Drug Detail:Adenosine (Adenosine [ a-den-oh-seen ])
Drug Class: Cardiac stressing agents Group V antiarrhythmics
Usual Adult Dose for Radionuclide Myocardial Perfusion Study
0.14 mg/kg/min infused over 6 minutes (total dose of 0.84 mg/kg)
Comments:
- Administer only as a continuous peripheral IV infusion.
- Inject thallium 201 at the infusion midpoint; may inject directly into the adenosine infusion set as close to venous access as possible to prevent inadvertent increase in the adenosine dose (the contents of the intravenous tubing).
Use: Adjunct to thallium 201 myocardial perfusion scintigraphy in patients unable to exercise adequately.
Usual Adult Dose for Supraventricular Tachycardia
Initial dose: 6 mg IV bolus over 1 to 2 seconds
Repeat dose: If initial dose fails to eliminate supraventricular tachycardia within 1 to 2 minutes: 12 mg IV bolus over 1 to 2 seconds; may repeat a second time if required
Maximum dose: 12 mg
Comments:
- For rapid IV bolus only; should be given peripherally.
- Administer directly into a vein or, if given into an IV line, as close to the patient as possible followed by a rapid saline flush.
- This drug does not convert atrial flutter, atrial fibrillation, or ventricular tachycardia to normal sinus rhythm; when atrial flutter or fibrillation is present, a transient modest slowing of ventricular response may occur immediately after administrating this drug.
Use: 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 administration of this drug.
Usual Adult Dose for Wolff-Parkinson-White Syndrome
Initial dose: 6 mg IV bolus over 1 to 2 seconds
Repeat dose: If initial dose fails to eliminate supraventricular tachycardia within 1 to 2 minutes: 12 mg IV bolus over 1 to 2 seconds; may repeat a second time if required
Maximum dose: 12 mg
Comments:
- For rapid IV bolus only; should be given peripherally.
- Administer directly into a vein or, if given into an IV line, as close to the patient as possible followed by a rapid saline flush.
- This drug does not convert atrial flutter, atrial fibrillation, or ventricular tachycardia to normal sinus rhythm; when atrial flutter or fibrillation is present, a transient modest slowing of ventricular response may occur immediately after administrating this drug.
Use: 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 administration of this drug.
Usual Pediatric Dose for Supraventricular Tachycardia
LESS THAN 50 KG:
Initial dose: 0.05 to 0.1 mg/kg IV bolus over 1 to 2 seconds
Repeat dose: If initial dose fails to eliminate supraventricular tachycardia within 1 to 2 minutes, repeat at incrementally higher doses, increasing by 0.05 to 0.1 mg/kg, until sinus rhythm or maximum single dose attained
50 KG OR MORE:
Initial dose: 6 mg IV bolus over 1 to 2 seconds
Repeat dose: If initial dose fails to eliminate supraventricular tachycardia within 1 to 2 minutes: 12 mg IV bolus over 1 to 2 seconds; may repeat a second time if required
Maximum dose: 0.3 mg/kg; 12 mg
Comments:
- For rapid IV bolus only; may be given centrally or peripherally.
- Administer directly into a vein or, if given into an IV line, as close to the patient as possible followed by a rapid saline flush.
- Follow each bolus with a saline flush.
- This drug does not convert atrial flutter, atrial fibrillation, or ventricular tachycardia to normal sinus rhythm; when atrial flutter or fibrillation is present, a transient modest slowing of ventricular response may occur immediately after administrating this drug.
Use: Conversion to sinus rhythm of paroxysmal supraventricular tachycardia (PSVT). When clinically advisable, appropriate vagal maneuvers (e.g., Valsalva maneuver), should be attempted prior to administration of this drug.
Renal Dose Adjustments
No adjustment recommended
Liver Dose Adjustments
No adjustment recommended
Precautions
Adenoscan(R) safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
General:
- Overdose: In clinical trials, theophylline 50 to 125 mg slow IV injection was used to treat delayed or persistent adverse reactions.