When not to use adenosine?
Adenosine should never be used in wide irregular tachycardias. Providers who are going to use adenosine must be experts in cardiac rhythm interpretation. They also must carefully review a rhythm ...
Does adenosine actually stop the heart?
Does adenosine stop the heart? Yes, sometimes, when used as an IV push med for P.A.T. The stoppage is due to a brief delay in the return of S.A. activity to sinus rhythm.
What does adenosine do to the body?
Side effects of adenosine include:
- facial flushing.
- difficulty breathing.
- chest pain.
- heart attack.
- lightheadedness.
- dizziness.
- tingling in arms.
- numbness.
Is adenosine a high alert medication?
Adenosine (Adenocard) IV Push . IV Push : IV Push (MD at bedside) IV Push (MD at bedside) Drug must be given RAPIDLY OVER 1-2 SECONDS. ... HIGH ALERT MEDICATION . BLACK BOX WARNING . IV infusion Do not mix with sodium bicarbonate. Avoid extravasation. See ICU protocol. BBW. for possible extravasation.
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What is adenosine used to treat?
What is this medicine? ADENOSINE (a DEN uh seen) is used to bring your heart back into a normal rhythm. This medicine is not useful for all types of irregular heart beats. It may be used to test the heart for coronary artery disease.
Why would adenosine be given?
Adenosine is the primary drug used in the treatment of stable narrow-complex SVT (Supraventricular Tachycardia). Now, adenosine can also be used for regular monomorphic wide-complex tachycardia. When given as a rapid IV bolus, adenosine slows cardiac conduction particularly affecting conduction through the AV node.
What is the most common side effect of adenosine?
General. The most common adverse reactions are flushing, chest discomfort, dyspnea, facial flushing, headache, throat/neck/jaw discomfort, gastrointestinal discomfort, and lightheadedness/dizziness.
How does adenosine work?
Adenosine exerts a negative chronotropic effect by suppressing the automaticity of cardiac pacemakers, and a negative dromotropic effect through inhibition of AV-nodal conduction. These effects of adenosine constitute the rationale for its use as a diagnostic and therapeutic agent.
How does adenosine make you feel?
As adenosine builds up in the bloodstream, it interacts with specific cell receptors, inhibiting neural activity and causing drowsiness. What does this actually mean? Well, when the body runs out of fuel in the form of easily digestible sugars from the food we eat, adenosine signals the body to become drowsy.
Why does adenosine make you sleepy?
Our neurons, or nerve cells, are embedded with adenosine receptors. When adenosine binds to these receptors, a variety of proteins that inhibit neurons are released. This suppression of nerve cell activity is what causes the feeling of drowsiness.
What drug stops your heart and restarts?
Amiodarone is prescribed to restore the heart to normal sinus rhythm, or it may be used to keep the heart in normal rhythm after electrical cardioversion (a minimally invasive procedure where the heart is shocked into normal rhythm).
How does adenosine affect sleep?
Abstract. Adenosine acting in the basal forebrain is a key mediator of sleep homeostasis. Extracellular adenosine concentrations increase during wakefulness, especially during prolonged wakefulness and lead to increased sleep pressure and subsequent rebound sleep.
Does adenosine increase heart rate?
Adenosine did not affect blood pressure, but increased heart rate by 33+/-6 beats/min, and reduced PT, PH, PL and PH/PT.
Does your heart stop with adenosine?
While adenosine can slow conduction through the AV node, it does not affect accessory pathways. In such cases, this can cause severe tachycardia that can deteriorate to a non-perfusing rhythm, leading to cardiac arrest.
How safe is adenosine?
Abstract. Adenosine is an effective, safe drug for the diagnosis and treatment of paroxysmal tachycardias in adult and pediatric patients. A starting dose of 0.05-0.10 mg/kg as a rapid bolus injection is recommended for infants and children. An electrophysiologic effect can be expected within 20 seconds after injection ...
What does adenosine do in the kidneys?
Adenosine lowers glomerular filtration rate by constricting afferent arterioles, especially in superficial nephrons, and thus lowers the salt load and transport work of the kidney consistent with the concept of metabolic control of organ function.
How long does it take to give adenosine?
A dose of 6 mg is given over 1-2 seconds. If this is not effective within 1-2 minutes, 12 mg can be given and repeated once if necessary.
What drugs interact with Adenosine?
