Adenosine (Adenocard)
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þ Per Dr. Adhar, 3/98, both adenosine and verapamil are OK for pregnant
  patients with SVT

þ Adenosine and COPD
 - "The literature describes bronchospasm in asthma patients lasting 30
   minutes or so after administration of adenosine. Therefore it may be
   contraindicated in asthma patients.   See the following site for a detailed
   description of its actions: http://pharminfo.com/pubs/msb/adenosine.html"
 - "In a review article in the NEJM (Vol 325, No. 23, 1991, pp.1621-1629)
   Oates and Wood state, "a single inhalational dose of adenosine can cause
   measurable bronchoconstriction for at least 30 minutes. The mechanism of
   this response is unknown. The effects of IV adenosine and their time course
   in patients with asthma have not yet been reported." No comment on COPD (or
   CAL as we would say)."
 - "Similarly, Rankin et al (American Journal of Medicine; Vol92, June 1992,
   pp.655-664) stated, "inhalation of adenosine may produce
   bronchoconstriction in asthmatics, but intravenous infusion does not. There
   is a single report, in the French literature, of bronchospasm after bolus
   injection of adenosine. It is prudent to advise caution.". Again no mention
   of COPD."
 - "Don't forget that aminophylline is a potent antagonist of adenosine.  An
   exaggerated or adverse response to adenosine can be improved by a bolus of
   250-500mg aminophylline, given as rapidly as the gravity of the situation
   indicates. Edward S. Bessman, MD Department of Emergency Medicine
   Hopkins/Bayview"

*Adenosine may cause bronchospasm and one case report of anaphylactoid reaction:
1) Drake I. Bronchospasm induced by intravenous adenosine. Hum Exp Toxicol.
1994;13:263-5.
2) DeGroff CG. Bronchospasm after intravenous administration of adenosine in
a patient with asthma. J Pediatr. 1994;125:822-3.
3) Aggarwal A. Intraoperative bronchospasm caused by adenosine.
Anesthesiology. 1993;79:1132-5.
4) Burkhart KK. Respiratory failure following adenosine administration. Am J
Emerg Med. 1993;11:249-50.
Another adenosine safety issue was discussed in "Anaphylactoid Reaction to
Adenosine," a single case report (Prehospital and Disaster Medicine Vol.11,
No. 2, April-June, 1996). Patient experienced urticaria and hypotension, no
bronchospasm. Etiology remained unclear since adenosine is an endogenous
substance and is supplied without preservatives, etc. Includes statement that
inhalation of adenosine may cause bronchospasm (BrJPharmacol 1983;
15:161-165) but that IV administration does not (Chest 1988; 93: 280-284!