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10 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What is the best-known trade name for adenosine?
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Adenocard
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A formulation of adenosine used as a pharmacologic stress agent is called Adenoscan. Adenosine is often abbreviated "Ado".
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What is the functional class of adenosine?
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Antidysrhythmic
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Adenosine is a class V antidysrythmic (direct nodal inhibition). Adenosine also has topical anti-inflammatory properties
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What is the mechanism of action of adenosine?
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A naturally occurring nucleoside that decreases conduction through the AV node and interrupts AV and SA re-entry pathways thus restoring normal sinus rhythm in patients with SVT.
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Adenosine also indirectly causes a shortening of the refractory period in atrial tissue and can precipitate A Fib if administered via a central lumen catheter.
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What are the listed indications for adenosine?
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SVT refractory to vagal maneuvers including Wolff-Parkinson-White (WPW)
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WPW features ventricular preexcitation due to an accessory pathway from the atria to the ventricles known as the bundle of Kent.
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What are the listed contraindications for adenosine?
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- 2nd and 3rd Degree AV heart blocks
- Symptomatic bradycardia - Sick sinus syndrome - Hypersensitivity |
2nd and 3rd degree AV heart blocks and sick sinus syndrome may be permitted if a cardiac pacemaker is present.
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What are the listed precautions for adenosine?
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- Place patient in semi-Fowler position as patients will typically develop arrhythmias at the time of conversion
- Use cautiously in patients with asthma |
This can be expanded to include patients with acute bronchospasm and other obstructive lung diseases.
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What are the listed side effects for adenosine?
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- Syncope
- Dizziness - Dyspnea - N/V - Headaches - Palpitations - Chest pain - Hypotension - Dysrhythmias Side effects are usually self-limiting due to short half-life. |
A metallic taste in the mouth is a hallmark side effect of adenosine.
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What are the listed interactions for adenosine?
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- Patients taking caffeine or xanthines (aminophylline or theophylline) may require larger doses as these drugs antagonize adenosine
- Patients on dipyridamole (Persantine) and carbamazepine (Tegretol) may need smaller doses of adenosine as these drugs potentiate adenosine’s effects |
Some sources state that verapamil (and related medications) may increase the risk of V Fib.
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What is the dosage and route of adenosine?
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Adult:
- 6mg rapid IVP followed by a 10-20mL NS flush - If no conversion after 1-2 minutes administer 12mg rapid IVP followed by a 10-20mL NS flush - If no conversion after 1-2 minutes administer repeat 12mg rapid IVP followed by a 10-20mL NS flush Pedi: - 0.1mg/kg IVP/IO (maximum single dose is 6mg) - May repeat only once in 1-2 minutes at 0.2mg/kg (maximum second dose is 12mg) |
Because of the very short half-life, administer adenosine as close to the heart as possible.
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What are the pharmacokinetics of adenosine?
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Onset = rapid
Half-Life = approximately 10 seconds |
Adenosine is broken down by adenosine deaminase, which is present in RBCs and vessel walls.
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