Page 118 - 2023 SMOG Digital

ADENOSINE Lactation Yes (Caution) Trade Name: Adenocard®
Class / Mechanism of Action
Antiarrhythmic Agent
Slows conduction time through the AV node, inhibits re-entry pathways through the AV node, restoring
normal sinus rhythm. The half-life of under 10 seconds allows for rapid repeat dosing.
Indications
Labeled Indications: Paroxysmal supraventricular tachycardia (PSVT) when clinically advisable, vagal
maneuvers should be attempted first; not effective for conversion of atrial fibrillation, atrial flutter, or
ventricular tachycardia.
Unlabeled: ALS/PALS Guidelines (2020): Stable, narrow-complex regular tachycardias; unstable narrow-
complex regular tachycardias while preparations are made for synchronized direct-current cardioversion;
stable regular monomorphic, wide-complex tachycardia as a therapeutic (if SVT) and diagnostic
maneuver.
Contraindications
• Hypersensitivity to adenosine or any component of the formulation
• Second- or third-degree AV block, sick sinus syndrome, or symptomatic bradycardia (except in
patients with a functioning artificial pacemaker)
• Use in patients with atrial fibrillation/flutter with underlying Wolff-Parkinson-White (WPW) syndrome
(Fuster, 2006); asthma (ALS, 2020)
• Known or suspected bronchoconstrictive (Asthma) or bronchospastic lung disease.
Adverse Reactions / Precautions
• May cause transient asystole and new arrhythmia after cardioversion (PACs, AF, PVCs) chest
discomfort
• Headache, Dizziness, Flushing, GI upset
• Dyspnea, Bronchospasm in asthmatics
Dose and Administration: ADULT PEDIATRIC Always Reference BROSELOW Tape
Paroxysmal supraventricular tachycardia: Paroxysmal supraventricular tachycardia:
I.V. (rapid push, over 1-2 seconds, via proximal IV/IO as close to core as possible (rapid push, over
peripheral line (forearm or above, large bore). 1-2sec, see Note): Follow each dose with
• Initial:6mg; if not effective within 1-2min, 10-20mL normal saline flush..
12mg may be given if needed (maximum
single dose: 12mg). • Initial: 0.1mg/kg (maximum initial dose: 6mg);
if not effective within 1-2min, administer 0.2mg/
kg (maximum single dose: 12mg). Follow
Notes): Follow each dose with 20mL normal saline each dose with 5-10mL normal saline flush.
flush.
Note: Initial dose of adenosine should be reduced to
3mg if patient is currently receiving carbamazepine
or dipyridamole, has a transplanted heart or if
adenosine is administered via central line (ALS,
2020).
Note: Adenosine effects are antagonized by
caffeine and theophylline, and patients may require
higher doses.

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