Adenosine

Classification

Antidysrhythmic agent

Action:

Terminates supraventricular dysrhythmias

Depresses automaticity in the sinus node

 Suppresses AV conduction

Indications:

Perfusing SVT unresponsive to valsalva

Poorly perfusing SVT in a conscious patient

Contraindications:

History of Sick Sinus Syndrome

2nd or 3rd degree heart blocks

Patients known to be taking:

               Persantine (dipyridamole)

               Tegretol (carbamazepine

Adverse Effects:   

Cardiovascular                                     Neurological

chest pain/pressure                       seizures

hypotension                                     headache

bradycardia/asystole                    blurred vision 

2nd/3rd degree blocks                      tingling  

PAC's/PVC's                                       numbness

                                                          dizziness

Respiratory                            

 dyspnea/shortness of breath

 bronchoconstriction in asthmatic patients

6mg rapid IV/IO, within 1-3 seconds. Follow with rapid flush of 10-20 ml NS. May repeat 12 mg in 1-2 minutes (x2)

Pediatric:      

0.1mg/kg rapid IV/IO, within 1-3 seconds.

Follow with rapid flush of 10 ml NS.

Onset:                        

Duration:                   

Onset:                         Immediate

Duration:                   Less than 10 seconds

Precautions:

Because of short duration, to ensure rapid administration into central circulation:

Cannulate a large vein (antecubital fossa) using an 18g - 20g catheter.

       Use IV port closest to patient and immediately flush with 10-20ml NS

Note:   

Monitor patient continually and run a 6 second strip before,

during and after administration.

Adverse effects of chest pain/pressure, numbness/tingling or shortness of breath will resolve within 1-2 minutes.

Persantine and Tegretol potentiate the actions of adenosine which may result in 2nd/3rd degree heart blocks.

Theophylline and Xanthing preparations may render adenosine ineffective.

Adenosine will not convert sinus tachycardia, atrial flutter or atrial fibrillation to a normal sinus rhythm, but may cause transient slowing of the heart rate in atrial fibrillation with a rapid ventricular response.