Drug General Information (ID: DDI6ZDFE09)
Drug Name			Adenosine		Drug Info		Digitoxin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiarrhythmic Agents				Antiarrhythmic Agents
Structure

Mechanism of Adenosine-Digitoxin Interaction (Severity Level: Major)
Increased risk of atrioventricular block Click to Show/Hide Mechanism Graph
Drug Name		Adenosine				Digitoxin
Mechanism 1		Delay atrioventricular conduction				Delay atrioventricular conduction
Key Mechanism Factor 1
		Factor Name		Atrioventricular block
		Factor Description		Atrioventricular block is a type of cardiac conduction block that occurs when the electrical signal from the atria to the ventricles is impaired. In an Atrioventricular block, this electrical signal is either delayed or completely blocked. When the signal is completely blocked, the ventricles produce their own electrical signal to control the heart rate. The heart rate produced by the ventricles is much slower than that produced by the sinus node.
Mechanism Description		Increased risk of atrioventricular block by the combination of Adenosine and Digitoxin
Increased risk of bradycardia Click to Show/Hide Mechanism Graph
Drug Name		Adenosine				Digitoxin
Mechanism 2		Bradycardia				Bradycardia
Key Mechanism Factor 2
		Factor Name		Bradycardia
		Factor Description		Bradycardia is a slow heart rate in which the heart beats less than 60 times per minute. If the heart rate is very slow and the heart is not pumping enough oxygen-rich blood to the body, and you may feel dizzy, very tired or weak, and short of breath.
Mechanism Description		Increased risk of bradycardia by the combination of Adenosine and Digitoxin

Recommended Action
Management		Adenosine should be used with caution in patients receiving digitalis glycosides. Adenosine should be discontinued immediately if angina, severe bradycardia, severe hypotension, or asystole occurs. Also, patients who develop high-level atrioventricular block on one dose of adenosine should not be given additional doses. Appropriate resuscitative measures should be readily available.

References
1	Ben-Sorek ES, Wiesel J "Ventricular fibrillation following adenosine administration. A case report." Arch Intern Med 153 (1993): 2701-2.[PMID: 8250667]
2	Mulla N, Karpawich PP "Ventricular fibrillation following adenosine therapy for supraventricular tachycardia in a neonate with concealed wolff-parkinson-white syndrome treated with digoxin." Pediatr Emerg Care 11 (1995): 238-9.[PMID: 8532572]
3	Product Information. Adenocard (adenosine). Fujisawa, Deerfield, IL.