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Adenosine

Medical Uses of Adenosine: – Used to identify and convert supraventricular tachycardia (SVT) rhythms. – Terminates certain SVTs like AV reentrant tachycardia (AVRT) and atrial […]

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Medical Uses of Adenosine:
– Used to identify and convert supraventricular tachycardia (SVT) rhythms.
– Terminates certain SVTs like AV reentrant tachycardia (AVRT) and atrial tachycardia.
– Considered a class V antiarrhythmic agent.
– Can cause ventricular asystole temporarily during cardioversion.
– Used in nuclear stress tests with thallium or technetium as an adjunct for patients unable to undergo exercise stress testing.

Dosage and Administration:
– Initial doses for SVT evaluation range from 6mg to 12mg via rapid parenteral infusion.
– IV line placement is critical due to adenosine’s short half-life.
– Dosage for arterial dilation during stress tests is typically 0.14mg/kg/min.
– Theophylline users may require increased doses of adenosine.
– Doses are adjusted based on specific conditions or medications.

Pharmacological Effects and Mechanism of Action:
– Adenosine modulates physiological processes via four receptor subtypes.
– Functions in cytoprotection during stress or injury.
– Activation of A2A receptors leads to anti-inflammatory responses.
– Intravenous adenosine causes transient heart block in the atrioventricular node.
– Metabolism involves de novo purine biosynthesis and breakdown by adenosine deaminase.

Drug Interactions and Contraindications:
– Dipyridamole enhances adenosine’s action, necessitating lower doses.
– Caffeine acts as an antagonist to adenosine receptors.
– Methylxanthines compete with adenosine, affecting dosage requirements.
– Asthma is traditionally considered a contraindication.
– Specific drug interactions and contraindications need to be considered.

Research and Clinical Applications:
– Adenosine analogs show promise in inhibiting viruses like dengue and hepatitis C.
– Anti-inflammatory properties are being explored, especially in wound healing and inflammatory conditions.
– Implications in the central nervous system, hair growth, and sleep regulation are areas of active research.
– Adenosine’s role in cardiovascular health, dermatology, and immune responses is being studied for potential therapeutic applications.
– Ongoing research focuses on the diverse pharmacological effects and clinical uses of adenosine in various medical fields.

Adenosine (Wikipedia)

Adenosine (symbol A) is an organic compound that occurs widely in nature in the form of diverse derivatives. The molecule consists of an adenine attached to a ribose via a β-N9-glycosidic bond. Adenosine is one of the four nucleoside building blocks of RNA (and its derivative deoxyadenosine is a building block of DNA), which are essential for all life on Earth. Its derivatives include the energy carriers adenosine mono-, di-, and triphosphate, also known as AMP/ADP/ATP. Cyclic adenosine monophosphate (cAMP) is pervasive in signal transduction. Adenosine is used as an intravenous medication for some cardiac arrhythmias.

Adenosine
Clinical data
Trade namesAdenocard; Adenocor; Adenic; Adenoco; Adeno-Jec; Adenoscan; Adenosin; Adrekar; Krenosin
Other namesSR-96225 (developmental code name)
AHFS/Drugs.comMonograph
Pregnancy
category
  • C

(adenosine may be safe to the fetus in pregnant women)

Routes of
administration
Intravenous
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Pharmacokinetic data
BioavailabilityRapidly cleared from circulation via cellular uptake
Protein bindingNo
MetabolismRapidly converted to inosine and adenosine monophosphate
Elimination half-lifecleared plasma <30 seconds; half-life <10 seconds
Excretioncan leave cell intact or can be degraded to hypoxanthine, xanthine, and ultimately uric acid
Identifiers
  • (2R,3R,4S,5R)-2-(6-amino-9H-purin-9-yl)-5-(hydroxymethyl)oxolane-3,4-diol
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.000.354 Edit this at Wikidata
Chemical and physical data
FormulaC10H13N5O4
Molar mass267.245 g·mol−1
3D model (JSmol)
  • n2c1c(ncnc1n(c2)[C@@H]3O[C@@H]([C@@H](O)[C@H]3O)CO)N
  • InChI=1S/C10H13N5O4/c11-8-5-9(13-2-12-8)15(3-14-5)10-7(18)6(17)4(1-16)19-10/h2-4,6-7,10,16-18H,1H2,(H2,11,12,13)/t4-,6-,7-,10-/m1/s1 checkY
  • Key:OIRDTQYFTABQOQ-KQYNXXCUSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Adenosyl (abbreviated Ado or 5'-dAdo) is the chemical group formed by removal of the 5′-hydroxy (OH) group. It is found in adenosylcobalamin (an active form of vitamin B12) and as a radical in the radical SAM enzymes.

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