Download Adenosine - paramediclab

Adenosine (Adenocard)
Class:
Endogenous nucleoside, miscellaneous antidysrhythmic
Description:
Adenosine primarily is formed from the breakdown of adenosine triphosphate. Adenosine triphosphate and adenosine
are found in every cell of the human body & have a wide range of metabolic roles. Adenosine slows conduction
through the AV node without causing negative inotropic effects. It also acts directly on sinus pacemaker cells &
vagal nerve terminals to decrease chronotropic (heart rate) activity. Adenosine is recommended as the drug of choice
for paraoxysmal supraventricular tachycardia & can be used diagnostically for stable, wide-complex tachycardias of
unknown type, following two doses of lidocaine.
Onset & Duration:
Onset: Immediate
Duration: 10 sec.
Indications:
First drug for most forms of narrow-complex paroxysmal SVT in adults & pediatric PT’s
Contrindications:
2nd degree or 3rd degree atrioventricular block, or sick sinus syndrom
Hypersensitivity to adenosine, Atrial Flutter, Atrial Fibb, VT, (Adenosine is not effective in converting
these rhythms to sinus rhythm.)
Adverse Reactions:
Light-headedness, paraesthesis, headache, diaphoresis, palpitations, chest pain, flushing, hypotension, shortness of
breath. Transient periods of sinus bradycardia, sinus pause, or bradyasystole. Ventricular ectopy (fibrillation, flutter,
tachycardia, torsades de points, nausea, metallic taste.
Drug Interactions:
Methylxanthines (e.g. caffeine and theophyline) antagonize the action of adenosine. Dipyridamole potentates the
effect of adenosine; reduction of adenosine dose may be required. Carbamazepine may potentiate the atrioventricularnodal blocking effect of adenosine.
How Supplied:
Parenteral of IV injection 3mg/mL in 2-mL and 5-mL flip-top vials
Dosage & Administration:
Adult:
Initial dose: 6-mg rapid IV bolus over 1-3 sec, followed by a 20-mL saline flush; elevate extremity.
Repeat dose: If no response is observed after 1-2 min, administer a 12-mg dose. Maybe repeated once
more in 1-2 min same as last dose. (max dose is 12 mg)
Peiatric: Initial dose 0.1 mg/kg; may be doubled once (max first dose: 6 mg); rapid bolus, followed by a 5mL saline flush
Special Considerations:
Pregnancy safety: Category C- place patient in mild trendelenburg position before administration.
A brief period of asystole (up to 15 sec.) following conversion, followed by resumption of normal sinus
rhythm, is common after rapid administration.
Patients taking theophylline may require larger doses of adenosine; cardiac transplant recipients may require
only a small dose.
Adenosine may produce bronchoconstriction in patients with asthma and in patients with bronchopulmonary
disease.
Monitor electrocardiogram during administration.
Reduce initial dose to 3 mg in patients taking dipyridamole (Persantin) or carbamepazine (Tegretol) or
patients with transplanted hearts.