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Medications

Adenosine

Last Updated on October 16, 2022

Mechanism of Action

  • Slows transmission across AV node
  • It has only little effect on other myocardial cells / conduction pathways

Notes
• Adenosine receptors are found in the lungs
• Thus, adenosine can stimulate sensory nerve fibres in lungs to produce shortness of breath
• Adenosine causes bronchoconstriction

Indications

  • Stable supraventricular tachycardia

Administration

Preparation

  • Make sure patient has a large bore branula at antecubital fossa, with a 3-way stop cock
  • 10 – 20 mL syringe with normal saline / water for injection

Administration

  • Before administering IV Adenosine, warn the patient that the medication may cause transient shortness of breath / chest discomfort / nausea / flushing
  • Straighten and lift up patient’s hand (the side of adenosine administration)
  • Adenosine is given as rapid intravenous push, followed by 10 – 20 mL water for injection / normal saline

Dosage

Stable supraventricular tachycardia

  • IV Adenosine 6 mg stat, followed by 10 – 20 mL saline flush
  • If unsuccessful, to give IV Adenosine 12 mg stat 1 – 2 minutes later

Adverse Effects

  • Transient unpleasant side effects: chest discomfort, nausea, flush
  • Bronchoconstriction → shortness of breath
  • Atrial fibrillation

Precautions

  • Asthma

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