Adenosine Drug Card Flashcards

Adenosine Overview

• Trade name: Adenocard
• Classification: Endogenous nucleoside, miscellaneous antidysrhythmic

Mechanism of Action

• Formed from the breakdown of adenosine triphosphate (ATP); present in every cell.
• Decreases electrical conduction through the AV node to slow supraventricular tachycardia without negative inotropic effects.
• Acts directly on sinus pacemaker cells and vagal nerve terminals to reduce heart rate.
• First-line treatment for paroxysmal supraventricular tachycardia (SVT) and assists in diagnostics for wide complex tachycardia.

Indications

• First-line treatment for narrow-complex PSVT and dysrhythmias associated with bypass tracts, such as Wolff-Parkinson-White syndrome in adults and children.

Contraindications

• Ineffective in converting rhythms like atrial flutter and fibrillation; contraindicated in second or third-degree AV block, Sick Sinus Syndrome, hypersensitivity, and V-tach.

Adverse Reactions

• Possible reactions include lightheadedness, paresthesia, headache, diaphoresis, palpitations, chest pain, flushing, hypotension, shortness of breath (SOB), transient bradycardia, ventricular ectopy, nausea/vomiting (N/V).

Drug Interactions

• Methylxanthines (caffeine, theophylline) can antagonize adenosine effects.
• Dipyridamole may necessitate lower doses as it can enhance adenosine effects.
• Carbamazepine might intensify adenosine's AV nodal blocking effects.

Dosage and Administration

• Adults: Initial dose of 6 mg IV bolus over 1-3 seconds, followed by a 20 ml flush. If no response in 1-2 minutes, a 12 mg repeat dose can be administered similarly.
• Pediatrics: Initial dose of 0.1 mg/kg, may double once with a maximum of 6 mg, given as a rapid IV bolus followed by a 5 ml flush.

Onset and Duration

• Effects of IV administration are immediate, lasting approximately 10 seconds.

Special Considerations

• Position the patient in slight reverse Trendelenburg before administration to optimize outcomes. Be prepared for a brief period of asystole during administration.