Adenosine (Adenocard)

Question 1

What is the description of Adenosine (Adenocard)

Answer 1

Adenosine (Adenocard) is a naturally occurring substance present in all body cells. It is considered first-line therapy in the management of narrow complex paroxysmal supraventricular tachycardia.

Question 2

What is the mechanism of action of Adenosine (Adenocard)

Answer 2

Adenosine decreases conduction of the electric impulse through the AV node, Which can effectively terminate rapid supraventricular arrhythmias such as paroxysmal supraventricular tachycardia (PSVT). The half-life of adenosine is less than 5 seconds. Because of its rapid onset action and very short half-life, the administration of adenosine is sometimes referred to as “chemical cardioversion.” A single bolus of the drug was effective in converting PSVT to a normal sinus rhythm in a significant number (greater than 90%) of patient in the initial drug studies. Adenosine does not appear to cause hypotension to the same degree as does verapamil.

Question 3

What are the indications of Adenosine (Adenocard)

Answer 3

Accepted use of adenosine includes:

Narrow complex paroxysmal supraventricular tachycardia (including that associated with Wolff-Parkinson-White syndrome) refractory to common vagal maneuvers.

Question 4

What are the contraindications of Adenosine (Adenocard)

Answer 4

Adenosine is contraindicated in patients with second or third-degree heart blocks, sick sinus syndrome, or those with a known hypersensitivity to the drug

Question 5

What are the precautions of Adenosine (Adenocard)

Answer 5

Adenosine will typically cause arrhythmias at the time of cardioversion. These will generally last a few seconds or less and may include PVC’s, PAC’s, sinus bradycardia, sinus tachycardia, and various degrees of AV block. In extreme cases, transient Asystole may occur. If this occurs, appropriate therapy should be initiated. Adenosine should be used with caution in patient’s with asthma as it may potentially cause bronchospams. Common side effects associated with adenosine administration include Chest pain, flushing, headache, shortness of breath, dizziness, and nausea among others. Because the half-life of adenosine I’d so brief, side-effects are generally self-limited.

Question 6

What is the dosage of Adenosine (Adenocard)

Answer 6

The limited dose of adenosine is 6mg given as a rapid IV bolus over 1-3 second period. To be certain that the drug rapidly reaches the central circulation, it should be given directly into a infusion port closest to the patient. It should be followed immediately by a rapid saline flush. If the initial dose does not result in cardioversion of the PSVT within 1-2 minutes, a 12mg dose may be given as a rapid intravenous bolus. The 12mg dose may be repeated a second time if required. Doses greater than 12-mg should not be administered.

Question 7

What is the route of Adenosine (Adenocard)

Answer 7

Adenosine should only be given by intravenous infusion, either directly into the vein or into the medication administration port closest to the patient.

Question 8

How Is Adenosine (Adenocard) supplied

Answer 8

6mg/2cc vial