Adenosine (Adenocard)

Question 1

Pharm. and Actions

Answer 1

Antiarrhythmic; Slows conduction time through the AV node; Can interrupt the re-entry pathways through the AV node and restore NSR in patients with PSVT including WPW; half-life is less than 10 seconds

Question 2

Indications

Answer 2

PSVT and WPW

Question 3

Contraindications

Answer 3

2nd or 3rd degree AV block; Sick Sinus Syndrome (except in patients with a functioning pacemaker); does not convert atrial flutter, A-Fib, or V-Tach

Question 4

Administration

Answer 4

6 mg rapid UV push given over 1-2 seconds followed by a 20cc flush; If initial dose fails to convert rhythm after 1-2 minutes, 2nd dose of 12 mg should be given; a 3rd dose of 12 mg may be given if required; Pediatric dose- 0.1-0.2 mg/kg rapid IV push, IO- 6mg max dose 12 mg.

Question 5

Side Effects and Special Notes

Answer 5

Nausea, flushing of the face, and tingling; Varying degrees of AV blacks, PVCs, PACs, an asystole; Due to the very short half-life (less than 10 seconds) these effects are generally self-limiting; Significant percentage of patients complain of chest pain following administration. The chest pain is usually self-limiting lasting less than 1 minute and not angina related. Consider NTG only if pain persists longer than 1 minute; Dose should be given to the closest port to the IV site and followed by rapid flush. Documentation of the rhythm with ECG tracings prior to, during, and after administration should be obtained.

Question 6

Class

Answer 6

A