Adenosine

It is an endogenously occurring purine nucleoside. It offers a unique and novel option for the treatment of certain re-entrant varieties of Supraventricular tachyarrhythmias.

Indications

Treatment of paroxysmal supraventricular tachycardia. Diagnosis of re-entrant atrial and ventricular tachycardias.

Dosage

Adults: Initial dose: 3.5 mg given as a rapid intravenous bolus. Second dose: If the first dose does not result inn elimination of PSVT within 1 to 2 minutes, 6 mg should be given also as a rapid IV bolus. Third dose: If the second dose does not result in elimination of PSVT within 1 to 2 minutes, 12 mg should be given also as a rapid IV bolus. Additional or higher doses are not recommended. Children: 0.0375-0.25 mg/kg.

Contra-Indications

Second or third degree AV block, Sick sinus syndrome, Bronchial asthma.

Special Precautions

Patients with atrial fibrillation/flutter and an accessory bypass tract may develop increased conduction down the anomalous pathway. Pregnancy: Should only be used during pregnancy where absolutely necessary.

Side Effects

Facial flush, dyspnoea, nausea and light headedness occur commonly. Rarely sweating, palpitations, heaviness in arms.

Drug Interactions

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 Adenocard