Adenosine (Adenocard) Flashcards
Drug Classification
Antidysrhythmic (class V)/nucleoside
Mechanism of Action
Adenosine(A1) R agonist->slows AV conduction by activation of G protein second messenger, decreasing cAMP and inhibiting calcium entry into the cardiac pacemaker cells.
Pharmacokinetics
- Onset of Action- immediate
- Peak Effects- immediate
- Duration of Effects- 30-45 seconds
- Half Life- 6 seconds
Indications/Field Use
- SVT (PSVT)/ Narrow Complex Tachycardia
- Diagnostic maneuver: stable narrow complex SVT
- Wide regular monomorphic tachycardia
Contraindications
- 2/3 degree heart block, sick sinus syndrome, Torsades (Polymorphic VT)
- Poison/Chemical induced SVT (ie. Cocaine)
Side Effects/Adverse Reactions
Facial Flushing, HA, chest pain, dizziness
Dose
Adult:
1st dose- 6mg rapid IVP (proximal vein) followed by 30cc NS flush
2nd dose- 12mg rapid IVP followed by 30cc NS flush
Pedi:
1st dose - 0.1mg/kg IV/IO rapid push (proximal vein), max dose 6 mg
2nd dose - 0.2mg/kg IV/IO rapid push IV/IO rapid push, max dose 12mg
Precautions
- Begin printing rhythm strip before administering adenosine
- Caution with asthma and COPD- may induce wheezing
Drug-drug interactions
- Methylxanthines (ie. caffeine) are nonspecific competitive antagonists for adenosine receptors- double the dose for patients taking large amounts
- Carbamazepines (ie. Tegretol, Phenobarbitol) and dipyridamole (Persantine, Aggrenox) potentiates effects of Adenosine- halve the dose