Adenocard

Name: Adenocard

Uses For Adenocard

Adenosine injection is used in combination with Thallium-201 as a pharmacologic stress agent for myocardial perfusion scintigraphy in patients unable to undergo adequate exercise stress. This medicine works by dilating the arteries of the heart and increase blood flow to help identify coronary artery disease.

This medicine is to be given only by or under the direct supervision of a doctor.

Uses of Adenocard

  • It is used to treat certain types of abnormal heartbeats.
  • It is used during a stress test of the heart.
  • It may be given to you for other reasons. Talk with the doctor.

What are some things I need to know or do while I take Adenocard?

  • Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists.
  • Have an ECG checked often. Talk with your doctor.
  • High or low blood pressure may happen with Adenocard. Have your blood pressure checked as you have been told by your doctor.
  • Avoid use of caffeine (for example, tea, coffee, cola) and chocolate.
  • If you are taking aminophylline, dipyridamole, theophylline, or any drug containing caffeine, talk with doctor. These drugs can affect how well this medicine works.
  • Heart attacks and very bad fast heartbeat have rarely happened with Adenocard. Sometimes this has been deadly. Talk with the doctor.
  • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this medicine while you are pregnant.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Indications and Usage

Intravenous Adenocard (adenosine injection) is indicated for the following.

Conversion to sinus rhythm of paroxysmal supraventricular tachycardia (PSVT), including that associated with accessory bypass tracts (Wolff-Parkinson-White Syndrome). When clinically advisable, appropriate vagal maneuvers (e.g., Valsalva maneuver), should be attempted prior to Adenocard administration.

It is important to be sure the Adenocard solution actually reaches the systemic circulation (see Dosage and Administration).

Adenocard does not convert atrial flutter, atrial fibrillation, or ventricular tachycardia to normal sinus rhythm. In the presence of atrial flutter or atrial fibrillation, a transient modest slowing of ventricular response may occur immediately following Adenocard administration.

Overdosage

The half-life of Adenocard (adenosine injection) is less than 10 seconds. Thus, adverse effects are generally rapidly self-limiting. Treatment of any prolonged adverse effects should be individualized and be directed toward the specific effect. Methylxanthines, such as caffeine and theophylline, are competitive antagonists of adenosine.

Pharmacology

Mechanism of Action

PSVT: Slows conduction through AV node and interrupts AV reentry pathways, which restore normal sinus symptoms

Stress testing: A2A adenosine receptor agonist; activation of the A2A adenosine receptor produces coronary vasodilation and increases coronary blood flow

Pharmacokinetics

Half-Life: <10 sec

Duration: <10 sec

Onset: 20-30 sec

Metabolism: Blood & tissue; deaminated to inosine & subsequently to hypoxanthine; adenosine also undergoes phosphorylation to adenosine monophosphate (AMP) within blood cells

Metabolites: inosine, hypoxanthine, AMP (inactive)

Total Body Clearance: 30 sec

Pregnancy

Information about this adenosine-intravenous-route
Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Caffeine

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Angina, unstable or
  • Unstable heart or blood vessel problem (eg, cardiovascular instability)—Avoid use, as this medicine may increase the risk for heart attack.
  • Atrial fibrillation (heart rhythm problem), or history of or
  • Breathing problems or lung disease (eg, bronchitis, emphysema) or
  • Hypertension (high blood pressure) or
  • Hypotension (low blood pressure) or
  • Seizures or
  • Stroke, history of—Use with caution. May make these conditions worse.
  • Heart block, second or third degree (type of abnormal heart rhythm), without a pacemaker or
  • Sinus node disease (such as sick sinus syndrome), without a pacemaker—Should not be used in patients with these conditions, unless patients have a pacemaker that works.
  • Breathing problems or lung disease (eg, asthma)—Should not be used in patients with these conditions.
  • Heart or blood vessel disease (eg, coronary artery stenosis, ischemia, pericardial effusion, pericarditis) or
  • Heart valve disease or
  • Hypovolemia (low blood volume), uncorrected—May increase risk for more serious side effects.

Adenosine Pregnancy Warnings

Animal reproduction studies have not been conducted with adenosine; nor have studies been performed in pregnant women. There are no controlled data in human pregnancy. AU TGA pregnancy category B2: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals are inadequate or may be lacking, but available data show no evidence of an increased occurrence of fetal damage. US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Use is recommended only if clearly needed and the benefit outweighs the risk. AU TGA pregnancy category: B2 US FDA pregnancy category: C

(web3)