Known brand names include Adenocard.
An IV drug pushed in quickly to stop paroxysmal supraventricular tachycardia (PSVT), a sudden, very fast heart rhythm. It is cleared from the blood in seconds, so its common effects, such as flushing, shortness of breath, and a brief pause in the heartbeat, pass quickly.
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High-alert medication. IV antiarrhythmics are on the ISMP acute care high-alert list. Adenosine is not among the named examples, but this record covers only its IV use as an antiarrhythmic.
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The label does not describe a narrow therapeutic index or direct dosing by measured blood levels of the drug.
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No specific antidote. The half-life is under 10 seconds, so adverse effects usually resolve on their own; treat any prolonged effect directly. Methylxanthines such as caffeine and theophylline are competitive antagonists. Keep resuscitation equipment available, and give no further doses to a patient who develops high-level block.
Doses come from the FDA label. Study tool, not for clinical decisions.
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None. Adenosine needs no kidney function for activation or clearance, so renal failure is not expected to change its effect or tolerability.
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None. Adenosine needs no liver function for activation or clearance, so hepatic failure is not expected to change its effect or tolerability.
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An endogenous nucleoside used as an antiarrhythmic. It slows AV nodal conduction and interrupts reentry pathways through the AV node, restoring sinus rhythm in PSVT, including PSVT with WPW. Methylxanthines such as caffeine and theophylline competitively antagonize it, dipyridamole potentiates it, and atropine does not block it. It is cleared by uptake into red cells and vascular endothelium, with a half-life under 10 seconds, and needs no hepatic or renal function for activation or inactivation. A 6 or 12 mg bolus usually has no systemic hemodynamic effect.