Medications for gout (Antigout drugs) interacts with ADENOSINE
How long does it take for adenosine to work on hair?
Early research shows that applying a solution of adenosine to the scalp two times daily for 6 months doesn't improve hair growth. Athletic performance. Early research shows that taking ATP by mouth daily for 2 weeks can help healthy young men to maintain muscle strength for longer while sprinting.
Why is ATP used for weight loss?
Adenosine, AMP, or ATP are also used for involuntary weight loss in people who are very ill, leg sores caused by weak blood circulation, male-pattern baldness, athletic performance, and many other conditions, but there is no good evidence to support most of these uses.
Is adenosine safe to take?
More evidence is needed to rate the effectiveness of adenosine for these uses. Adenosine is LIKELY SAFE for most people when given by intravenous (IV) injection by qualified healthcare providers. This form of adenosine is approved by the U.S. Food and Drug Administration (FDA).
Can you give adenosine after surgery?
Giving adenosine by injection after surgery doesn't seem to reduce pain or the use of pain medication. Nausea and vomiting after surgery. Giving adenosine by injection after surgery doesn't seem to reduce nausea or vomiting. Male-pattern baldness (androgenic alopecia ).
Does ATP help with weight loss?
Involuntary weight loss in people who are very ill (cachexia or wasting syndrome). Intravenous ATP seems to improve appetite, food intake, and quality of life in people with advanced non-small-cell lung cancer and other tumors. Leg sores caused by weak blood circulation (venous leg ulcer).
When to use adenosine?
Pregnancy and Lactation. Use adenosine during pregnancy with caution if benefits outweigh risks. Animal studies show risk and human studies are not available, or neither animal nor human studies were done. Adenosine use when breastfeeding has potential for serious adverse reaction in nursing infants.
What Is Adenosine and How Does It Work?
Adenosine is a prescription drug used for conversion to sinus rhythm of paroxysmal supraventricular tachycardia (PVST), including that associated with accessory bypass tracts ( Wolff-Parkinson-White Syndrome ). When clinically advisable, appropriate vagal maneuvers ( Valsalva maneuver ), should be attempted prior to adenosine administration.
What Are Dosages of Adenosine?
When clinically advisable for paroxysmal supraventricular tachycardia (PSVT), appropriate vagal maneuvers ( Valsalva maneuver), should be attempted before adenosine administration
What are the interactions between adenosine and other drugs?
Adenosine has no known serious interactions with other drugs. Moderate interactions of adenosine include: dipyridamole. dyphylline. green tea. hawthorn. nicotine inhaled. nicotine intranasal.
How long does it take to give Adenocard?
Adenocard: 6 mg intravenous push over 1-3 seconds (maybe given as an intraosseous infusion) followed by a rapid flush with 20 ml normal saline, if no conversion within 1-2 minutes give 12 mg intravenous push, repeat a second time if necessary (30 mg total)
Can adenosine be used while breastfeeding?
Adenosine use when breastfeeding has potential for serious adverse reaction in nursing infants. A decision to interrupt nursing after administration of adenosine should take into account the importance of the drug to the mother.
Does aminophylline cause seizures?
New- onset or recurrence of convulsive seizures reported following adenosine; some seizures are prolonged and require emergent anticonvulsive management; aminophylline may increase risk of seizures associated with adenosine;
How is adenosine given?
Before your heart stress test: Avoid coffee, tea, cola, chocolate, energy drinks or other sources of caffeine. They can interfere with the results of your test.
What is adenosine?
Adenosine is a naturally occurring substance that relaxes and dilates blood vessels. Adenosine also affects the electrical activity of the heart.
What is the most important information I should know about adenosine?
Before receiving adenosine, tell your doctor if you have asthma or other breathing problems, or if you have ever had a seizure.
What happens if I overdose?
Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What are the side effects of adenosine?
What are the possible side effects of adenosine? Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Tell your caregivers right away if you have: severe shortness of breath; chest pain or tightness, pain spreading to your jaw or shoulder; ...
What other medications affect adenosine?
Tell your doctor about all your other medicines, especially: aminophylline; digoxin; dipyridamole; theophylline; or. verapamil. This list is not complete. Other drugs may affect adenosine, including prescription and over-the-counter medicines, vitamins, and herbal products.
Can you take adenosine if you have a heart condition?
You should not be treated with adenosine if you have a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker), or slow heartbeats that have caused you to faint.
