Adenosine

Generic Details

Generic Name

Adenosine

Other Names

  • Adenocard

Drug Class

  • Antiarrhythmic Agent

Chemical Formula

C10H13N5O4

Molecular Weight

267.24 g/mol

Mechanism of Action

  • Adenosine works by slowing down electrical conduction in the heart, primarily in the AV node. It also dilates coronary arteries, increasing blood flow to the heart.

Indications

  • Supraventricular tachycardia (SVT)
  • Adenosine stress test for evaluation of coronary artery disease

Common Dosage Forms

  • Intravenous solution

Typical Dosage

  • 6 mg rapid IV push followed by a 20 mL saline flush, may repeat at 12 mg if needed

Pediatric Dosage

  • Initial dose: 0.1 mg/kg rapid IV push (max 6 mg), may repeat at 0.2 mg/kg (max 12 mg) if necessary

Geriatric Dosage

  • No specific geriatric dosage adjustments

Side Effects

  • Facial flushing
  • Chest pain or discomfort
  • Shortness of breath
  • Headache
  • Dizziness
  • Nausea

Contraindications

  • 2nd or 3rd-degree AV block
  • Sick sinus syndrome
  • Asthma or COPD

Pregnancy Category

  • C - Risk cannot be ruled out

Lactation Safety

  • Not recommended during breastfeeding

Drug Interactions

  • Methylxanthines (e.g., theophylline, caffeine) may decrease adenosine's effectiveness

Overdose Symptoms

  • Severe bradycardia
  • Hypotension
  • Asystole

Antidote for Overdose

  • Theophylline or caffeine may be given to reverse the effects of adenosine overdose

Storage Conditions

  • Store at room temperature (20-25°C)
  • Protect from light

Pharmacokinetics

  • Absorption: Rapidly cleared from circulation after intravenous administration
  • Distribution: Distributes widely into tissues
  • Metabolism: Quickly metabolized in tissues
  • Excretion: Primarily excreted as uric acid

Precautions

  • Administer in a setting where emergency resuscitation equipment and trained personnel are available
  • Monitor ECG and blood pressure during administration

Warnings

  • May cause bronchoconstriction in patients with asthma or COPD
  • May result in transient heart block or asystole during administration

Others

  • Adenosine has a short half-life of approximately 10 seconds