Adenosine

Question 1

Adenosine - Type

Answer 1

endogenous purine nucleoside

Question 2

Adenosine - Presentation

Answer 2

6mg in 2ml

Question 3

Adenosine - Action

Answer 3

Transient inhibition of conduction in the heart, especially in AV node
Onset 5-10 sec Duration approx 10 sec

Question 4

Adenosine - Use

Answer 4

Treatment of SVT

Question 5

Adenosine - Adverse effects (7)

Answer 5

Common, though transient and generally minor

1. Arrhythmias at the time of conversion
2. Transient flushing of the skin
3. Mild dyspnoea
4. Chest tightness
5. Nausea
6. Headache
7. Feelings of apprehension and feer

Question 6

Adenosine - Contraindications (2)

Answer 6

1. 2nd or 3rd deg heart block

2. Known hypersensitivity

Question 7

Adenosine - Precautions (4)

Answer 7

1. Asthma - may exacerbate bronchospasm
2. Pregnancy - use only if very poorly perfused
3. Antagonised by - theophylline (nucleon)
4. Potentiated by - dipyridamole (persantin, asasantin)
   - carbamezepine (tegretol, teril)

Question 8

Adenosine - Dose

Answer 8

Adult:
- 6mg IV rapid bolus into fast flowing pump set
- 12mg if first dose is unsuccessful after 2/60,
Paediatric
- 0/05mg/kg IV rapid bolus into fast flowing pump set
- 0.1mg/kg if first dose is unsuccessful after 2/60

Question 9

Adenosine - Special notes

Answer 9

Use only after 2 x valsalva
12 lead before, during and after
elevate limb if possible
Via fast flowing pump set
Midaz 1-1.5mg if previous unpleasant (fearful) experience.