Adenosine

Question 1

Indications

Answer 1

• Patients aged greater than or equal to 12 years with SVT and a ventricular rate greater than or equal to 150/minute, and
• The patient is not severely compromised, and
• The rhythm fails to revert following two Valsalva manoeuvres.

Question 2

Contraindications and cautions

Answer 2

Contraindications:
- Known Severe allergy

• Known sick sinus syndrome without an internal pacemaker in place. Adenosine may cause severe bradycardia if the patient has sick sinus syndrome.

> Previous 2nd or 3rd degree heart block without an
internal pacemaker in place. Adenosine may cause
heart block if the patient has had previous heart
block.

> Previous heart transplantation without an internal pacemaker in place. Following a heart transplant the heart is denervated and adenosine may cause severe bradycardia.

Cautions:
- Asthma, COPD, WPW

Question 3

Actions

Answer 3

Adenosine is an antidysrhythmic
used for the treatment of
paroxysmal supraventricular
tachycardia (SVT). It is a nucleoside that depresses
conduction through the AV node.
This interrupts re-entry circuits
within the heart and may restore
sinus rhythm in patients with SVT.

Question 4

Route

Answer 4

• IV
• Preferred ACF
• Requires 20ml rapid flush

Question 5

Dosage

Answer 5

• First 6mg
• second 12mg

seek advice if less than 12 years old

Question 6

Side Effects

Answer 6

• bradycardia or sinus pause (up to 30 secs)
• SOB
• light headedness
• Nausea and flushing
• chest pressure or severe apprehension