Cardiovascular Medicine Book

Congestive Heart Failure

Pericardial Disorders

http://www.fpnotebook.com/

Adenosine

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  1. Mechanism
    1. Endogenous purine nucleoside
    2. Slows AV Node conduction
    3. Interrupts AV Nodal Reentry pathways
  2. Pharmacokinetics
    1. Rapidly sequestered by Red Blood Cells
    2. Half-life: under 10 seconds
  3. 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
  4. Dose
    1. General
      1. Rapid IV bolus over 1-3 seconds
      2. Follow dose immediately with saline flush of IV line
      3. Expect brief period of Asystole (under 15 seconds)
    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. Dosing Adjustments for special circumstances
      1. Theophylline: may require higher adenosine dose
      2. Cardiac Transplant: Small Adenosine dose effective
  5. 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
  6. Drug Interactions
    1. Reduced effect of Adenosine
      1. Theophylline
      2. Methylxanthine (Caffeine, Theobromine)
    2. Potentiated effect of Adenosine
      1. Dipyridamole

Adenosine (C0001443)

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.
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)
ConceptsNucleic Acid, Nucleoside, or Nucleotide (T114) , Pharmacologic Substance (T121) , Neuroreactive Substance or Biogenic Amine (T124)
EnglishAdenosine, Adenosine agent, Adenosine preparation, Adenosine product
Spanishadenosina, agente con adenosina, preparado con adenosina, preparado de adenosina
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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