Comparative Pharmacology
Head-to-head clinical analysis: ADENOCARD versus ADENOSINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ADENOCARD versus ADENOSINE.
ADENOCARD vs ADENOSINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Adenosine is an endogenous purine nucleoside that acts on A1 and A2 adenosine receptors. It slows conduction through the AV node, interrupts reentry pathways, and can restore normal sinus rhythm in patients with paroxysmal supraventricular tachycardia (PSVT).
Adenosine is an endogenous purine nucleoside that acts as a non-selective agonist at adenosine A1, A2A, A2B, and A3 receptors. It slows atrioventricular (AV) conduction through activation of A1 receptors, which increases potassium efflux and reduces calcium influx, hyperpolarizing nodal cells and prolonging refractoriness. This terminates reentrant supraventricular tachyarrhythmias involving the AV node.
6 mg IV bolus over 1-2 seconds, followed by 20 mL saline flush; if no conversion to sinus rhythm within 1-2 minutes, give 12 mg IV bolus; may repeat 12 mg once more if needed.
Paroxysmal supraventricular tachycardia: 6 mg rapid IV bolus over 1-2 seconds; if no conversion in 1-2 minutes, give 12 mg rapid IV bolus; may repeat 12 mg once if necessary. Maximum single dose: 12 mg. Also used for cardiac stress testing: 140 mcg/kg/min IV infusion over 6 minutes, total dose 0.84 mg/kg.
None Documented
Clinical Note
moderateCarbamazepine + Adenosine
"The risk or severity of adverse effects can be increased when Carbamazepine is combined with Adenosine."
Clinical Note
moderateTheophylline + Adenosine
"The therapeutic efficacy of Adenosine can be decreased when used in combination with Theophylline."
Clinical Note
moderateDyphylline + Adenosine
"The therapeutic efficacy of Adenosine can be decreased when used in combination with Dyphylline."
Clinical Note
moderateAminophylline + Adenosine
None Documented
Terminal half-life is less than 10 seconds; clinically, the effect is very transient due to rapid cellular uptake and metabolism.
Terminal elimination half-life <10 seconds (rapidly cleared from plasma by cellular uptake and metabolism); clinical context: transient effects require continuous IV infusion for sustained action.
Primarily renal excretion of metabolites; adenosine is rapidly metabolized intracellularly to inosine and adenosine monophosphate, with less than 1% excreted unchanged in urine.
Hepatic metabolism (primarily via adenosine deaminase and adenosine kinase) to inosine and AMP; renal excretion of metabolites accounts for <10% of elimination.
Category C
Category C
Antiarrhythmic
Antiarrhythmic
"The therapeutic efficacy of Adenosine can be decreased when used in combination with Aminophylline."