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Adenosine
drug capsule
21
Pharmacology
Professional
04/13/2010

Additional Pharmacology Flashcards

 


 

Cards

Term
Adenosine - trade name
Definition
Adenocard
Term
Adenosine - class
Definition

endogenous nucleoside

misc. antidysrhythmic

Term
Adenosine - description
Definition

 

  • formed by breakdown of ATP
  • adenosine and ATP found in all human cells - many roles
  • slows SVT's by decreasing electrical conduction through AV node w/out causing negative inotropic effects 
  • acts on sinus pacemaker cells and vagal nerve terminals to decrease chronotropic activity
  • drug of choice for PSVT's, used diagnostically for wide-complex tach.s of unknown type following two doses of lidocaine

 

Term
inotropic
Definition
force of muscle contraction
Term
chronotropic
Definition
heart rate
Term
Adenosine - onset and duration
Definition

onset - immediate

duration - 10 sec

Term
adenosine - indications
Definition

  • first drug for most forms of narrow-complex PSVT in adults and peds

Term
Adenosine - Contraindications
Definition

 

  • 2nd or 3rd degree AV block, sick sinus syndrome
  • hypersensitivity
  • atrial flutter, atrial fibrillation, v-tach (adenosine not effective in converting these rhythms to sinus rhythm)

 

Term
second degree AV block
Definition
conduction block between atria and ventricles - one or more but not all impulses fail to conduct to ventricles
Term
third degree av block
Definition
complete heart block - signal generated in SA node does not propogate to ventricles
Term
sick sinus syndrome
Definition
a group of arrhythmias caused by malfunction at sinus node
Term
Adenosine - Adverse reactions
Definition

 

  • light-headedness, headache
  • paresthesia
  • diaphoresis, flushing
  • palpitations, chest pain
  • hypotension
  • shortness of breath
  • transient periods of sinus bradycardia, sinus pause or bradyasystole
  • ventricular ectopy (fibrillation, flutter, tachycardia, torsades de pointes)
  • nausea
  • metallic taste

 

Term
paresthesias
Definition
sensation of tingling, pricking or numbness of a person's skin
Term
bradyasystole
Definition

any electrical rhythm with ventricualr beats under 60 bpm in adults, or periods of asystole

frequently a precursor to cardiac arrest

Term
Adenosine - drug interactions
Definition

  • methylxanthines (caffeine, theophylline) - antagonize action of adenosine
  • dipyrimidamole - potentiates effects, consider reduced dose
  • carbamazepine - may potentiate AV-nodal blocking effect

 

Term
Adenosine - supply
Definition

parenteral for IV

3 mg/ml in 2 ml and 5 ml fip top vials

Term

Adenosine - dosage and administration

adult

Definition

initial

6 mg rapid IV bolus over 1-3 sec, followed by 20 ml saline flush, elevate extremity

repeat (if no response observed in 1-2 min)

12 mg, may repeat once in 1-2 min (max single dose 12 mg)

Term

Adenosine - dosage and administration

ped

Definition

initial

0.1 mg/kg

may be doubled once (max first dose 6 mg), rapid IV bolus followed by 5ml saline flush

Term
Adenosine - special considerations
Definition

 

  • preg c
  • place pt in mild reverse trandelenburg before admin
  • brief period of asystole (up to 15 sec) following conversion, followed by resumption of normal sinus rhythm is common after admin
  • pts taking theophylline may require larger doses
  • cardiac transplant recipients may require only small dose
  • may produce bronchoconstriction in pts with asthma or bronchopulmonary disease
  • monitor ECG
  • reduce initial dose to 3mg in pts taking dipyridamole (persantin) or carbamepazine (tegretol) or pts with transplanted hearts

 

 

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