Adenosine

Classification

• Antiarrhythmic (miscellaneous class)

• Briefly blocks the AV Node from receiving conduction in an attempt to break the “electrical loop” keeping the heart stuck in a fast rate

Effects

• Stimulates adenosine recpetors that are found in the heart and lungs in low density

• Slow conduction time through the AV Node and can interrupt the re-entry pathways through the AV and SA Nodes

• Can restore sinus rythm in pateints with SVT

Pharmacokinetics

• Onset: 10-30 seconds

• Peak: n/a

• Duration: 1-2 minutes

Dosage Form

• 12mg/4ml vial or pre-filled syringe

• 6mg/2ml vial or pre-filled syringe

Pre-Hospital Routes of Administration

• IV bolus: rapid IV push

• IO: humerus or sternum

OCEMS

• SO-O-025: Narrow QRS Complex Tachycardia Regular Rythm

• BH-P-055: Supraventrcular Tachycardia Pediatric

Side Effects

• Chest pressure

• Facial flushing

• Bronchospasm

• Hypotnesion

• Metallic taste

• Palpitations

Precautions

• Persatine (Dipyridamole, an anti-platelet and vasodilator) and Tegretol (Carbamazepine, an anti-convulsant ) potentiate Adenosine

• Theophylline ( bronchodilator used for COPD patients) and caffeine may act as Adenosine receptor antagonists

• reactive airway disease such as Asthma or COPD may develop bronchospams

• Consider withholding Adenosine or synchronized cardio version in pateints with sever Asthma or contact Base Hospital

• Not effective for Wolf Parkinsons White, A-Fib, or A-Flutter

• Unstable or severly symptomatic patients, such as ALOC, with a HR of greater than 150 should be treated with synchronized cardio version

• Use large bore IV in a promximal vein

• Flush with 10-20ml immediately after rapid IV push

• Run EKG strip to capture rhythm before and after administration