Adenosine

Question 1

Generic Name for Adenocard?

Answer 1

Adenosine

Question 2

Trade Name for adenosine?

Answer 2

Adenocard

Question 3

Adenosine drug classification?

Answer 3

antiarrhythmic, (a naturally occurring nucleoside)

Question 4

How is adenosine supplied?

Answer 4

3mg/mL in 2 and 5 mL vials

Question 5

MOA of adenosine?

Answer 5

Antiarrhythmic:
❑ Acts on the SA and AV node to slow conduction and inhibit reentry pathways.
❑ Also useful in PSVT linked to accessory bypass tracts (Wolf-Parkinson White Syndrome)

Question 6

Indications for adenosine?

Answer 6

❑ Stable, narrow-complex regular tachycardia (SA and AV nodal origin)
❑ Therapeutic and diagnostic maneuver for stable narrow complex SVT (Not AV nodal in origin)
❑ May be considered for: Unstable narrow-complex regular tachycardias while preparations are made for electrical cardioversion
❑ Stable, regular, monomorphic, wide complex tachycardia thought or previously defined to be re-entry SVT with aberrancy

Question 7

What is the ADULT dose for adenosine?

Answer 7

1st dose 6 mg rapid IVP; Use a 2nd dose of 12mg after 1-2min IF required. Each dose followed immediately with a 20 mL flush while elevating the arm.

AHS dosing starts with 12mg

Question 8

Contraindications to adenosine use?

Answer 8

❑ Hypersensitivity to drug or any component
❑ Poisoning / drug induced tachycardia
❑ 2nd or 3rd degree block
❑ Symptomatic bradycardia
❑ Sick sinus syndrome
❑ Atrial fib / flutter; may induce ventricular arrhythmias

Question 9

Precautions when using adenosine?

Answer 9

❑ Concurrent use of AV conduction slowing drugs
❑ May cause bronchoconstriction in asthmatics
❑ Patients receiving theophylline (Methylxanthines) or caffeine will antagonize the effects of adenosine. These patients may require higher doses or may not respond to adenosine therapy.
❑ Give a reduced dose in heart transplant Pts, or if given via a central line. Also if Pt is taking carbamazepine (Tegretol) or dipyridamole (Persantine) as it may increase the risk of progressive (higher degrees) of heart block.

Question 10

Notable notes (adenosine)

Answer 10

❑ Does not convert a-fib, a-flutter or VT
❑ Try a vagal maneuver before admin
❑ Administer via a large peripheral vein (preferably antecubital) at closest medication port, run monitor strip prior, during and after administration (short, transient 1st, 2nd, and 3rd degree blocks or asystole may occur following injections, however should resolve quickly due to short half-life).

Question 11

What is the PEDIATRIC dose for adenosine?

Answer 11

Initial dose: 0.1 mg/kg; max 6 mg per dose

Repeat doses: 0.2mg/kg to a max of 12mg/dose

IV or IO

Question 12

What side effects of adenosine should the patient be warned of prior to administration?

Answer 12

(Transient) Flushing, Dyspnea, Chest pain, Arrhythmias, Feeling of “impending doom”.