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Adenosine

Q: Is adenosine used as a dietary supplement?

No, adenosine is not typically used as a dietary supplement. It is primarily used in medical settings for specific cardiovascular conditions like SVT and as an adjunctive therapy in AMI.

Q: Are the side effects of adenosine serious?

Side effects are common but usually transient, such as bradycardia, hypotension, and chest discomfort. Serious side effects are rare, but adenosine should be administered by healthcare professionals in a monitored setting.

Q: How is adenosine administered?

Adenosine is administered intravenously or intracoronarily by healthcare professionals due to its potent effects and the need for continuous monitoring. It is given as a rapid bolus for acute conditions like SVT.

Q: What are the expected results of adenosine treatment?

In SVT, adenosine is expected to rapidly reduce heart rate and terminate the arrhythmia. In AMI, it aims to improve myocardial reperfusion and reduce adverse cardiovascular events.

Q: Can adenosine be used for general health improvement?

No, adenosine is not commonly used as a supplement for general health. Its primary applications are in specific medical scenarios requiring rapid cardiovascular intervention.

Also known as: Adenosine, Adenosine Monophosphate (AMP), C10H13N5O4

Overview

Adenosine is a naturally occurring purine nucleoside composed of adenine and ribose. It plays a vital role in various physiological processes, particularly in the cardiovascular system. Primarily, adenosine is used medically to treat supraventricular tachycardia (SVT) by rapidly slowing heart rate. It also serves as an adjunctive therapy in acute myocardial infarction (AMI) to improve myocardial reperfusion. Adenosine exhibits vasodilatory and anti-inflammatory properties, influencing heart rate and blood vessel dilation. It acts through A1, A2A, A2B, and A3 receptors, affecting heart rate, vasodilation, and anti-inflammatory responses. Due to its short half-life, adenosine is typically administered intravenously or intracoronarily for acute conditions. Research on adenosine is mature, with extensive studies on its cardiovascular effects, providing a solid foundation for its clinical applications.

Benefits

Adenosine provides significant cardiovascular benefits, particularly in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Research indicates that adenosine significantly increases ST resolution (RR: 1.30; 95% CI: 1.15–1.46; *p* < 0.001) and reduces major adverse cardiovascular events (MACEs) (RR: 0.67; 95% CI: 0.51–0.87; *p* = 0.003). It also reduces the risk of heart failure (RR: 0.66; 95% CI: 0.44–0.99; *p* = 0.044). Furthermore, adenosine improves myocardial reperfusion and reduces the no-reflow phenomenon. In patients with supraventricular tachycardia (SVT), adenosine is highly effective in rapidly terminating the arrhythmia. These benefits are supported by high-quality systematic reviews and meta-analyses, underscoring the clinical importance of adenosine in specific cardiovascular conditions.

How it works

Adenosine exerts its effects by interacting with specific adenosine receptors (A1, A2A, A2B, and A3) located throughout the body, particularly in the cardiovascular system. Activation of A1 receptors in the heart slows heart rate and reduces AV nodal conduction, which is crucial for terminating SVT. Adenosine also promotes vasodilation, primarily through A2A receptor activation in vascular smooth muscle. This vasodilation improves myocardial reperfusion in AMI. Additionally, adenosine has anti-inflammatory properties that contribute to its beneficial effects in reducing myocardial damage. Its rapid metabolism and short half-life necessitate intravenous administration for acute effects.

Side effects

Adenosine is generally safe when administered appropriately in medical settings, but it can cause several side effects. Common side effects (occurring in >5% of patients) include bradycardia, hypotension, and atrioventricular (AV) block. Less common side effects (1-5%) include dyspnea and chest discomfort. Rare side effects (<1%) include extravasation and phlebitis at the injection site. Adenosine interacts with drugs like dipyridamole and carbamazepine, which can affect its metabolism and efficacy. It is contraindicated in patients with asthma or second- or third-degree AV block without a pacemaker. Caution is advised in patients with severe heart failure or bronchospastic disease. Due to its potential to cause significant cardiovascular effects, adenosine should only be administered by trained healthcare professionals in a monitored setting.

Dosage

For the treatment of supraventricular tachycardia (SVT), the typical initial dose of adenosine is 6 mg administered intravenously as a rapid bolus. If the initial dose is ineffective, a subsequent dose of 12 mg may be given. In the context of acute myocardial infarction (AMI), dosages vary, often involving intravenous or intracoronary administration as determined by the treating physician. Due to its rapid metabolism, adenosine is not suitable for oral administration. The maximum safe dose is not well-defined for long-term use and is typically limited by the occurrence of side effects. Adenosine should be administered under continuous ECG monitoring due to the risk of transient but potentially significant arrhythmias.

FAQs

Is adenosine used as a dietary supplement?

No, adenosine is not typically used as a dietary supplement. It is primarily used in medical settings for specific cardiovascular conditions like SVT and as an adjunctive therapy in AMI.

Are the side effects of adenosine serious?

Side effects are common but usually transient, such as bradycardia, hypotension, and chest discomfort. Serious side effects are rare, but adenosine should be administered by healthcare professionals in a monitored setting.

How is adenosine administered?

Adenosine is administered intravenously or intracoronarily by healthcare professionals due to its potent effects and the need for continuous monitoring. It is given as a rapid bolus for acute conditions like SVT.

What are the expected results of adenosine treatment?

In SVT, adenosine is expected to rapidly reduce heart rate and terminate the arrhythmia. In AMI, it aims to improve myocardial reperfusion and reduce adverse cardiovascular events.

Can adenosine be used for general health improvement?

No, adenosine is not commonly used as a supplement for general health. Its primary applications are in specific medical scenarios requiring rapid cardiovascular intervention.

Research Sources

https://www.imrpress.com/journal/RCM/26/2/10.31083/RCM24065/htm – This systematic review and meta-analysis of 2467 patients with AMI found that adenosine significantly increases ST resolution and reduces major adverse cardiovascular events (MACEs) and heart failure. The study highlights the potential benefits of adenosine as an adjunctive therapy in improving outcomes for AMI patients undergoing PCI, although the overall quality was considered moderate due to heterogeneity among studies.
https://www.mdpi.com/2227-9067/10/5 – This meta-analysis involving 1736 patients with AMI demonstrated that adenosine improves myocardial reperfusion and reduces the no-reflow phenomenon. The findings suggest that adenosine can enhance microvascular function in AMI patients. However, the study acknowledges variability in dosages and administration routes as a limitation, contributing to moderate overall quality.
https://journals.lww.com/md-journal/fulltext/2015/08020/efficacy_of_adenosine_in_patients_with_acute.22.aspx – This study investigates the efficacy of adenosine in patients with acute myocardial infarction. The research focuses on the impact of adenosine on myocardial reperfusion and clinical outcomes, providing insights into its potential as an adjunctive therapy. The findings contribute to the understanding of adenosine's role in improving cardiac function post-infarction.
https://pubmed.ncbi.nlm.nih.gov/38535745/ – This systematic review and meta-analysis of 180 patients with SVT compares the efficacy of the single-syringe technique (SST) versus the double-syringe technique (DST) for SVT termination. The study suggests that SST may be as effective as DST, simplifying the administration process. However, the moderate quality assessment reflects the small sample size and limited number of included studies.
https://academic.oup.com/eurheartj/article/44/Supplement_1/ehac779.025/7000490 – This abstract presents findings on the use of adenosine in cardiac procedures. It highlights the role of adenosine in inducing transient AV block to facilitate visualization and ablation of arrhythmias. The research contributes to the understanding of adenosine's utility in electrophysiological studies and interventions.