Therapeutic or Pharmacological Class: Endogenous nucleoside with peripheral vasodilator/antiarrhythmic effect. ATC Code: Other Cardiac Preparations C01EB10.
Pharmacology: Pharmacodynamics: Antiarrhythmic drug: Adenosine is a purine nucleoside which is present in all cells of the body. Animal pharmacology studies have in several species shown that adenosine has a negative dromotropic effect on the atrioventricular (AV) node.
In man Sanacore (adenosine) administered by rapid intravenous injection slows conduction through the AV node. This action can interrupt re-entry circuits involving the AV node and restore normal sinus rhythm in patients with paroxysmal supraventricular tachycardias. Once the circuit has been interrupted, the tachycardia stops and normal sinus rhythm is re-established.
One acute interruption of the circuit is usually sufficient to arrest the tachycardia.
Since atrial fibrillation and atrial flutter do not involve the AV node as part of a re-entry circuit, adenosine will not terminate these arrhythmias.
By transiently slowing AV conduction, atrial activity is easier to evaluate form ECG recordings and therefore the use of adenosine can aid the diagnosis of broad or narrow complex tachycardias.
Adenosine may be useful during electrophysiological studies to determine the site of AV block or to determine in some cases of pre-excitation, whether conduction is occurring by an accessory pathway or via the AV node.
Pharmacokinetics: Adenosine is impossible to study via classical ADME protocols. It is present in various forms in all cells of the body where it plays an important role in energy production and utilization systems. An efficient salvage and recycling system exists in the body, primarily in the erythrocytes and blood vessel endothelial cells. The half life in vitro is estimated to be < 10 seconds. The in vivo half life may be even shorter.
Toxicology: Preclinical Safety data: There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the Summary of Product Characteristics (SPC).
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