Adenosine (Adenocard)

Question 1

Class / Action

Answer 1

1. Anti-arrhythmic - Acts on AV node slowing conduction. May inhibit re-entry pathways.

Question 2

Onset / Duration of Action

Answer 2

1. Immediate Onset IV/IO / Duration Less than 1min

Question 3

Indications

Answer 3

1. Conversion of stable narrow complex SVT to sinus rhythm
2. Conversion of unstable narrow complex re-entry tachycardia to sinus rhythm
3. Regular and monomorphic wide complex tachycardia, thought to be or previously defined to be re-entry SVT

Question 4

Contraindications

Answer 4

1. 2nd or 3rd Degree Heart Blocks and Sick Sinus Syndrome, Unless pt has a pacemaker
2. Hypersensitivity

Question 5

Precautions

Answer 5

1. May produce TRANSIENT 1st, 2nd, or 3rd Degree Blocks or Asystole for 10-15 seconds
2. Asystolic pause may be longer in patients taking Tegratol (Carbamazepine) or Presantine (Dipyridamole)
3. Pts taking Theophylline or Caffeine may require higher doses
4. Pts with asthma may experience bronchocostriction
5. May be used with wide QRS complex SVT at direction of Base Station. Its use may cause acceleration of the rate.
6. It is ineffective in atrial fibrillation or flutter, and ventricular tachycardia

Question 6

Dosage / Administration

Answer 6

1. ADULT: 6mg Rapid IVP/1-3seconds followed by rapid 20mL NS flush, then elevate extremity. If no response within 1-2min, give 12mg Rapid IVP/1-3sec followed by rapid 20mL NS flush.
2. PEDS: 0.1mg/kg up to 6mg RIVP/1-3seconds followed by rapid 5-10mL NS flush. If no response within 1-2min, give 0.2mg/kg up to 12mg RIVP/1-2sec followed by rapid 5-10mL NS flush.
3. Place IV in A/C for best absorptions using at least and 18 gauge catheter.

Question 7

Adverse Reactions

Answer 7

Common but transient: Asystole, temporary Bradycardia, Hypotension, Chest Pain, Flushing, Dyspnea, Apprehension, Back/Neck Pain, Blurred Vision, Burning sensation, Dizziness, Numbness, Tingling in arms, Sweating, Palpitations, Nausea.