Adenosine disodium triphosphate (ATP) is an important drug, especially in the anti-arrhythmia and the treatment of many diseases.
Scope of application of adenosine disodium triphosphate
(1) For heart failure, myocarditis, cerebral arteriosclerosis, sequelae of cerebral haemorrhage, acute poliomyelitis, progressive muscular atrophic disease, etc.
As a coenzyme, adenosine disodium triphosphate has the function of improving body metabolism, participating in the metabolism of body fat, protein, sugar, nucleic acid and nucleotide, and is closely related to tissue growth, repair and regeneration, and is also the main source of energy in the body.
For these diseases, adenosine disodium triphosphate can promote the recovery of patients by improving metabolism, providing energy and so on.
(2) It is used to terminate paroxysmal supraventricular tachycardia and return to sinus rhythm.
In the treatment of arrhythmias, adenosine disodium triphosphate has a unique mechanism of action, which can inhibit calcium ion flow, block or delay the forward conduction in the atrioventricular reentry pathway, and also has a brief but strong effect on strengthening the vagus nerve, thus terminating the arrhythmias caused by atrioventricular node reentry and bypass reentry mechanism.
Analysis of pharmacological action
Adenosine triphosphate (ATP) in adenosine disodium triphosphate is a coenzyme, which plays an important role in the body.
It is involved in many important metabolic processes in the body, including the metabolism of fats, proteins, sugars, nucleic acids and nucleotides. These metabolic processes are essential for maintaining normal physiological functions of the body.
Adenosine disodium triphosphate is the main source of energy in the body. When the body needs energy, ATP is broken down into adenosine diphosphate and phosphate group, and energy is released at the same time.
In animal experiments, adenosine disodium triphosphate can inhibit calcium influx, which is of great significance for the treatment of arrhythmia.
Calcium influx is an important factor leading to arrhythmia. By inhibiting calcium influx, the forward conduction in atrioventricular reentry pathway can be blocked or delayed, thus stopping arrhythmia.
Adenosine disodium triphosphate also has a brief but strong vagus nerve strengthening effect.
The vagus nerve has an important regulatory role in the activity of the heart, and enhancing the action of the vagus nerve can slow down the heart rate and reduce the excitability of the heart, thus helping to stop arrhythmias.
Adverse reaction manifestation
(1) Adverse reactions of oral preparations:
- Gastrointestinal system: nausea, vomiting, abdominal pain, diarrhea. These adverse reactions may affect the patient’s appetite and digestive function, resulting in discomfort in the patient.
- Nervous system: dizziness, headache. Dizziness and headaches may affect the patient’s daily life and work and reduce the patient’s quality of life.
- Skin and subcutaneous tissue: rash, itching. The rash and itching may cause discomfort and even affect the patient’s sleep.
- Other: palpitations, chest discomfort, fatigue. Palpitations and chest discomfort can be unsettling, and fatigue can affect physical strength and mobility.
(2) Injection adverse reactions:
- Systemic reactions: chills, fever, fatigue, excessive sweating, chest discomfort. These systemic reactions may make the patient feel uncomfortable and affect the patient’s physical state.
- Skin and subcutaneous tissue: rash, itching, hives, erythema. Rashes, itching, hives and erythema may cause discomfort and even affect the patient’s appearance.
- Nervous system: dizziness, headache, tremors, twitching, loss of sensation. Dizziness and headaches may affect the patient’s daily life and work, and tremors, twitching, and decreased sensation may affect the patient’s nervous system function.
- Gastrointestinal system: nausea, vomiting, abdominal pain. Nausea, vomiting and abdominal pain may affect the patient’s appetite and digestive function, causing the patient to experience discomfort.
- Respiratory system: dyspnea, shortness of breath, choking, coughing. Dyspnea, shortness of breath, choking and coughing may affect the patient’s respiratory function and even endanger the patient’s life in severe cases.
- Cardiovascular system: palpitations, atrial flutter, bradycardia. Palpitations, atrial flutter, and bradycardia can affect a patient’s heart function, leading to problems such as arrhythmias.
- Immune system: anaphylactic shock, anaphylaxis, hypersensitivity. Anaphylactic shock, anaphyloid reaction and hypersensitivity reaction are serious adverse reactions, which may endanger the life of patients.
- Other: flushing, cyanosis, pallor. Flushing, cyanosis, and pallor may affect the person’s appearance, and may also signal that something is wrong.
Contraindications
(1) If allergic to this product, it is prohibited
If the patient is allergic to adenosine disodium triphosphate, use of the drug can cause a severe allergic reaction, even life-threatening. Therefore, before using adenosine disodium triphosphate, the doctor needs to ask the patient’s allergy history in detail to ensure that the medication is safe.
