Adenosine
Adenocard
Class:
Endogenous Nucleotide
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.
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.
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.
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.
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.
Onset and peak effect in seconds; duration 12 seconds.
Special Considerations:
Short half-life limits side effects in most patients.
Pregnancy safety: Category C.
Short half-life limits side effects in most patients.
Pregnancy safety: Category C.