Pharm
Adenosine
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Adenosine
Mechanism
Endogenous purine nucleoside
Slows
AV Node
conduction
Interrupts AV Nodal Reentry pathways
Pharmacokinetics
Rapidly sequestered by
Red Blood Cell
s
Half-life: under 10 seconds
Indications
Chemical conversion of
AV Node
re-entry
Tachycardia
s
Paroxysmal Supraventricular Tachycardia
(
PSVT
)
Wolff-Parkinson-White Syndrome
(
WPW Syndrome
)
Diagnosis in non-reentry
Tachycardia
s
Atrial Flutter
Atrial Fibrillation
Ventricular Tachycardia
Dose
Gene
ral
Rapid IV bolus over 1-3 seconds
Expect brief period of
Asystole
(under 15 seconds)
Follow dose immediately with saline flush (15-20 cc
Normal Saline
in adults)
May also combine Adenosine with
Normal Saline
(15 cc in adults) and push the combined solution
Choi (2003) J Korean Soc Emerg Med 14(3): 224-7 [PubMed]
Children
0.1-0.2 mg/kg rapid IV push (Max: 12 mg)
Adults
Initial: 6 mg rapid IV push
Next: 12 mg rapid IV push
Higher starting dose indications (12 mg in adults)
Caffeine
within the last 4 hours
Theophylline
Lower starting dose indications (3 mg in adults)
Carbamazepine
Dipyridamole
(
Persantine
)
Heart Transplant
status
Central Line
administration (risk of severe
Bradycardia
and
Asystole
)
Adverse effects
Transient effects (resolve within 2 minutes)
Flushing
Dyspnea
Chest Pain
Transient
Arrhythmia
s following
PSVT
conversion
Sinus Bradycardia
Ventricular ectopy
Drug Interactions
Reduced effect of Adenosine
Theophylline
Methylxanthine
(
Caffeine
, Theobromine)
Potentiated effect of Adenosine
Dipyridamole
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