Adenosine

Aliases: Adenocard 

Indications: Supraventricular Tachycardia SVT (including WPW) refractory to vagal maneuvers 

Contraindications:  2nd or 3rd degree heart block (without a functioning pacemaker); Known Sick sinus syndrome; Known History of Long QT Syndrome; Pregnancy Category C; Irregular Wide-complex tachycardia presumed to be WPW 

Concentrations: 

Injection: 3mg/mL

Dosing

Adult:

Indication	Dose	Route	Note
Supraventricular Tachycardia	12 mg	Rapid IV Push (mixed in 10 cc flush)	May repeat once

Pediatric:

Indication	Dose	Route	Note
Supraventricular Tachycardia	0.2 mg/kg (Max: 12 mg)	Rapid IV Push (mixed in 10 cc flush)	May repeat once

Precautions: 

Advising patient of the side effects of adenosine prior to administering can help minimize patient anxiety. Large bore IV, antecubital access, or IO access & IV wide open during administration; it may help to have your partner administer the fluid bolus. 

Start your EKG printout before administration and continue printing through bolus and conversion. 

Administration of adenosine will cause a period of asystole & various conversion dysrhythmias, be patient, most will transiently resolve 

Adverse/Side Effects: Flushing, Dizziness, Chest Pain, Lightheadedness, Dyspnea, Numbness, Headache, Nausea/Vomiting, Diaphoresis, Palpitations, Metallic Taste  

Class: Supraventricular Antiarrhythmic, Nucleoside 

Mechanism of Action:

Slows tachycardias associated with the AV node via modulation of the autonomic nervous system without causing negative inotropic effects. 

 It acts directly on sinus pacemaker cells and vagal nerve terminals to decrease chronotropic & dromotropic activity. Slows conduction through the AV node, blocks reentry pathways through the AV node, can transiently slow conduction in the SA node. 

Onset of Action	Peak Effect	Duration of Action
Rapid	Rapid	Very Brief