Drug General Information (ID: DDIKJRQ1VO)
Drug Name			Ibutilide		Drug Info		Adenosine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiarrhythmic Agents				Antiarrhythmic Agents
Structure

Mechanism of Ibutilide-Adenosine Interaction (Severity Level: Major)
Increased risk of ventricular arrhythmias Click to Show/Hide Mechanism Graph
Drug Name		Ibutilide				Adenosine
Mechanism 1		Prolong QT interval				Bradycardia
Key Mechanism Factor 1
		Factor Name		Ventricular arrhythmias
		Factor Description		Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
Mechanism Description		Increased risk of ventricular arrhythmias by the combination of Ibutilide and Adenosine
Mechanism 2		Prolong QT interval				Delay atrioventricular conduction
Key Mechanism Factor 2
		Factor Name		Ventricular arrhythmias
		Factor Description		Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
Mechanism Description		Increased risk of ventricular arrhythmias by the combination of Ibutilide and Adenosine

Recommended Action
Management		Adenosine should be used with caution in patients receiving drugs that are known to prolong the QT interval. Adenosine should be discontinued immediately if severe bradycardia occurs.

References
1	Celiker A, Tokel K, Cil E, Ozkutlu S, Ozme S "Adenosine induced torsades de pointes in a child with congenital long QT syndrome." Pacing Clin Electrophysiol 17 (1994): 1814-7. [PMID: 7838793]
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Teodorovich N, Margolin E, Kogan Y, Paz O, Swissa M. Torsades de pointes after adenosine administration. J Electrocardiol. 2016;49(2):171-173. [PMID: 26850499]
4	Harrington GR, Froelich EG "Adenosine-induced torsades de pointes." Chest 103 (1993): 1299-1301. [PMID: 8131497]
5	Mallet ML "Proarrhythmic effects of adenosine: a review of the literature." Emerg Med J 21 (2004): 408-10. [PMID: 15208219]
6	Michalets EL, Williams CR "Drug interactions with cisapride: clinical implications." Clin Pharmacokinet 39 (2000): 49-75. [PMID: 10926350]
7	Tachakra SS, Robinson S "Adenosine and cardiac arrhythmias." BMJ 305 (1992): 422. [PMID: 1392935]
8	Wesley RC Jr, Turnquest P "Torsades de pointe after intravenous adenosine in the presence of prolonged QT syndrome." Am Heart J 123 (1992): 794-6. [PMID: 1539535]