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Adenosine 3/11/10 Part I Notes PY Drug Book Class - short acting anti-arrhythmic - naturally occurring purine nucleoside Mechanism of Action - depression of SA & AV nodal activity - antagonises cAMP-mediated catecholamine stimulation of ventricular muscle -> negative chronotropy & dromotropy - direct agonist at specific cell membrane receptors (A1 & A2) - A1 = coupled to K+ channels by a guanine nucleotide-binding protein in supraventricular tissue. Pharmaceutics - clear, colourless - 3mg/mL - in saline Dose - rapid IV bolus followed by saline flush - 3mg -> 6mg -> 12mg (adult) - 0.04 to 0.25mg/kg (children) Onset - 10 seconds Duration - 10 seconds Indications - diagnosis and treatment of paroxysmal SVT Adverse Effects - bronchospasm flushing SOB chest pain Contraindications - second and third degree AV block Jeremy Fernando (2011) - allergy - care with asthma and COPD PK Absorption – must be given IV Distribution Metabolism – absorbed by RBC’s and endothelium Elimination – t ½ = 10 seconds Evidence Jeremy Fernando (2011)