Adenosine Drug Monograph

adenocard

-Endogenous nucleoside
-antiarrhythmic

-Found in all cells of body
-rapidly metabolized in the blood vessels
-Slows sinus rate
-Slows conduction time through AV Node
-can interupt reentry pathways through AV Node
-Can restore sinus rhythm in re-entry narrow complex SVT, including SVT with WPW

-Stable, narrow complex AV nodal or sinus nodal reentry tachycardias
-for unstable reentry SVT while prepping for cardioverison
-undefined stable narrow complex svt as a combo therapeutic and diagnostic maneuver
-stable, wide complex tach in pt's with recurrence of a known reentry pathway that has been defined

-6mg rapid IV push over 1-3 seconds
-if no response within 1 to 2 minutes, give 12mg
-may repeat 12mg dose once in 1-2 minutes

-side effects common but transient and usually resolve within 1-2 minutes
-Cardiovascular: facial flushing, chest pain, headache, sweating, palpitations, hypotension
-respiratory: SOB, dyspnea, chest pressure, hyperventilation
-CNS: Lightheadness, dizziness, tingling in arms, numbness, apprehension, blurred vision, burning sensation, heaviness in arms, neck and back pain
-GI: Nausea, metallic taste, tightness in throat, pressure in groin
-caution in obstructive lung disease not associated with brochoconstriction (emph, bronchitis)

-Poison/drug induced tachycardia
-Brochoconstricion or bronchospasm
-second or third degree Heart block
-Sick sinus syndrome (except in patients with a functioning artifical pacer)

-IV site A/C perfered
-Follow each dose with 20ml N/S flush
-Use injection closest to Hub
-Cases of prolonged asystole, VT, and VF, transient increase in BP, bradycardia, A-Fib and bronchospasm have been reported with adenosine
-D/c in any patient that develops severe respiratory hx
-Because works by decreasing conduction thru AV node admin may result in 1st, 2nd, 3rd degree block
-1/2 life is short these effects are self limiting

10 seconds