Adenosine (Adenocard)

Question 1

Class

Answer 1

Antiarrhythmic (antidysrhytmic)

Question 2

Actions (4)

Answer 2

• Endogenous nucleoside (found in all cells of the body and is formed from the breakdown of ATP) depresses AV node and SA node activity
• Decreases conduction through the AV node and interrupts AV nodal reentry pathways that causes SVT
• Works both at the AV node and in aberrant conduction
• Does not convert afib/flutter but may transiently increase AV block and unmask flutter waves. Cleared from plasma in 30 sec, half life is 10 sec, a brief period of asystole (15 sec) is common

Question 3

Indications

Answer 3

SVT’s thought to be due to reentrant mechanisms

Question 4

Dose/Route

Answer 4

• 6 mg rapid bolus over 1-3 seconds followe by a 20 cc flush at most proximal site of IV catheter
• If no response within 1-2 min, 12 mg repeat bolus can be administered i the same manner (repeat bolus remains at 12 mg)
• Onset: Immediate
• Duration: 10 seconds
• Pediatric: 0.1mg/kg

Question 5

Standard Prep

Answer 5

6 mg/2 cc

Question 6

Contraindications (2)

Answer 6

• Hypersensitivity

- 2nd or 3rd degree heart block or sick sinus syndrome SSS unless has a functioning pacemaker

Question 7

Side Effects (6)

Answer 7

• Flushing
• Chest pain
• Arrhythmias: PAC’s, 2nd or 3rd degree heart block, asystole, ventricular ectopy
• Bronchoconstriction (rare-especially in reactive airway disease, ie. asthma, COPD)
• Note: Adenosine has a half-life of about 10 seconds so these side effects are usually transient and resolve within 1-2 minutes

Question 8

Precautions (3)

Answer 8

• Pts taking theophyllines, caffeine, or theobromine may need higher doses
• Use with caution in denervated, transplanted hearts may require only a small dose
• Reactive airway disease–increase brochoconstriction