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Adenosine

Page history last edited by PBworks 11 years, 11 months ago

 

Indications

  • Stable narrow-complex PSVT
  • May consider for unstable narrow-complex reentry tachycardia while preparing for synchronized cardioversion
  • Wide-complex regular tachycardia thought to be or previously defined to be reentry SVT
  • Does NOT convert atrial fibrillation, atrial flutter or VT

 

Contraindications

  • Known allergy, poison/drug induced tachycardia or second- or third-degree heart block

 

Precautions

  • Side effects include: flushing, chest pain or tightness, brief periods of Asystole or bradycardia, ventricular ectopy
  • This drug is less effective in patients taking theophylline or caffeine; reduce dose to 3mg in patients receiving dipyridamole or carbamazepine
  • If administered for wide-complex tachycardia/VT, may cause deterioration (including hypotension)
  • Transient periods of sinus bradycardia and ventricular ectopy are common after termination of SVT
  • Safe and effective in pregnancy

 

IV Rapid Push

  • Place patient in mild reverse Trendelenburg position before administration of drug
  • Initial bolus of 6mg given rapidly over 1 – 3 seconds followed by NS bolus of 20mL; then elevate the extremity
  • A second dose (12mg) can be given in 1 – 2 minutes if needed
  • A third dose (12mg) can be given in 1 – 2 minutes if needed

 

Injection Technique

  • Record rhythm strip during administration
  • Drawn up adenosine dose and flush in 2 separate syringes
  • Attach both syringes to the IV injection port closer to the patient
  • Clamp IV tubing above injection port
  • Push IV adenosine as quickly as possible (1 – 3 seconds)
  • While maintaining pressure on adenosine plunger, push NS flush as rapidly as possible after adenosine
  • Unclamp IV tubing

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