Group 5 - Adenosine

Question 1

Adenosine

Drug Class?

Answer 1

Adenosine Drug Class:

• Antiarrhythmic

Question 2

Adenosine

Mechanism of Action (MOA)?

Answer 2

Adenosine Mechanism of Action (MOA):

• Slows sinus rate
• Slows conduction time, by interrupting re-entrant pathways, through AV node

Question 3

Adenosine

Indications?

Answer 3

Adenosine Indications:

• Conversion of supraventricular tachycardias (SVT) with no known atrial fibrillation or atrial flutter
• Undifferentiated regular monomorphic wide-complex tachycardia

Question 4

Adenosine

Contraindications?

Answer 4

Adenosine Contraindications:

• Atrial fibrillation or atrial flutter
• Pregnancy (no controlled studies)
• Use cautiously in patients with known asthma (has precipitated acute bronchospasm)
• Sick sinus syndrome, 2nd or 3rd degree AV blocks (except in patients with a functioning ventricular pacemaker)

Question 5

Adenosine

Adverse Reactions?

Answer 5

Adenosine Adverse Reactions:

• CV: Palpitations, chest pressure, chest pain, hypotension, facial flushing, sweating, transient hypertension, transient dysrhythmias (asystole, bradycardia)
• Resp: Dyspnea, hyperventilation, tightness in throat, bronchospasm
• CNS: Lightheadedness, dizziness, paresthesias
• GI: Nausea, metallic taste

Question 6

Adenosine

Adult Dose?

Answer 6

Adenosine Adult Dose:

• Initial: 6 mg rapid IV bolus over 1 - 3 seconds
• Repeat: If no response in 1 - 2 minutes, may repeat with 12 mg rapid IV bolus
• Procedure: Follow bolus with a 20 ml NS flush. IV site recommended is antecubital fossa (close to central circulation); use injection port nearest hub of IV catheter; arm elevated during procedure; constant ECG monitoring

Question 7

Adenosine

Pediatric Dose?

Answer 7

Adenosine Pediatric Dose:

• Initial: 0.1 mg/kg rapid IV bolus
• Repeat: If no response in 1 - 2 minutes, may repeat with 0.2 mg/kg rapid IV bolus
• Maximum single dose: should not exceed 12 mg
• Procedure: Follow bolus with a 2 - 3 ml NS flush. Use injection port nearest hub of IV catheter; constant ECG monitoring

Question 8

Adenosine

Onset of Action?

Answer 8

Adenosine Onset of Action:

• Seconds

Question 9

Adenosine

Peak Effects?

Answer 9

Adenosine Peak Effects:

• Seconds

Question 10

Adenosine

Duration of Action?

Answer 10

Adenosine Duration of Action:

• 10 - 12 seconds (1/2 life of 5 seconds)

Question 11

Adenosine

AZ Drug Box Minimum Supply?

Answer 11

Adenosine

AZ Drug Box Minimum Supply:

• 18 mg

Question 12

Adenosine

Special Notes?

Answer 12

Adenosine Special Notes:

• Dysrhythmias may recur (short half-life)
• Second dose must be prepared and available
• Check for crystallization in cold climates