What is adenosine injection?
Adenosine injection is indicated as an adjunct to thallium-201 myocardial perfusion scintigraphy in patients unable to exercise adequately.
What drugs inhibit adenosine?
Effects of Other Drugs on Adenosine. The vasoactive effects of Adenosine are inhibited by Adenosine receptor antagonists, (such as methylxanthines (e.g., caffeine, aminophylline, and theophylline).
How does adenosine affect blood flow?
Adenosine causes cardiac vasodilation which increases cardiac blood flow. Adenosine is thought to exert its pharmacological effects through activation of purine receptors (cell-surface A 1 and A 2 Adenosine receptors). Although the exact mechanism by which Adenosine receptor activation relaxes vascular smooth muscle is not known, there is evidence to support both inhibition of the slow inward calcium current reducing calcium uptake, and activation of adenylate cyclase through A 2 receptors in smooth muscle cells. Adenosine may also lessen vascular tone by modulating sympathetic neurotransmission. The intracellular uptake of Adenosine is mediated by a specific transmembrane nucleoside transport system. Once inside the cell, Adenosine is rapidly phosphorylated by Adenosine kinase to Adenosine monophosphate, or deaminated by Adenosine deaminase to inosine. These intracellular metabolites of Adenosine are not vasoactive.#N#Myocardial uptake of thallium-201 is directly proportional to coronary blood flow. Since Adenosine significantly increases blood flow in normal coronary arteries with little or no increase in stenotic arteries, Adenosine causes relatively less thallium-201 uptake in vascular territories supplied by stenotic coronary arteries i.e., a greater difference is seen after Adenosine between areas served by normal and areas served by stenotic vessels than is seen prior to Adenosine.
How long does adenosine last?
The half-life of Adenosine is less than 10 seconds and adverse reactions of Adenosine usually resolve quickly when the infusion is discontinued, although delayed or persistent reactions have been observed. Methylxanthines, such as caffeine, aminophylline, and theophylline, are competitive Adenosine receptor antagonists and theophylline has been used to terminate persistent adverse reactions. In clinical trials, theophylline (50 to 125 mg slow intravenous injection) was used to attenuate Adenosine adverse reactions in approximately 2% of patients. Methylxanthine use is not recommended in patients who experience seizures in association with Adenosine [see Drug Interactions ( 7.1 )].
How long does it take for adenosine to return to basal levels?
Coronary blood flow velocity returns to basal levels within one to two minutes of discontinuing the Adenosine infusion.
What is USP injection?
Adenosine injection, USP is a sterile, non-pyrogenic, clear, colorless solution for intravenous use. Each mL of Adenosine injection, USP contains Adenosine USP, 3 mg and sodium chloride 9 mg in water for injection q.s. The pH of the solution is between 4.5 and 7.5.
What is the name of the phosphate that is formed by deamination of adenosine?
Inosine formed by deamination of Adenosine can leave the cell intact or can be degraded to hypoxanthine, xanthine, and ultimately uric acid. Adenosine monophosphate formed by phosphorylation of Adenosine is incorporated into the high-energy phosphate pool. Elimination.
What are the effects of adenosine?
The adverse effects of adenosine are secondary to the activation of adenosine receptors found on vascular tissue, causing vasodilation. Symptoms of skin flushing, lightheadedness, nausea, sweating, nervousness, numbness, feeling of impending doom have all been described; however, these effects are very transient and short-lived secondary to adenosine’s short half-life. [6]
What drugs block adenosine?
The effects of adenosine can be blocked by caffeine and theophylline, which fall under a class of drugs called methylxanthines. Methylxanthines derive from another purine base, xanthine, which has a chemical structure similar enough to that of adenine, that they can bind to adenosine receptors acting as a competitive antagonist to adenosine. Patients on these drugs may require larger doses. [7]
What is dexmedetomidine used for?
Dexmedetomidine: therapeutic use for the termination of reentrant supraventricular tachycardia.
How does adenosine undergo phosphorylation?
Adenosine has a rapid onset of action with a very short half-life and undergoes rapid intracellular metabolism, either by phosphorylation, forming adenosine monophosphate, or deamination. Phosphorylation, via adenosine kinase, allows adenosine to be further metabolized as cellular energy while deamination occurs by adenosine deaminase, eventually forming xanthine and further metabolized into uric acid.
