ADENOSINE (Adenocard®)

Question 1

Drug Classification

Answer 1

Antidysrhythmic (Class V) / Nucleoside

Question 2

Mechanism of Action

Answer 2

Adenosine (A1) R-agonist →Slows AV conduction by activation of G-protein second messengers, decreasing cAMP and inhibiting calcium entry into the cardiac pacemaker cells

Question 3

Pharmacokinetics

Answer 3

Onset of Action = Immediate
Peak Effects = Immediate
Duration of Effect = 30-45 seconds
Half-Life = 6 seconds

Question 4

Indications

Answer 4

Stable Narrow Complex Tachycardia (SVT)

Stable Wide Complex Tachycardia (Regular, Monomorphic)

Question 5

Contraindications

Answer 5

WPW

**Controversial / If given for WPW, may cause paradoxical increase in heart rate

Question 6

Side Effects

Answer 6

Facial flushing, headache, chest pain, dizziness, sense of impending doom

Question 7

Dose

Answer 7

(ADULT): 1stdose - 6mg rapid IVP (proximal vein) followed by 20cc NS flush
2nddose - 12mg rapid IVP followed by 20cc NS flush
(PEDI): 1stdose - 0.1mg/kg IV/IO rapid push (proximal vein), max dose 6mg
2nddose - 0.2mg/kg IV/IO rapid push, max dose 12mg

Question 8

Precautions

Answer 8

Begin printing rhythm strip before administering adenosine

Question 9

Drug Interactions

Answer 9

Methylxanthines (i.e. caffeine) are nonspecific competitive antagonists for adenosine receptors – double the dose for patients taking large amounts