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adenosine
Overview
What is Adenocard?
Adenosine is an endogenous nucleoside occurring in all cells of the body. It is chemically 6-amino-9-β-D-ribofuranosyl-9-H-purine and has the following structural formula:
CHNO 267.24
Adenosine is a white crystalline powder. It is soluble in water and practically insoluble in alcohol. Solubility increases by warming and lowering the pH. Adenosine is not chemically related to other antiarrhythmic drugs. Adenocard (adenosine injection) is a sterile, nonpyrogenic solution for rapid bolus intravenous injection. Each mL contains 3 mg adenosine and 9 mg sodium chloride in Water for Injection. The pH of the solution is between 4.5 and 7.5.
The plastic syringe is molded from a specially formulated polypropylene. Water permeates from inside the container at an extremely slow rate which will have an insignificant effect on solution concentration over the expected shelf life.
Solutions in contact with the plastic container may leach out certain chemical components from the plastic in very small amounts; however, biological testing was supportive of the safety of the syringe material.
What does Adenocard look like?
What are the available doses of Adenocard?
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What should I talk to my health care provider before I take Adenocard?
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How should I use Adenocard?
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 ).
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.
For rapid bolus intravenous use only.
Adenocard (adenosine injection) should be given as a rapid bolus by the peripheral intravenous route. To be certain the solution reaches the systemic circulation, it should be administered either directly into a vein or, if given into an IV line, it should be given as close to the patient as possible and followed by a rapid saline flush.
What interacts with Adenocard?
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What are the warnings of Adenocard?
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What are the precautions of Adenocard?
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What are the side effects of Adenocard?
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What should I look out for while using Adenocard?
Intravenous Adenocard (adenosine injection) is contraindicated in:
What might happen if I take too much Adenocard?
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.
How should I store and handle Adenocard?
TROKENDI XR (topiramate) extended-release capsules should be stored in well closed containers at controlled room temperature [25°C (77°F); excursions 15°C-30°C (59°F-86°F)]. Protect from moisture and light.Adenocard (adenosine injection) is supplied as a sterile non-pyrogenic solution in normal saline.NDC 0469-8234-12 Product Code 8234126 mg/2 mL (3 mg/mL) in 2 mL (fill volume) plastic disposable syringe, in a package of ten.NDC 0469-8234-14 Product Code 82341412 mg/4 mL (3 mg/mL) in 4 mL (fill volume) plastic disposable syringe, in a package of ten.Store at controlled room temperature 15º-30ºC (59º-86ºF).DO NOT REFRIGERATEContains no preservatives. Discard unused portion.May require needle or blunt. To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.Rx OnlyAdenocard (adenosine injection) is supplied as a sterile non-pyrogenic solution in normal saline.NDC 0469-8234-12 Product Code 8234126 mg/2 mL (3 mg/mL) in 2 mL (fill volume) plastic disposable syringe, in a package of ten.NDC 0469-8234-14 Product Code 82341412 mg/4 mL (3 mg/mL) in 4 mL (fill volume) plastic disposable syringe, in a package of ten.Store at controlled room temperature 15º-30ºC (59º-86ºF).DO NOT REFRIGERATEContains no preservatives. Discard unused portion.May require needle or blunt. To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.Rx OnlyAdenocard (adenosine injection) is supplied as a sterile non-pyrogenic solution in normal saline.NDC 0469-8234-12 Product Code 8234126 mg/2 mL (3 mg/mL) in 2 mL (fill volume) plastic disposable syringe, in a package of ten.NDC 0469-8234-14 Product Code 82341412 mg/4 mL (3 mg/mL) in 4 mL (fill volume) plastic disposable syringe, in a package of ten.Store at controlled room temperature 15º-30ºC (59º-86ºF).DO NOT REFRIGERATEContains no preservatives. Discard unused portion.May require needle or blunt. To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.Rx OnlyAdenocard (adenosine injection) is supplied as a sterile non-pyrogenic solution in normal saline.NDC 0469-8234-12 Product Code 8234126 mg/2 mL (3 mg/mL) in 2 mL (fill volume) plastic disposable syringe, in a package of ten.NDC 0469-8234-14 Product Code 82341412 mg/4 mL (3 mg/mL) in 4 mL (fill volume) plastic disposable syringe, in a package of ten.Store at controlled room temperature 15º-30ºC (59º-86ºF).DO NOT REFRIGERATEContains no preservatives. Discard unused portion.May require needle or blunt. To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.Rx OnlyAdenocard (adenosine injection) is supplied as a sterile non-pyrogenic solution in normal saline.NDC 0469-8234-12 Product Code 8234126 mg/2 mL (3 mg/mL) in 2 mL (fill volume) plastic disposable syringe, in a package of ten.NDC 0469-8234-14 Product Code 82341412 mg/4 mL (3 mg/mL) in 4 mL (fill volume) plastic disposable syringe, in a package of ten.Store at controlled room temperature 15º-30ºC (59º-86ºF).DO NOT REFRIGERATEContains no preservatives. Discard unused portion.May require needle or blunt. To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.Rx OnlyAdenocard (adenosine injection) is supplied as a sterile non-pyrogenic