Adenosine Flashcards

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1
Q

Adenosine (adenocard)

Class

A

Antiarrhythmic, endogenous nucleotide

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2
Q

Adenosine (adenocard)

Mechanism of Action

A

Slows conduction time through the AV node; can interrupt re-entrant pathways; slows heart rate; acts directly on sinus pacemaker cells. The drug of choice for re-entry SVT. Can be used diagnostically for stable, wide-complex tachycardias (suspected SVT with aberrancy).

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3
Q

Adenosine (adenocard)

Indication

A

Regular tachycardias (narrow and wide). Conversion of PSVT to sinus rhythm. May convert re-entry SVT due to Wolff-Parkinson-White syndrome. Not effective in converting atrial fibrillation/flutter, or V-tach.

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4
Q

Adenosine (adenocard)

Contraindications

A

Torsades de Pointes (polymorphic V-tach), second- or third- degree heart block or sick sinus syndrome, atrial fibrillation/flutter, ventricular tachycardia, hypersensitivity to adenosine, poison induced tachycardia.

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5
Q

Adenosine (adenocard)

Adverse Reactions

A

Facial flushing, shortness of breath, chest pain, headache, paresthesia, diaphoresis, palpitations, hypotension, nausea

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6
Q

Adenosine (adenocard)

Drug Interactions

A

Methylxanthines (theophylline and caffeine-like drugs) antagonize the effects of adenosine. Dipyridamole (Persantine) potentiates the effects of adenosine. Carbamazepine (Tegretol) may potentiate the AV node, blocking the effects of adenosine. May cause bronchoconstriction in asthmatic patients.

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7
Q

Adenosine (adenocard)

Adult Dosage

A

6 mg over 1 – 3 seconds, followed by a 20 mL saline flush and elevate the patients extremity. If no response after 1 – 2 minutes, administer 12 mg over 1 – 3 seconds; maximum total dose 30 mg.

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8
Q

Adenosine (adenocard)

Pediatric Dosage

A

0.1 – 0.2 mg/kg rapid IV; maximum single dose of 12 mg.

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9
Q

Adenosine (adenocard)

Onset

A

Seconds

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10
Q

Adenosine (adenocard)

Durations

A

12 Seconds

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11
Q

Adenosine (adenocard)

Special Considerations

A

Short half-life limits side effects in most patients, but arrhythmias including blocks are common at the time of conversion. Should be administered directly into a large bore medication port closest to the patient’s heart and followed by a flush.

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