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Adenosine has an excellent safety profile and is often the drug of choice to treat hemodynamically stable patients with a narrow complex paroxysmal supraventricular tachycardia. It has an ultra-short half life (<10 secs) and lacks the vaso- and myocardial depressant effects of some other AV nodal agents. Although it produces side effects (flushing, dyspnea, and chest pain), they are transient. Adenosine has several drug interactions. Its effects are antagonized by the methylxanthines (theophylline, caffeine) since methylxanthines prevent binding of adenosine at receptor sites. Therefore large doses of adenosine may be required in the presence of methylxanthines.
Dipyridamole (D), carbamazepine (B), and diazepam (C) potentiate the effects of adenosine therefore smaller doses (or an alternative agent) should be used with these medications. There is no interaction with aspirin (A) that requires a dosing change in adenosine.
Yealy DM, Delbridge TR: Dysrhythmias, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 77:p 994
Parsons WJ, Stiles GL. Methylxanthines as Adenosine Receptor Antagonists. Ann Inn Med. 1985;103(4):643
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