Adenosine

Question 0

Drug classification

Answer 0

Antidysrhythmic agent

Question 1

Trade name

Answer 1

Adenocard

Question 2

Actions (2)

Answer 2

1. Depresses automaticity in the SA node and Purkinje fibers

2. Depresses AV node conduction

Question 3

Indication (3)

Answer 3

1. Perfusion PSVT unresponsive to Valsalva maneuver
2. Poorly perfusing PSVT in a conscious patient
3. Regular in monomorphic wide complex tachycardia

Question 4

Contraindications

Answer 4

1. History of sick sinus syndrome
2. Second or 3rd° heart block
3. Poison or drug induced tachycardia

Question 5

Adverse effects – cardiovascular

Answer 5

Chest pain/pressure
Hypotension
Transient PAC's, PVC's
Bradycardia/asystole
Second or 3rd° blocks
ventricular ectopy

Question 6

Adverse affects – neurological

Answer 6

Seizures
Headache
Blurred vision
Tingling/numbness
Lightheadedness/dizziness

Question 7

Adverse affects – gastrointestinal

Answer 7

Nausea
metallic taste
throat tightness

Question 8

Adverse affects – other

Answer 8

Flushed skin

feeling of doom

Question 9

Adverse effects – respiratory

Answer 9

Shortness of breath/dyspnea

bronchospasm in asthmatic patients

Question 10

Administration -SVT

Answer 10

6mg rapid (within 1–3 seconds) IVP, followed immediately with 20 ml NS rapid IVP bolus 
may repeat 12 mg rapid IVP in 1-2 minutes x 1

Question 11

Administration – poorly perfusing SVT

Answer 11

12 mg rapid (within 1–3 seconds) IVP, followed immediately with 20 ml NS rapid IVP bolus
may repeat 12 mg rapid IVP in 1-2 minutes x 1

Question 12

Pediatrics

Answer 12

0.1 mg/kg rapid (within 1–3 seconds) IVP,

followed immediately with 10 ml NS rapid IVP bolus

may repeat 0.2 MG/KG a rapid IVP in 1-2 minutes x 1

Question 13

Onset

Answer 13

Immediate

Question 14

Duration

Answer 14

Less than 10 seconds

Question 15

Precaution

Draw up medication in two separate syringes and use port closest to patient and flushed with 10–20 ml NS bolus injection immediately after drug a ministration

use large vein in antecubital fossa

elevate arm

Answer 15

Rationale

To ensure all of drug is administered as rapidly as possible since the drug is metabolized in less than 10 seconds

Question 16

Precaution

Patient should be supine

Answer 16

Rationale

Be prepared for cardiac arrest

Question 17

Precaution

Check current drug use

Answer 17

Persantine and Tegretol increase heart block (AHA says a reduced dose of three MG may be utilized)

less effective in patients taking Theophylline or caffeine and may require large doses or render adenosine ineffective

Question 18

Precaution

Put patient on monitor

Answer 18

Rationale

Document rhythm with a 6 second strip before and after drug administration

Adenosine does not convert atrial flutter, atrial fibrillation

Question 19

Signs/symptoms of poor perfusion

Answer 19

Chest pain 
shortness of breath 
crackles (rales) 
hypotension 
altered skin signs 
decreased capillary refill 
altered level of consciousness

Question 20

How supplied

Answer 20

Pre-filled syringe 6mg/2ml or 12mg/4mL

Vial 6mg/2ml

Question 21

Define PSVT

Answer 21

Paroxysmal Supraventricular Tachycardia

A Supraventricular rhythm caused by rapid atrial depolarization which overrides the SA node. The rhythm is regular with narrow complexes and a rarer greater than 150 beats per minute (pediatric patients = infants >220/min and children >180/min) and May last from minutes to hour. A patient’s history will determine its sudden onset or abrupt termination.