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Adenosine

Adenosine Triphosphate
(Adenocard®)

CLASS

Antiarrhythmic agent, Endogenous nucleotide

DOSAGE

    Adult dosage: 6 mg rapid IVP immediately followed by 20 ml NS flush. Repeat in 2 minutes at 12 mg IVP followed by 20 ml NS flush PRN.
    Pediatric dosage: 0.1 mg/kg (max. 6 mg) rapid IVP immediately followed by 5 ml NS flush. Repeat in 2 minutes, at 0.2 mg/kg (max. 12 mg) rapid IVP followed by 5 ml NS flush PRN.

ACTIONS

    Adenosine exerts its effects by decreasing conduction through the AV node. The half-life of Adenocard (Adenosine) is less than 15 seconds.

INDICATIONS

    Adenocard is indicated for supraventricular tachycardia (PSVT), including that associated with accessory bypass tracts (Wolf-Parkinson-White Syndrome). When appropriate vagal maneuvers should be attempted prior and post Adenocard administration if needed.

CONTRAINDICATIONS

    Adenocard is contraindicated in second-or third degree AV block and sick sinus syndrome (except in patients with a functioning artificial pacemaker), and known hypersensitivity to adenosine.

WARNINGS

    Adenocard may produce a short-lasting first, second, or third degree heart block. In extreme cases, transient asystole may result. At the time of conversion to normal sinus rhythm, a variety of new rhythms may appear (PVC's, PAC's, sinus bradycardia, sinus tachycardia, skipped beats, and varying degrees of AV block) and generally last only a few seconds without intervention.
    The effects of adenosine are antagonized by methylxanthines such as caffeine and theophylline. Thus, larger doses of adenosine may be required for adenosine to be effective. Adenosine effects are potentiated by dipyridamole (PersantineTM). Thus, smaller doses of adenosine may be effective. Adenosine may produce bronchoconstriction in patients with asthma.

SIDE EFFECTS

    Cardiovascular: Facial flushing, headache, and rarely: sweating, palpitations, chest pain, and hypotension.

    Respiratory: Shortness of breath, chest pressure, and rarely: hyperventilating, metallic taste. tightness in throat and head pressure.

    CNS: Light headedness and rarely: dizziness, blurred vision, tingling and numbness in extremities, apprehension.

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