience with Adenosine, cases of prolonged asystole, ventricular tachycardia, ventricular fibrillation, transient increase in blood pressure, bradycardia, hypotension, atrial fibrillation and bronchospasm, in association with Adenosine use, have been reported.

The half-life of Adenosine is less than 10 seconds. Thus, adverse effects are generally rapidly self-limiting. Treatment of any prolonged adverse effects should be individualized and be directed toward the specific effect. Methylxanthines, such as, Caffeine and Theophylline, are competitive antagonists of Adenosine.

US FDA pregnancy category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.