Adenosine: Difference between revisions
(Created page with "== Adult Dosing == *6mg rapid IV bolus over 1-2s **If ineffective can try 12mg 2min later ***If still ineffective can try another 12mg == Contraindications == *2nd, 3rd AV block...") |
(Caveat addition) |
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**If ineffective can try 12mg 2min later | **If ineffective can try 12mg 2min later | ||
***If still ineffective can try another 12mg | ***If still ineffective can try another 12mg | ||
*Caveat | |||
**Higher dose (1st 12mg, 2nd/3rd 18mg) in pt taking methylxanthines (ie caffeine, theophylline) | |||
***Blocks adenosine binding at receptor sites (competitive antagonist) | |||
**Lower dose (1st 3mg, 2nd/3rd 6mg) in pt taking carbamazepine (Tegretol), diazepam (Valium) or dipyridamole (Persantine) OR with a heart transplant. | |||
== Contraindications == | == Contraindications == | ||
Revision as of 00:08, 1 January 2014
Adult Dosing
- 6mg rapid IV bolus over 1-2s
- If ineffective can try 12mg 2min later
- If still ineffective can try another 12mg
- If ineffective can try 12mg 2min later
- Caveat
- Higher dose (1st 12mg, 2nd/3rd 18mg) in pt taking methylxanthines (ie caffeine, theophylline)
- Blocks adenosine binding at receptor sites (competitive antagonist)
- Lower dose (1st 3mg, 2nd/3rd 6mg) in pt taking carbamazepine (Tegretol), diazepam (Valium) or dipyridamole (Persantine) OR with a heart transplant.
- Higher dose (1st 12mg, 2nd/3rd 18mg) in pt taking methylxanthines (ie caffeine, theophylline)
Contraindications
- 2nd, 3rd AV block
- Sick sinus syndrome
- Reentrant SVTs not involving AV node are not terminated
- No effect on anterograde WPW
Indications
- Conversion of reentrant PSVT to NSR
Mechanism of Action
- Negative inotropic, dromotropic, chronotropic effects
- Transient AV nodal block
Adverse Drug Rxns
- Bronchoconstriction (responds to bronchodilators)
- Bradyarrhythmia
- Hypotension (if given too slowly)
Kinetics
Onset of action = 20-30s Duration of action = 60-90s