Drug Index

Adenosine

 
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Mechanism :

Adenosine is an endogenous nucleoside occurring in all cells of the body. It
slows conduction time through the A-V node, and can interrupt the re-entry pathways through the A-V node, therefore can restore normal sinus rhythm in patients with paroxysmal supraventricular tachycardia (PSVT), including PSVT associated with Wolff-Parkinson-White Syndrome.


Indication :

• PSVT to convert to sinus rhythm, including those associated with accessory bypass tracts WPW syndrome.

• Diagnostic to elucidate mechanism of tachycardia.


Contraindications :

Second- or third-degree A-V block.

Sinus node disease, such as sick sinus syndrome or symptomatic bradycardia.

Known hypersensitivity to adenosine.


Dosing :

Children with a Body Weight <50 kg

Initial dose: 0.05 to 0.1 mg/kg as a rapid IV bolus given either centrally or peripherally.

Repeat administration: If conversion of PSVT does not occur within 1-2 minutes, additional bolus injections of adenosine can be administered at incrementally higher doses, increasing the amount given by 0.05 to 0.1 mg/kg. Follow each bolus with a saline flush. This process should continue until sinus rhythm is established. (Cumulative dose of 12 mg should not be exceeded).

Children with a Body Weight >50 kg

Initial dose: 6 mg given as a rapid intravenous bolus (administered over a 1-2 second period).

Repeat administration: If the first dose does not result in elimination of the supraventricular tachycardia within 1-2 minutes, 12 mg should be given as a rapid intravenous bolus. This 12 mg dose may be repeated a second time if required.

Max dose: 12 mg/dose or cumulative dose of 30 mg.

For diagnostic test for tachycardia:

0.1 mg/kg IV followed by 0.2 mg/kg IV given with a rapid IV push over 1-3 seconds.

Maximum dose: 6 mg initial dose.


Adverse Effect :

Transient chest pain, bradycardia, dyspnoea, diaphoresis, facial flushing, headache, nervousness, numbness, paraesthesia, bronchospasm, chest pain, hemolytic anemia, choking, tingling in arms and light headedness.


Interaction :

Dipyridamole: Enhanced effect, reduce dose of adenosine.
Theophylline/xanthines: Antagonise action.
Caffeine: May diminish the therapeutic effect of Adenosine.
Carbamazepine: May enhance the adverse/toxic effect of Adenosine. Specifically, the risk of higher degree heart block may be increased. Management: Consider using a lower initial dose of adenosine in patients who are receiving carbamazepine.
Digoxin: May enhance the adverse/toxic effect of Adenosine.


07/14/2019 06:52:39 Adenosine
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