Adenosine (Adrenocard®)

Question 1

Adenosine - Class

Answer 1

• Antidysrythmic

* Naturally occurring nucleoside

Question 2

Adenosine - Actions

Answer 2

Slows electrical conduction through the AV node - Converts SVT to NSR

Question 3

Adenosine - Indications

Answer 3

Stable SVT including WPW

Question 4

Adenosine - Dosage/Route

Answer 4

• First dose: 6 mg rapid IVP (over 1-3 sec)
• Second dose: 12 mg rapid IVP 1 -2 min later, if indicated
• FOLLOW EACH DOSE WITH RAPID 20 ML NS BOLUS & elevate extremity

Question 5

Adenosine - Side Effects (seldom seen)

Answer 5

• Decreased peripheral vascular resistance (mild HoTN)
• Facial flushing & headache
• SOB/Dyspnea; may cause bronchospasm in asthma pts
• Chest pressure

Question 6

Adenosine - Contraindications

Answer 6

• Second or third degree AV block
• Sick Sinus Syndrome (without pacemaker)
• Recent MI or Cerebral Hemorrhage
• Known hypersensitivity to Adenosine

Question 7

Adenosine - Special Information

Answer 7

• Caffeine and theophylline are antagonists
• Rapid IV push is necessary because drug is metabolized very quickly (5-10 sec)
• Large bore IV in large proximal vein will assist in admin of rapid IV push
• Use syringe with 20 cc NS bolus to rapidly flush tubing after each dose
• Conversion usually takes about 30 sec
• Will not convert a-fib, a-flutter, or VT
• Discontinue if second or third degree block develops
• TRANSIENT dysrythmias (PVC’s, PAC’s, sinus brady/tach. AV block, asystole) expected immediately after dosing. These are generally not treated and are quickly self-limiting
• Obtain ECG documentation before, during, and after admin

Question 8

Adenosine - Pediatric Note

Answer 8

• Refer to Pediatric Drug Guide

* For SVT give 0.1 mg/kg first dose, 0.2 mg/kg repeat doses followed by 20 ml saline bolus - do not exceed adult dose