Adenosine Flashcards
What is another name for Adenosine?
Adenocard
What drug class is Adenosine in?
endogenous nucleoside
miscellaneous antidysrhythmic
How does Adenosine work?
Adenosine slows supraventricular tachycardias by decreasing electrical conduction through the AV node without causing negative inotropic effects.
It also acts directly on sinus pacemaker cells and vagal nerve terminals to decrease chronotropic (heart rate) activity.
It is the first drug choice for most forms of stale, narrow-complex SVT.
Adenosine DOES NOT convert Afib, Aflutter or VT.
What is the onset of Adenosine?
immediate
What is the duration of Adenosine?
10 seconds
What are the indications for Adenosine?
- first choice for most narrow-complex paroxysmal SVT and dysrhythmias associated with bypass tracts such as WPW syndrome
- in undifferentiated, stable wide-complex tachycardia, IV Adenosine may be considered relatively safe. It may convert the rhythm to sinus and may help diagnose the underlying rhythm
What are contraindications for Adenosine?
- drug induced tachy
- 2nd or 3rd degree AV block
- Aflutter, Afib, VT, WPW with Afib/flutter
What are some adverse reactions of Adenosine?
- transient periods of bradycardia, sinus pause or bradyastole
- ventricular ectopy (VT, Vfib, Vflutter)
- chest pain
- hypotension
- paresthesias
- light-headedness
- metallic taste
- nausea, facial flushing, headache, diaphoresis
What are some drug interactions with Adenosine?
- methylxanthines (caffeine, theophylline) antagonize the action of Adenosine
- Diprydamole potentiates the effect of Adenosine; smaller dose may be required
- Carbamazepine may potentiate the AV nodal blocking effect of Adenosine
How is Adenosine supplied?
parenteral for IV injection
3mg/mL in 2mL and 5mL vials
What is the initial dose of Adenosine?
6mg rapid IV followed by 20mL saline bolus
then elevate extremity
What is the second dose of Adenosine?
second dose may be given 1-2 minutes after initial dose
12mg rapid IV bolus followed by 20mL saline bolus
What are some special considerations for Adenosine?
- pregnancy safety category C
- brief period of asystole (up to 15 sec) may follow conversion
- reduce initial dose to 3mg in heart transplant patients, patients receiving Dipyridamole or Carbamazepine, or in a central line
- patients taking Theophylline or caffeine may require larger doses
- may cause bronchoconstriction in patients with asthma and in patients with bronchopulmonary disease