Adenosine*

• Adenosine

• Adenocard

Classification:

• Class V Antidysrhythmic; naturally occurring nucleoside.

Mechanism of Action:

• Slows AV nodal conduction

Indications:

• Stable narrow – complex tachycardia
• Unstable narrow-complex, re-entry tachycardia while preparing for cardioversion
• Regular and monomorphic wide complex tachycardia thought to be, or previously defined as, re-entry SVT.

Contraindications:

• Poison/drug induced tachycardia
• Polymorphic wide complex tachycardia
• Hypersensitivity
• Drug-induced tachycardia
• 2^nd or 3^rd degree heart block
• Wolff-Parkinson-White with wide-complex or atrial fibrillation

Precautions:

• Should not be used for:
  • 2^nd Degree Type II or 3^rd Degree heart block
  • Sick sinus syndrome
  • Use caution with asthma patients
  • Remember short half-life of drug

Adverse Effects:

• Asystole
• Bradycardia
• Ventricular ectopics
• Dizziness
• Facial flushing
• Chest pain
• SOB
• Headache
• Nausea and vomiting

Dose:

Adult:

• 6 mg IV rapid bolus followed by 20 mL normal saline flush; may be repeated in 1-2 minutes (if symptoms persist) as a second dose of 12 mg IV rapid bolus with 20 mL normal saline flush.

Pediatric:

• Pediatric 50 kg (110 lb) or more
  • 6 mg IV rapid bolus followed by 20 mL normal saline flush; may be repeated in 1-2 minutes (if symptoms persist) as a second dose of 12 mg IV rapid bolus with 20 mL normal saline flush.
• Pediatric less than 50 kg (110 lb)

  • 0.1 mg/kg (maximum of 6 mg) IV rapid bolus followed by 5 mL normal saline flush; may be repeated in 1-2 minutes (if symptoms persist) as a second dose of 0.2 mg/kg (maximum of 12 mg) IV rapid bolus with 5 mL normal saline flush.

• IV

• Compendium of Pharmaceuticals and Specialties (CPS)
• Pharmacology for the Prehospital Professional 2^nd Edition