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Adenosine
Trade Name
Adenocard
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Adenosine
Class
Endogenous Nucleoside
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Adenosine
Mechanism of Action
- Slows conduction timethrough the AV Node
- Can interrupt re-entrant pathways
- Slows heart rate
- Acts directly on sinus pacemaker cells
- Is drug of choice for Supraventricular Tachycardia (SVT)
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Adenosine
Indications
- Conversion of SVT
- May convert SVT due to Wolff-Parkinson-White (WPW) syndrome
- Stable undifferentiated wide-QRS complex tachycardia (rate regular, QRS monomorphic)
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Adenosine
Contraindications
- Second or Third-degree Heart Block
- Sick Sinus Syndrome
- Atrial flutter / Atrial fibrillation
- Ventricular Tachycardia
- Hypersensitivity to Adenosine
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Adenosine
Adverse Reactions
- Facial flushing
- Shortness of breath
- Chest pain
- Headache
- Paresthesia
- Diaphoresis
- Palpitations
- Hypotension
- Nausea
- Metallic taste
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Adenosine
Drug Interactions
- Methylxanthines (theophylline-like drugs) antagonize the effects of adenosine
- Dipyridamole (Persantine) potentiates the effects of adenosine
- Carbamazepine (Tegretol) may potentiate the AV Node blocking effects of adenosine
- May cause bronchoconstriction in asthmatic patients.
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Adenosine
How Supplied
- 3 mg/ml in 2-ml flip-top vials for IV injection
- 6-12 mg prefilled syringes
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Adenosine
Dosage and Administration
Adult
- 6 mg RAPID IVP over 1-3 seconds (60% effective);
- If no response after 1-2 min, administer 12 mg RAPID IVP over 1-3 seconds (92% effective)
- If no response after 1-2 min, administer 12 mg RAPID IVP over 1-3 seconds
- Note: Follow all boluses with a 20cc flush of NS
- Maximum total dose = 30 mgs
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Adenosine
Dosage and Administration
Pediatric
- 0.1 mg/kg RAPID IVP
- if no effect 0.2 mg/kg RAPID IVP
- Note: Follow all boluses with a NS flush
- Maximum single dose = 12 mgs
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Adenosine
Duration of Action
- Onset: Seconds
- Peak Effects: Seconds
- Duration: 12 seconds
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Adenosine
Special Considerations
- Pregnancy safety: Category C
- Short half-life limits side effects in most patients
- IV Size/Location is Crucial (L A/C 18g or >)
- Adenosine RAPID IVP MUST be followed with NS flush (20 cc)
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