(2) Contraindicated in patients with early cerebral hemorrhage
In the early stage of cerebral hemorrhage, the patient’s condition is relatively unstable, and the use of adenosine disodium triphosphate may aggravate the condition, so it is contraindicated.
(3) Patients with sick sinus syndrome should not be allowed
Sick sinus syndrome is a heart condition in which the sinus node functions abnormally, and the use of adenosine disodium triphosphate may worsen the condition, so it is condone.
(4) Contraindicated in patients taking propranolol, dipyridamole, and diazepam
Adenosine disodium triphosphate interacts with these drugs and may increase the risk of adverse reactions, so it is prohibited.
(5) Patients with severe chronic bronchitis and asthma are prohibited
The respiratory system function of patients with severe chronic bronchitis and asthma is impaired, and the use of adenosine disodium triphosphate may aggravate the condition, so it is prohibited.
(6) Patients with atrioventricular block should not be allowed
Atrioventricular block is a heart condition in which a person’s heart conduction system functions abnormally, and the use of adenosine disodium triphosphate may worsen the condition, so it is contraindicated.
Detailed explanation of precautions
(1) Use with caution
Use with caution for people over 60 years old. As the older people age, their physical functions gradually decline and their tolerance to drugs decreases.
The older people need to be more cautious when using adenosine disodium triphosphate, and doctors need to adjust the dosage according to the specific situation of the patient.
Use with caution in sinus bradycardia. Sinus bradycardia is a heart condition in which a person’s heart rate is slower.
The use of adenosine disodium triphosphate may further slow the heart rate and cause the condition to worsen. Adenosine disodium triphosphate should used with caution in sinus bradycardia.
(2) Influence on test value or diagnosis
Transient elevation of glutalanine aminotransferase occurs in very few patients and returns to normal after discontinuation.
During the use of adenosine triphosphate, the doctor needs to check the patient’s liver function regularly to ensure that the drug is not causing damage to the liver.
If the patient has elevated glutalanine aminotransferase, the doctor needs to adjust the medication regimen according to the specific situation.
(3) Check or monitor before and after medication and during medication
Ecg and blood pressure should closely monitored during medication.
Adenosine disodium triphosphate has a certain effect on the heart and blood pressure, so the ECG and blood pressure need to closely monitored during use to ensure the safety of patients.
(4) This drug has obvious inhibition of sinus node, so it should used with caution or not in sick sinus syndrome or sinus node dysfunction or the older people
Adenosine disodium triphosphate has an inhibitory effect on the sinoatrial node, so special attention needs to paid to the function of the patient’s sinoatrial node during use.
If the patient has diseased sinus syndrome or sinus node dysfunction, or is older people, the use of adenosine triphosphate needs to be more cautious, and the doctor needs to adjust the medication regimen according to the patient’s specific situation.
(5) Part of the efficacy of this product is not clear, do not abuse
Although adenosine disodium triphosphate has some role in the treatment of a variety of diseases, some of the efficacy is unknown.
In the process of use, doctors need to strictly grasp the indications to avoid abuse of drugs.
(6) Anaphylactic shock adverse reaction reports of adenosine disodium triphosphate injection detected after marketing
It is recommended to use in medical institutions with rescue conditions.
Before medication, patients should carefully asked about medication history and allergy history, and pay attention to observation during medication.
Once symptoms and signs such as rash, itching, dyspnea, and decreased blood pressure appear, the medication should stopped immediately and treated in time.
Anaphylactic shock is a serious adverse reaction that can endanger the patient’s life.
When using adenosine disodium triphosphate injection, it needs to used in medical institutions with rescue conditions. Doctors need to carefully inquire about the patient’s medication history and allergy history, closely observe the patient’s reaction during the medication process, and stop the drug immediately and conduct timely treatment in case of adverse reactions.
(7) Intravenous injection of this product should be slow, so as not to cause dizziness, head distension, chest tightness and hypotension
If the speed of intravenous injection of adenosine disodium triphosphate is too fast, it may cause dizziness, head distension, chest tightness and hypotension.
When injected intravenously, it is necessary to inject slowly to avoid the occurrence of adverse reactions.
(8) Use this product in paroxysmal supraventricular tachycardia
A variety of arrhythmias and systemic reactions can occur, although they are instantaneous reactions without treatment, but still have a certain potential danger.
The therapeutic dose should start from a small dose, and gradually increase the dose when ineffective, and should not exceed 40mg each time.
When used in combination with drugs that have negative conduction and lower heart rate, reduce the dose and avoid combining as much as possible.
In the treatment of paroxysmal supraventricular tachycardia, the use of adenosine disodium triphosphate requires special attention to dosage and combination.