solution in normal saline.NDC 0469-8234-12 Product Code 8234126 mg/2 mL (3 mg/mL) in 2 mL (fill volume) plastic disposable syringe, in a package of ten.NDC 0469-8234-14 Product Code 82341412 mg/4 mL (3 mg/mL) in 4 mL (fill volume) plastic disposable syringe, in a package of ten.Store at controlled room temperature 15º-30ºC (59º-86ºF).DO NOT REFRIGERATEContains no preservatives. Discard unused portion.May require needle or blunt. To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.Rx OnlyAdenocard (adenosine injection) is supplied as a sterile non-pyrogenic solution in normal saline.NDC 0469-8234-12 Product Code 8234126 mg/2 mL (3 mg/mL) in 2 mL (fill volume) plastic disposable syringe, in a package of ten.NDC 0469-8234-14 Product Code 82341412 mg/4 mL (3 mg/mL) in 4 mL (fill volume) plastic disposable syringe, in a package of ten.Store at controlled room temperature 15º-30ºC (59º-86ºF).DO NOT REFRIGERATEContains no preservatives. Discard unused portion.May require needle or blunt. To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.Rx OnlyAdenocard (adenosine injection) is supplied as a sterile non-pyrogenic solution in normal saline.NDC 0469-8234-12 Product Code 8234126 mg/2 mL (3 mg/mL) in 2 mL (fill volume) plastic disposable syringe, in a package of ten.NDC 0469-8234-14 Product Code 82341412 mg/4 mL (3 mg/mL) in 4 mL (fill volume) plastic disposable syringe, in a package of ten.Store at controlled room temperature 15º-30ºC (59º-86ºF).DO NOT REFRIGERATEContains no preservatives. Discard unused portion.May require needle or blunt. To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.Rx OnlyAdenocard (adenosine injection) is supplied as a sterile non-pyrogenic solution in normal saline.NDC 0469-8234-12 Product Code 8234126 mg/2 mL (3 mg/mL) in 2 mL (fill volume) plastic disposable syringe, in a package of ten.NDC 0469-8234-14 Product Code 82341412 mg/4 mL (3 mg/mL) in 4 mL (fill volume) plastic disposable syringe, in a package of ten.Store at controlled room temperature 15º-30ºC (59º-86ºF).DO NOT REFRIGERATEContains no preservatives. Discard unused portion.May require needle or blunt. To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.Rx OnlyAdenocard (adenosine injection) is supplied as a sterile non-pyrogenic solution in normal saline.NDC 0469-8234-12 Product Code 8234126 mg/2 mL (3 mg/mL) in 2 mL (fill volume) plastic disposable syringe, in a package of ten.NDC 0469-8234-14 Product Code 82341412 mg/4 mL (3 mg/mL) in 4 mL (fill volume) plastic disposable syringe, in a package of ten.Store at controlled room temperature 15º-30ºC (59º-86ºF).DO NOT REFRIGERATEContains no preservatives. Discard unused portion.May require needle or blunt. To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.Rx Only
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
Adenocard (adenosine injection) slows conduction time through the A-V node, can interrupt the reentry pathways through the A-V node, and can restore normal sinus rhythm in patients with paroxysmal supraventricular tachycardia (PSVT), including PSVT associated with Wolff-Parkinson-White Syndrome.
Adenocard is antagonized competitively by methylxanthines such as caffeine and theophylline, and potentiated by blockers of nucleoside transport such as dipyridamole. Adenocard is not blocked by atropine.
Non-Clinical Toxicology
Intravenous Adenocard (adenosine injection) is contraindicated in:Intravenous Adenocard (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 (see ). Because of the potential for additive or synergistic depressant effects on the SA and AV nodes, however, Adenocard should be used with caution in the presence of these agents. The use of Adenocard in patients receiving digitalis may be rarely associated with ventricular fibrillation (see ).
The effects of adenosine are antagonized by methylxanthines such as caffeine and theophylline. In the presence of these methylxanthines, larger doses of adenosine may be required or adenosine may not be effective. Adenosine effects are potentiated by dipyridamole. Thus, smaller doses of adenosine may be effective in the presence of dipyridamole. Carbamazepine has been reported to increase the degree of heart block produced by other agents. As the primary effect of adenosine is to decrease conduction through the A-V node, higher degrees of heart block may be produced in the presence of carbamazepine.
Intravenous Adenocard (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 (see ). Because of the potential for additive or synergistic depressant effects on the SA and AV nodes, however, Adenocard should be used with caution in the presence of these agents. The use of Adenocard in patients receiving digitalis may be rarely associated with ventricular fibrillation (see ).
The effects of adenosine are antagonized by methylxanthines such as caffeine and theophylline. In the presence of these methylxanthines, larger doses of adenosine may be required or adenosine may not be effective. Adenosine effects are potentiated by dipyridamole. Thus, smaller doses of adenosine may be effective in the presence of dipyridamole. Carbamazepine has been reported to increase the degree of heart block produced by other agents. As the primary effect of adenosine is to decrease conduction through the A-V node, higher degrees of heart block may be produced in the presence of carbamazepine.
The following reactions were reported with intravenous Adenocard (adenosine injection) used in controlled U.S. clinical trials. The placebo group had less than 1% rate of all of these reactions.
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"
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