Adenozin Special Precautions

Due to the possibility of transient cardiac arrhythmias arising during conversion of the supra ventricular tachycardia to normal sinus rhythm, administration should be carried out in a hospital setting with monitoring and cardio-respiratory resuscitation equipment available for immediate use if necessary. During administration, continuous ECG monitoring is necessary as life-threatening arrhythmia might occur. Hypotension is possible when large doses of adenosine are administered by continuous IV infusion. Discontinue infusion in patients who develop persistent or symptomatic hypotension.
Adenosine should be used with caution in patients with recent myocardial infarction, severe heart failure, or in patients with minor conduction defects (first degree A-V block, bundle branch block) that could be transiently aggravated during infusion. Adenosine should be used with caution in patients with atrial fibrillation or flutter and especially in those with an accessory by-pass tract since particularly the latter may develop increased conduction down the anomalous pathway.
Cardiac denervation in patients who have undergone cardiac transplantation reportedly may enhance sensitivity to the bradycardic effects of adenosine.
Adenosine does not require renal or hepatic function for therapeutic effect or inactivation, so renal or hepatic dysfunction would not be expected to alter its effectiveness or tolerability.
Use adenosine with caution in patients with obstructive lung disease not associated with bronchoconstriction (eg. bronchitis, emphysema), and avoid use in patients with bronchoconstriction or bronchospasm (eg. asthma). Discontinue adenosine in any patient who develops severe respiratory difficulties.
Use in Children: The safety and efficacy of adenosine in children aged 0-18 years old have not been established.