Adenosine

Question 1

What class of drug is Adenosine

Answer 1

Antiarrhythmic

Question 2

What are the Indications for Adenosine

Answer 2

Supraventricular Tachycardia (Svt)
Stable, monomorphic wide complex tachycardia suspected to be wide complex SVT

Question 3

What are the Contraindications of Adenosine

Answer 3

-Drug induced tachycardia
-Atrial Fibrillation with Wolf-Parkinson-White Syndrome
-Suspected ventricular tachycardia
-Second or third degree atrioventricular block (if no pace maker)
- Sick sinus syndrome
-Brochoconstrictive or bronchospastic lung disease (Asthma, COPD)

Question 4

What are the adverse Reactions/Side effects of Adenosine

Answer 4

*Generally very short lived
CNS: headache, dizziness
Respiratory: dyspnea, bronchospasm
CV: arrhythmias, sinus pause/asystole, palpitation, hypotension, chest pain, cardia arrest
GI/GU: nausea, metallic taste
Musculoskeletal: Pain in the head or neck
other: paresthesia, flushing, diaphoresis, “sense of impending doom”

Question 5

Drug interactions of Adenosine

Answer 5

None

Question 6

Initial adult dose for Adenosine

Answer 6

6mg rapid IV push (12 in RI)

Question 7

Second Adult dose for Adenosine

Answer 7

12 mg rapid IV

Question 8

Initial Pedi dose Adenosine

Answer 8

0.1 mg/kg rapid IV push (max of 6mg)

Question 9

Second Pedi Dose Adenosine

Answer 9

0.2 mg/kg rapid IV push (max of 12mg)

Question 10

Adenosine Duration of Action

Answer 10

Onset: Seconds
Peak Effect: Seconds
Duration: 12 seconds

Question 11

Special Considerations

Answer 11

-RI protocols 12mg for first and second dose
- NO effect on Ventricular Tachycardia
- May cause bronchoconstriction in asthma patient
-Evaluate elderly for signs of dehydration requiring fluid replacement prior to administering adenosine
-Short half life limits side effects in most patients