Adenosine (Adenocard)

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What is the classification?

Antiarrhythmic

What are the actions?

• Transiently blocks conduction through the AV node
• Interrupts reentry pathways through the AV node

What are the indications?

• Stable SVT (Supraventricular tachycardia, AVNRT atrioventricular nodal reentry tachycardia)
• Consider while preparations are made prior to cardioversion

What are the contraindications?

• Allergy to the drug
• Heart block
• Drug-induced tachycardia (e.g. from cocaine)
• Atrial flutter and atrial fibrillation

What are the precautions?

Very short duration of action; must reach the heart within 10-20 seconds

What are the common concentrations?

• 6mg/2mL prefilled syringe, 6mg/2ml vial
• 12mg/4ml prefilled syringe, 12mg/4ml vial

What is the adult dosage?

• 1st Dose: 0.1 mg/kg rapid IV push (maximum dose 6 mg) with 5-10 mL flush
•2nd Dose: .02 mg/kg rapid IVP (maximum dose 12 mg) with 5-10 mL flush

What is the pediatric dosage?

•1st Dose: 0.1 mg/kg rapid IV push (maximum dose 6 mg) with 5-10 mL flush
•2nd Dose: 0.2 mg/kg rapid IVP (maximum dose 12 mg) with 5-10 mL flush

What are the side effects?

• Headache
• Facial flushing
• Chest pressure
• Nausea

What are the key points?

• Half life less than 10 seconds
• Consider diluting small medication volume of pediatric dosages with 5 mL normal saline, followed by 5-10 mL flush
• Continuous ECG and attempt to capture conversion on ECG paper
• Vital signs before and within 5 minutes after administration
• Position patient supine, consider elevation of legs

What is the protocol use?

Narrow complex tachycardia