Adenosine in the episodic treatment of paroxysmal supraventricular tachycardia

Robert Parker, P. L. McCollam

Research output: Contribution to journalReview article

26 Citations (Scopus)

Abstract

The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage and administration of adenosine in the treatment of epidoses of paroxysmal supraventricular tachycardia (PSVT) are reviewed. Adenosine is an endogenous adenine nucleoside that markedly decreases heart rate and prolongs atrioventricular (AV)-nodal conduction. Adenosine is rapidly cleared from plasma by the cellular elements of the blood and by vascular endothelial cells and subjected to enzymatic metabolism. The drug has a half-life of 0.6 to 10 seconds. In noncomparative clinical trials, adenosine terminated 85% to 100% of induced or spontaneous episodes of PSVT involving the AV node in the reentrant circuit. In patients with arrhythmias that do not involve the AV node in reentrant circuit, adenosine produces AV block and does not restore sinus rhythm. Prospective, randomized trials comparing adenosine with verapamil in adults have not yet been performed. The adverse effects of adenosine include flushing, dyspnea, headache, cough, chest pain, sinus bradycardia, atrial fibillation, ventricular arrhythmias, and various degrees of AV block. Because of the short half-life of adenosine, these effects are transient and well tolerated. The initial dose of adenosine in treating acute PSVT is 6 mg given by rapid i.v. bolus injection, followed in one to two minutes by up to two additional 12-mg boluses if necessary. Adenosine has been found to be effective in terminating PSVT and thus offers an alternative to verapamil. Prospective, randomized trials comparing adenosine with verapamil are needed to definitively establish adenosine's role in the therapy of PSVT.

Original languageEnglish (US)
Pages (from-to)261-271
Number of pages11
JournalClinical Pharmacy
Volume9
Issue number4
StatePublished - Jan 1 1990
Externally publishedYes

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Paroxysmal Tachycardia
Supraventricular Tachycardia
Adenosine
Therapeutics
Verapamil
Atrioventricular Node
Atrioventricular Block
Half-Life
Cardiac Arrhythmias
Primary Headache Disorders
Adenine
Bradycardia
Chest Pain
Nucleosides
Dyspnea

All Science Journal Classification (ASJC) codes

  • Pharmaceutical Science

Cite this

Adenosine in the episodic treatment of paroxysmal supraventricular tachycardia. / Parker, Robert; McCollam, P. L.

In: Clinical Pharmacy, Vol. 9, No. 4, 01.01.1990, p. 261-271.

Research output: Contribution to journalReview article

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