Adenosine (Adenocard)

Question 1

Classification of Adenosine

Answer 1

Antiarrhythmic

Question 2

1. Action of Adenosine

2. Onset and Duration of Adenosine

Answer 2

1. Slows conduction of AV node, may inhibit reentry pathways

2. Immediate, Less than 1 min

Question 3

1. Indication of Adenosine

2. Contraindication

Answer 3

1. Conversion of paroxysmal SVT to sinus rhythm, WPW Syndrome with narrow QRS complex
2. 2nd & 3rd degree heart block, sick sinus syndrome unless pt has pacemaker, hypersensitivity

Question 4

Caution of Adenosine

Answer 4

May produce TRANSIENT 1ST, 2ND, &3RD DEGREE BLOCKS OR ASYSTOLE for 10-15 sec
Asystolic pause longer in pts. on TEGRETOL OR PERSANTINE
Pts. on THEOPHYLLINES OR CAFFEINE may require higher dose
ASTHMA pts may experience bronchiospasm
May be used with wide QRS complex SVT at direction of base station, but may cause acceleration of the rate

Question 5

Dosage of Adenosine

Answer 5

Adult: 6mg rapid IV push. If no response in 1-2 min give 12mg. Rapid push followed by 20ml NaCl bolus and elevate extremity.
Pediatric: .1mg/kg up to 6mg. If no response within 1-2 min, .2mg/kg up to 12mg rapid IV push
IV in AC with 18g or >

Question 6

Adverse reaction of Adenosine

Answer 6

Common but TRANSIENT ASYSTOLE, BRADYCARDIA, HYPOTENSION, CPX, flushing, dyspnea, numbness, tingling in arms, sweating, palpation, nausea

Question 7

Reference in protocol of Adenosine

Answer 7

Cardiac emergencies and pediatric cardiac arrest guide