Adenosine: Difference between revisions
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*All other uses: N/A; drug unlikely to be used during breastfeeding based on indication | *All other uses: N/A; drug unlikely to be used during breastfeeding based on indication | ||
===Renal Dosing=== | ===Renal Dosing<ref>Adenosine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019. </ref>=== | ||
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===Hepatic Dosing=== | ===Hepatic Dosing<ref>Adenosine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019. </ref>=== | ||
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** Not defined - not hepatic ally eliminated | ** Not defined - not hepatic ally eliminated | ||
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==References== | ==References== | ||
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[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
Revision as of 03:20, 2 May 2019
See critical care quick reference for drug doses by weight.
General
- Type: Antiarrhythmics
- Dosage Forms: IV
- Common Trade Names: Adenocard, Adenoscan
Indications
- Conversion of reentrant PSVT to NSR
Adult Dosing
Stable, narrow complex tachycardia
- 6mg rapid IV push over 1-2s
- If ineffective can try 12mg 2min later
- If still ineffective can try another 12mg
- Caveat
- For patients taking methylxanthines (ie caffeine, theophylline):
- Blocks adenosine binding at receptor sites (competitive antagonist) and can lead to bronchospasm
- Consider using lower dose (1st 3mg, 2nd/3rd 6mg) in patient taking carbamazepine (Tegretol), diazepam (Valium) or dipyridamole (Persantine) OR with a heart transplant.
- For patients taking methylxanthines (ie caffeine, theophylline):
Pediatric Dosing
See critical care quick reference for drug doses by weight.
Special Populations
Pregnancy Rating
- May use during pregnancy; risk of fetal harm not expected based on limited human data
Lactation
- Cardiac Stress Testing: may use while breastfeeding; no human data available, though risk of infant harm and adverse effects on milk production not expected based on drug properties.
- All other uses: N/A; drug unlikely to be used during breastfeeding based on indication
Renal Dosing[1]
- Adult
- Not defined - not renally eliminated
- Pediatric
- Not defined - not renally eliminated
Hepatic Dosing[2]
- Adult
- Not defined - not hepatic ally eliminated
- Pediatric
- Not defined - not hepatic ally eliminated
Contraindications
- Allergy to class/drug
- 2nd, 3rd AV block
- Sick sinus syndrome
- Reentrant SVTs not involving AV node are not terminated
- No effect on anterograde WPW
Adverse Reactions
- Bronchoconstriction (responds to bronchodilators)
- Bradyarrhythmia
- Hypotension(if given too slowly)
Pharmacology
- Kinetics: Onset of action = 20-30s Duration of action = 60-90s
- Half-life: <10 seconds
- Metabolism: vascular endothelial cells
- Excretion:
Mechanism of Action
- Negative inotropic, dromotropic, chronotropic effects
- Transient AV nodal block