Adenosine/ Adenocard

Question 1

Adenosine Class

Answer 1

• Supraventricular Antiarhythmic
• Endogenous purine nucleoside (present in all cells, wide range of metabolic roles, formed as a breakdown product of ATP)

Question 2

Adenosine Action

Answer 2

• Slows tachycardias associated with the AV node via modulation of the autonomic nervous system w/o causing negative terminals to decrease chronotropic and dromotropic activity. Thus it:
• Slows conduction through the AV node.
• Blocks reentry pathways through the AV node.
• Can slow conduction in the SA node somewhat.

Question 3

Adenosine Indications

Answer 3

• PSVT(including WPW) refractory to vagal maneuvers.

* Stable regular monomorphic wide complex tachycardia.

Question 4

Adenosine Contraindications

Answer 4

• High degree heart blocks(2nd and 3rd) w/o functioning pacemaker.
• SSS
• Known hypersensitivity
• Pregnancy (C)
• Known A-fib or A-flutter (not effective in managing).
• Irregular wide complex tachycardias

Question 5

Adenosine Dosage

Answer 5

Adults:
• 6mg rapid IVP bolus followed by 20mL flush.
• No response in 1-2min push 12mg followed by NS flush.
Peds:
• 0.1mg/kg rapid IVP.
• Max first dose- 6mg.
• If no effect, 0.2mg/kg.
• Max single dose- 12mg.
• Max total 18mg.
• Follow each dose with a flush of at least 20mL NS flush.

Question 6

Adenosine Onset/ Duration

Answer 6

• Onset: 30 seconds or less

* Duration: 10 seconds

Question 7

Adenosine Precautions

Answer 7

May cause refractory bronchospasm. Use with caution with COPD and Asthma.

Question 8

Adenosine Side Effects

Answer 8

• Flushing
• CP
• HA
• Dyspnea
• Diaphoresis
• Metallic taste
• Dizziness
• N/V
• light-headed
• Numbness
• Palpitations

Question 9

Adenosine Ineractions

Answer 9

• Additive effects— Digoxin and CCB.
• Antagonistic Effects— Methylxanthines (caffeine and theophyline).
• Potentiating Effects— Dipyridamole (Persantine).