Is adenosine an antiarrhythmic?
Adenosine further classifies as a miscellaneous antiarrhythmic drug outside the Vaughan-Williams classification scheme. It acts on receptors in the cardiac AV node, significantly reducing conduction time.[3] This effect occurs by activation of specific potassium channels, driving potassium outside of cells, and inhibition of calcium influx, disrupting the resting potential of the slow nodal cardiac myocyte. Driving potassium outside of the cell causes hyperpolarization of the resting membrane potential while slowing of calcium influx causes suppression of calcium-dependent action potentials, all requiring a longer time for depolarization to occur and thus slowing down conduction within these cells, which is useful in SVT. SVT is defined as any arrhythmia originating above and including the bundle of His and specifically excludes atrial fibrillation by the ACC/AHA 2015 guidelines.[4] Usually narrow complex, SVT consists of several specific arrhythmias, which at a high rate (greater than 150 beats per minute), is difficult to diagnose. Adenosine has a role in slowing down the heart rate enough to assist in diagnosis. It can also terminate specific reentrant tachycardia involving the AV node, including AV nodal reentrant tachycardia (AVNRT), orthodromic AV reentrant tachycardia (AVRT), and antidromic AVRT, although extreme caution is necessary when administering adenosine for antidromic AVRT as it should be used only if the diagnosis is certain.
Is adenosine a therapeutic agent?
Ad enosine can serve as a diagnostic or therapeutic agent. Diagnostically, adenosine is one pharmaceutical agent used in a myocardial perfusion stress imaging study for its vasodilatory effects. Therapeutically, adenosine is used for its antiarrhythmic properties in supraventricular tachycardia (SVT) and can function as a diagnostic tool as well, depending on the type of SVT.
Is adenosine a form of cardiac monitoring?
Healthcare workers, including nurse practitioners who plan to use adenosine, should be very familiar with the indications and contraindications. Any patient receiving adenosine should be on a form of cardiac monitoring. Patients receiving treatment for SVT are often on a 12-lead electrocardiogram rhythm monitoring to assess the underlying rhythm, while adenosine is actively affecting the AV node. In cases of WPWd, a defibrillator should be available in case of rapid decompensation. If one has never used adenosine before, it is important to first speak to a cardiologist.
warnings
You should not be treated with adenosine if you have a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker), or slow heartbeats that have caused you to faint.
Side Effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Pregnancy & Breastfeeding
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant.
Interactions
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
Dosage Guidelines & Tips
Use Adenosine (Adenocard) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.
Overdose Signs
Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What is adenosine used for?
Adenosine is used as an adjunct to thallium (TI 201) or technetium (Tc99m) myocardial perfusion scintigraphy (nuclear stress test) in patients unable to undergo adequate stress testing with exercise.
What is the function of adenosine?
Thus, in regard to stress or injury, the function of adenosine is primarily that of cytoprotection preventing tissue damage during instances of hypoxia, ischemia, and seizure activity. Activation of A 2A receptors produces a constellation of responses that in general can be classified as anti-inflammatory.
What is the main mechanism of action of caffeine?
Caffeine 's principal mode of action is as an antagonist of adenosine receptors in the brain. Methylxanthines (e.g. caffeine found in coffee, theophylline found in tea, or theobromine found in chocolate) have a purine structure and bind to some of the same receptors as adenosine.
How much adenosine is in a cell?
Extracellular adenosine concentrations from normal cells are approximately 300 nM; however, in response to cellular damage (e.g., in inflammatory or ischemic tissue), these concentrations are quickly elevated (600–1,200 nM).
How long does it take for methylxanthines to dilate the arteries?
When given to dilate the arteries, such as in a "stress test", the dosage is typically 0.14 mg/kg/min, administered for 4 or 6 minutes, depending on the protocol. The recommended dose may be increased in patients on theophylline since methylxanthines prevent binding of adenosine at receptor sites.
What is the bond between adenosine and ribose?
The molecule consists of an adenine attached to a ribose via a β-N 9 - glycosidic bond . Adenosine is one of four nucleoside building blocks to DNA and RNA, which are essential for all life.
Where is the IV line for adenosine?
Due to adenosine's extremely short half-life, the IV line is started as proximal (near) to the heart as possible, such as the antecubital fossa. The IV push is often followed with a flush of 10–20 mL of normal saline.
