What is the use of adenosine?
Adenosine is the primary drug used in the treatment of stable narrow-complex SVT (Supraventricular Tachycardia). It can now 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.
The effect of adenosine on blood pressure variability in sinoaortic denervated rats is mediated by adenosine A2a-Receptor. It is known that adenosine decreases blood pressure (BP) level as well as blood pressure variability (BPV). However, there is little information about the effect of adenosine on BPV.
- However, when given by itself, atropine does not exert a striking or uniform effect on blood vessels or blood pressure. Systemic doses slightly raise systolic and lower diastolic pressures and can produce significant postural hypotension.
- The use of atropine in cardiovascular disorders is mainly in the management of patients with bradycardia. Atropine increases the heart rate and improves the atrioventricular conduction by blocking the parasympathetic influences on the heart.
- Atropine, epinephrine, and dopamine may be used to treat bradycardia, with dosages depending on the acuity and severity of hemodynamic instability. Among other actions, epinephrine stimulates beta1 receptors, causing cardiac stimulation, which in turn increases the heart rate.
Doctors can usually stop an episode promptly by giving an intravenous injection of a drug, usually adenosine or verapamil. Rarely, drugs are ineffective, and cardioversion (delivery of an electrical shock to the heart) may be necessary.
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- Supraventricular tachycardia is a rapid heart rate (tachycardia, or a heart rate above 100 beats per minute) that is caused by electrical impulses that originate above the heart's ventricles. Supraventricular tachycardia is also called paroxysmal supraventricular tachycardia and abbreviated either SVT or PSVT.
- Dose in the Bradycardia ACLS algorithm is 0.5mg IV push and may repeat up to a total dose of 3mg. Dopamine: Second-line drug for symptomatic bradycardia when atropine is not effective. Dosage is 2-20 micrograms/kg/min infusion. Epinephrine: Can be used as an equal alternative to dopamine when atropine is not effective.
Common side effects include flushing, chest discomfort, shortness of breath, throat/neck/jaw discomfort, abdominal pain or discomfort, lightheadedness, dizziness, nausea, headache, upset stomach, pain at injection site, discomfort of the arms and hands, weakness, low blood pressure (hypotension), nervousness, and
- Dobson and Jones instead freeze the heart in the resting state using two drugs: adenosine, which opens some of the channels that transport potassium ions in and out of the cell, and lignocaine (known as lidocaine in the US), which blocks sodium ion channels. “There are two ways to stop a heart cell.
- The half-life of Adenocard (adenosine injection) is less than 10 seconds. Thus, adverse effects are generally rapidly self-limiting.
- 1. Adenosine is well known to cause bronchoconstriction when inhaled, but to date, there has been only one report following the intravenous route. We suggest that adenosine may aggravate bronchospasm in some asthmatics and alternative treatments for supraventricular tachycardia should be considered in this group.
Updated: 25th November 2019