Adenosine

Adenosine (Adenocor)

Mechanism of action

• Agonism on adenosine receptor – slows down conduction in sinoatrial and atrioventricular node, at higher (clinically used) doses blocks the latter, which is the main clinical purpose of adenosine. 
• Agonism on adenosine eceptor – causes peripheral vasodilation (including coronary arteries) 

Adenosine has negative chronotropy & dromotropy.

Indications and dose

Diagnosis and conversion of paroxysmal supraventricular tachycardia to sinus rhythm

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Pharmacokinetics

Onset of action: rapid (seconds) 

Duration of action: 10 seconds approx.

Half-life of elimination: < 10 seconds

Metabolism: Rapid; mostly in red blood cells and endothelial wall

Elimination: Kidneys (uric acid)  

Directions for administration

Bolus should be administered over 1–3 seconds and followed by a rapid saline flush.

Continuously monitor ECG during administration.

CPR equipment should be available for immediate use.

Medicinal forms

Solution for injection (3 mg/ml)

• 1 vial = 2 ml (6 mg)

Side-effects

Flushing

Short high-grade AV block

Short sinus pause

Dyspnoea/Bronchospasm

Headache, dizziness

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References

1. Adenocor 3 mg/ml Solution for injection - Summary of Product Characteristics (SmPC) - (emc) (medicines.org.uk)
2. Pharm 101: Adenosine • LITFL • Top 200 Drugs
3. Adenosine: Uses, Interactions, Mechanism of Action | DrugBank Online
4. Adenocard, Adenoscan (adenosine) dosing, indications, interactions, adverse effects, and more (medscape.com)

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