Since adenosine disodium triphosphate may cause multiple arrhythmias and systemic reactions, the therapeutic dose should start small and gradually increase, not exceeding 40mg each time.
When used in combination with drugs that have negative conduction and lower heart rate, the dosage should reduced and the combination should avoided as much as possible to reduce the risk of adverse reactions.
(9) Cardiac arrest during cardioversion with this product
Due to the short time, most of them do not need to treated, and can recover to sinus rhythm by themselves. However, if the duration of cardiac arrest is longer, external cardiac compression should given immediately and atropine should injected intravenously.
If cardiac arrest occurs during cardioversion with adenosine disodium triphosphate, different treatment measures should taken according to the length of the arrest time.
If the time of arrest is short, it generally does not need to treated, and the heart can return to a sinus rhythm on its own. However, if the cardiac arrest time is longer, external cardiac compression should immediately given, and intravenous atropine to restore the beating of the heart.
(10) This product is easy to degrade and inefficient after heat, and should dried and stored at low temperature
Adenosine disodium triphosphate is easily degraded by heat, reducing its efficacy.
During the preservation process, it needs to placed in a low temperature and dry place to ensure the stability and effectiveness of the drug.
(11) Intravenous injection should be slow, so as not to cause hypotension, vertigo, etc
As mentioned earlier, the intravenous injection of adenosine disodium triphosphate needs to be slow to avoid causing adverse reactions such as low blood pressure and vertigo.
(12) Excessive intramuscular injection can cause local pain, and a few people can have joint pain, lower limb pain, urticaria, etc
Intramuscular injection of adenosine disodium triphosphate, if the dose is too large, may cause local pain, a few people may also appear joint pain, lower limb pain, urticaria and other adverse reactions.
When intramuscular injection, it is necessary to strictly control the dose and avoid excessive injection.
Drug interaction
- Coronary artery dilators: mutually reinforcing effects. The combination of adenosine disodium triphosphate and coronary artery dilatation drugs can enhance the efficacy of drugs, and has certain help for the treatment of coronary heart disease and other diseases.
- Dipyridamole: may increase the adverse reactions of this product. The combination of adenosine disodium triphosphate and dipyridamole may increase the risk of adverse reactions and should used with caution.
- Atropine: can prevent the occurrence of severe transient arrhythmia. In the treatment of arrhythmias with adenosine disodium triphosphate, atropine can play an adjunct role in preventing the occurrence of severe transient arrhythmias.
- Cardiac glycosides: It can reduce the toxic reaction of cardiac glycosides and reduce the incidence of arrhythmia. The combination of adenosine disodium triphosphate and cardiac glycosides can reduce the toxicity of cardiac glycosides, reduce the incidence of arrhythmia, and have certain help for the treatment of heart failure and other diseases.
- Theophylline, caffeine: can resist adenosine action, thereby reducing the efficacy of this product. The combination of adenosine disodium triphosphate with theophylline, caffeine and other drugs may reduce the efficacy of the drug, so it should avoided.
Usage guide
(1) Oral administration
Adults usually take 20-40mg once, 3 times a day. Dosage can increased or decreased according to age. Oral adenosine disodium triphosphate is a more convenient way to use the drug, but it needs to pay attention to the dosage and usage.
The doctor will adjust the dosage according to the specific situation of the patient to ensure that the treatment is safe and effective.
(2) Injection
Intravenous injection: Dilute this product for injection with 5%-10% glucose injection 10-20ml and slowly inject it intravenously, 20mg once, 1-2 times a day.
Termination of supraventricular tachycardia: the first dose of 20mg, diluted to 5ml with glucose injection within 20 seconds of rapid intravenous injection, if ineffective, the interval of 5 minutes, then another 30mg, a single dose of no more than 40mg.
Intravenous injection of adenosine disodium triphosphate requires attention to dilution method, injection speed and dosage. When terminating supraventricular tachycardia, it is necessary to strictly control the dose and injection time to ensure the safe and effective treatment.
Intramuscular injection: 20mg once, 1-2 times a day. Intramuscular injection of adenosine disodium triphosphate requires attention to the dose and injection site to avoid excessive injection and local pain and other adverse reactions.
Key points of storage method
Adenosine disodium triphosphate should kept in a cool and dark place (not more than 20 ° C away from light).
The correct storage method can ensure the stability and effectiveness of the drug, and avoid the deterioration of the drug under the influence of light and temperature.
Sum up
Adenosine disodium triphosphate (ATP) is a drug that plays an important role in anti-arrhythmia and treatment of many diseases.
However, in the process of use, it is necessary to pay attention to the scope of application, pharmacological effects, adverse reactions, contraindications, precautions, drug interactions, use methods and storage methods to ensure the safety and effectiveness of the drug.
