CVS: Adenosine

Question 1

What class of Meds is Adenosine?

Answer 1

Anti-arrhythmic

Question 2

What does Adenosine treat?

Answer 2

SVT

Question 3

What is the GENERAL MOA of Adenosine?

Answer 3

Reduces conduction time in AV node –> Anti-arrhythmic effect

Question 4

What is the IN-DEPTH MOA of Adenosine? (5 steps)

Answer 4

1. Adenosine receptors A1 + A2 agonism
2. Induces Potassium Efflux + Inhibits Calcium Influx thru nerve cell channels
3. Hyperpolarization + Increased threshold for Calcium dependant APs
4. Decreased conduction time
5. Anti-arrhythmic effect

Question 5

What are the Doses for Adenosine? (3 step ups)

Answer 5

1. INITIALLY: 3mg (thru central / large peripheral vein) over 2 seconds
2. THEN: 6mg (PRN after 1-2 mins)
3. THEN: 12mg (PRN after 1-2 mins)

Question 6

Which pts are very sensitive to effects of Adenosine?

Answer 6

Pts with heart transplant

Question 7

What are the Monitoring Requirements for Adenosine? (2 things)

Answer 7

1. Monitor ECG
2. Have Resus facilities available

Question 8

What are the Side fx of Adenosine? (5 things)

Answer 8

1. Feeling like you’re gonna die
2. Chest pain
3. Facial flushing
4. SOB
5. Headache

Question 9

Which Side Fx of Adenosine should make you discontinue it?

Answer 9

Chest pain

Question 10

What are the CI for taking Adenosine? (7 things)

Answer 10

1. Asthma
2. COPD
3. HF
4. Long QT syndrome
5. 2^nd / 3^rd Degree HB
6. Sick sinus syndrome (unless pacemaker fitted)
7. Severe HTN

Question 11

When should Adenosine be used with Caution? (10 things)

Answer 11

1. AF
2. Atrial flutter
3. BBB
4. 1^st degree HB
5. Heart transplant
6. Coronary artery stenosis
7. Pericardial effusion
8. Pericarditis
9. HF
10. Hypovolaemia

Question 12

What is the Half life of Adenosine?

Answer 12

Under 10 seconds