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10 Cards in this Set

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What is the best-known trade name for adenosine?
Adenocard
A formulation of adenosine used as a pharmacologic stress agent is called Adenoscan. Adenosine is often abbreviated "Ado".
What is the functional class of adenosine?
Antidysrhythmic
Adenosine is a class V antidysrythmic (direct nodal inhibition). Adenosine also has topical anti-inflammatory properties
What is the mechanism of action of adenosine?
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.
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.
What are the listed indications for adenosine?
SVT refractory to vagal maneuvers including Wolff-Parkinson-White (WPW)
WPW features ventricular preexcitation due to an accessory pathway from the atria to the ventricles known as the bundle of Kent.
What are the listed contraindications for adenosine?
- 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.
What are the listed precautions for adenosine?
- 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.
What are the listed side effects for adenosine?
- 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.
What are the listed interactions for adenosine?
- 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.
What is the dosage and route of adenosine?
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.
What are the pharmacokinetics of adenosine?
Onset = rapid
Half-Life = approximately 10 seconds
Adenosine is broken down by adenosine deaminase, which is present in RBCs and vessel walls.