Drug Cards

Adenosine

Adenocard
Class:
Endogenous Nucleotide
Mechanism of Action:
Slows conduction time through the AV Node; can interrupt re-entrant pathways; slows heart rate; acts directly on sinus pacemaker cells. Is drug of choice for PSVT.
May convert Ventricular Tachycardia in 5 - 10% of cases.
Indications:
Conversion of PSVT to sinus rhythm. May convert PSVT due to Wolff-Parkinson-White syndrome.
Not effective converting atrial fibrillation / flutter.
Contraindications:
  • Second or third-degree block or Sick Sinus Syndrome
  • Atrial flutter / atrial fibrillation
  • Ventricular Tachycardia
  • Hypersensitivity to adenosine
Adverse reactions:
Facial flushing, shortness of breath, wheezing, chest pain, headache, paresthesia, diaphoresis, palpations, hypotension, nausea, metallic taste.
Drug Interactions:
  • Methylxanthines (tehophylline-like drugs) antagonize the effects of adenosine.
  • Diphyridamole (Persantine) potentiate the effects of adenosine.
  • Carbamazepine (Tegretol) may potentiate the AV Node blocking effects of adenosine.
Adult Dosage and Administration:
6mg over 1-3 seconds; If no response after 1-2 minutes, administer 12mg over 1-3 seconds.
Maximum total dose = 18mgs.
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Pediatric Dosage and Administration:
0.1 mg/kg rapid IV; if no response after 1-2 minutes, administer 0.2mg/kg over 1-3 seconds.
Maximum total dose = 18 mgs.
Maximum single dose = 12 mgs.
Duration of action:
Onset and peak effect in seconds; duration 12 seconds.
Special Considerations:
Short half-life limits side effects in most patients.
Pregnancy safety: Category C.