Adenosine: Difference between revisions
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**Lower dose (1st 3mg, 2nd/3rd 6mg) in patient taking carbamazepine (Tegretol), diazepam (Valium) or dipyridamole (Persantine) OR with a heart transplant. | **Lower dose (1st 3mg, 2nd/3rd 6mg) in patient taking carbamazepine (Tegretol), diazepam (Valium) or dipyridamole (Persantine) OR with a heart transplant. | ||
=== Indications=== | ===Indications=== | ||
*Conversion of reentrant PSVT to NSR | *Conversion of reentrant PSVT to NSR | ||
| Line 47: | Line 47: | ||
*Metabolism: | *Metabolism: | ||
*Excretion: | *Excretion: | ||
=== Mechanism of Action=== | ===Mechanism of Action=== | ||
*Negative inotropic, dromotropic, chronotropic effects | *Negative inotropic, dromotropic, chronotropic effects | ||
*Transient AV nodal block | *Transient AV nodal block | ||
Revision as of 08:50, 6 July 2016
See critical care quick reference for drug doses by weight.
General
- Type: Antiarrhythmics
- Dosage Forms:
- Common Trade Names:
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 patient taking methylxanthines (ie caffeine, theophylline)
- Blocks adenosine binding at receptor sites (competitive antagonist)
- Lower dose (1st 3mg, 2nd/3rd 6mg) in patient taking carbamazepine (Tegretol), diazepam (Valium) or dipyridamole (Persantine) OR with a heart transplant.
- Higher dose (1st 12mg, 2nd/3rd 18mg) in patient taking methylxanthines (ie caffeine, theophylline)
Indications
- Conversion of reentrant PSVT to NSR
Pediatric Dosing
See critical care quick reference for drug doses by weight.
Special Populations
- Pregnancy Rating:
- Lactation:
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
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:
- Metabolism:
- Excretion:
Mechanism of Action
- Negative inotropic, dromotropic, chronotropic effects
- Transient AV nodal block