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What is Adenosine Classification

Antidysrhythmic

Adenosine Indications

Perfusing SVT unresponsive to Valsalva
Poorly perfusing SVT (If Conscious)

Administration

6 or 12mg RAPID IVP, within 1-3 sec, followed by a rapid flush of 10 ml NS. May repeat 12mg in 1-2min one time

Pediatric administration

.1mg/kg rapid IVP, within 1-3 sec, followed by rapid flush of 10ml NS. May repeat 0.2mg/kg IVP in 1-2min one time

Actions/Pharmocology

Adenosine slow conduction through the AV node, can interrupt the reentry pathways through the AV snd SA nodes

Pharmocokinetics

Immidiate onset; Lasts less than 10 sec

Contraindications

HX of Sinus Node Disease
Preexisting Second and third degree heart block

Adverse Effects

Chest Pain, pressure Hypotension
Bradycardia/ Asystole Palpitations
Dyspnea Head Pressure
Light Head/Dizzy Tingling/numbness
Blured Vision Metalic Taste

Interactions

POTENTIATED by blockers of nucleoside transport such as dipyridamole (Persantine) and carbamazepine (Tegretol). ANTAGONIZED by methylxanthines such as caffine and theophyline

Prehospital considerations 1&2

Cannulate a large vein using an 18-20 guage catheter. Use IV port closest to Pt and immidate flush with 10-20ml NS to insure that drug is administered as rapidly as possible
Run a 6 Sec strip befor and after administration

Prehospital consideration 3&4

Pt will often have a 10 Sec of period of escape beats or Asystole before the Sinus Node starts again
Advise Pt that adverse effects such as chest pain, hypotension, or SOB are usually transient and will resolve spontaniuosly w/in 1-2min

Prehospital considerations 5&6

Use with cation with COPD Pt or those taking Dipyridamole or Carbamazepine
Could worsen those with bronchoconstrictive disease

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