Adenosine

Question 1

Adenosine

Class

Answer 1

• Endogenous nucleotide
• Antiarrhythmic

Question 2

Adenosine

Mechanism of action

Answer 2

• Slow conduction through AV node
• Interrupt re-entrant pathways
• Slow impulse formation in SA node
• Drug of choice for SVT
• Diagnostic tool for stable wide-complex tach of unknown origin after 2 doses of Lidocain

Question 3

Adenosine

Indications

Answer 3

• Convert PSVT to sinus rhythm
• Convert re-entry SVT due to WPW
• Not effective in converting A-fib/A-flutter or VT

Question 4

Adenosine (Adenocard)

Contraindications

Answer 4

• 2nd or 3rd deg AV block
• Sick sinus syndrome
• A-fib, A-flutter, VT
• Hypersensitivity
• Poison or drug induced tachycardia

Question 5

Adenosine

Side effects

Answer 5

• H/A
• Dizziness
• SOB & bronchospasm
• Dysrhythmias & palpitations
• Hypotension
• Facial flushing & Diaphoresis
• Nausea
• Metallic taste
• CP & Px in head or neck
• Paresthesia

Question 6

Adenosine

Drug interactions

Answer 6

• Methylxanthines antagonize (theophylline-like drugs)
• Dipyridamole potentiates (Persantine)
• Carbamazepine may potentiate AV node blocking effects (Tegretol)
• May cause bronchoconstriction in asthmatic pt

Question 7

Adenosine

Dosage and administration

Answer 7

• Adult:
  
  • 6-mg rapid IV push over 1-3 seconds
    
    • 20-mL flush
  • If no response after 1-2 min, give 2nd dose of 12 mg
  • If no response give 12 mg again. Max total dose, 30 mg
• Pediatric:
  
  • Initial dose 0.1-0.2mg/kg rapid IV push
  • Max single dose, 12 mg

Question 8

Adenosine

Duration of action

Answer 8

• Onset: Seconds
• Peak effect: Seconds
• **Duration: **12 seconds.

Question 9

Adenosine

Special considerations

Answer 9

• Pregnancy Cat C
• Short half-life limits side effects
• May cause bronchoconstriction in asthma pt
• Evaluate elderly for signs of dehydration requiring fluid replacement prior to administration