Name: ADENOSINE (AdenocardR) Classification: Antiarrhythmic: produces short acting AV block to aid in the diagnosis of supraventricular tachycardias may convert PSVT to sinus rhythm when verapamil is not effective or is contraindicated Dose: Bolus Dose: Administer each dose into a port as close to the patient as possible. Administer each dose undiluted by IV direct. Administer within 1-2 seconds. After each IV direct dose, administer a 20 mL sodium chloride 0.9% flush. Administer the flush as quickly as possible. First dose: 6 mg IV direct by rapid bolus Second dose if no response within 1-2 minutes: 12 mg IV direct by rapid bolus Third dose if no response within 1-2 minutes: 12 mg IV direct by rapid bolus Maximum total dose of 30 mg. Administration: IV Infusion: not given by IV infusion Adverse Effects: cardiovascular sinus bradycardia, sinus arrest, atrial fibrillation, AV block (usually < 1 minute) hypotension non-cardiovascular flushing and dyspnea headache, cough, malaise, or nausea usually lasting <1 minute due to very short half life Drug Interactions: adenosine + aminophylline/theophylline = decreased adenosine effect adenosine + digoxin = bradycardias and increased AV blocks adenosine + verapamil = bradycardias and increased AV blocks adenosine + beta blockers = bradycardias and increased AV blocks Monitoring Therapy: continuous heart rate and cardiac rhythm blood pressure Adult Critical Care Protocol: May be administered IV direct by an Adult Critical Care Nurse. A physician must be present during administration. This drug must be given by rapid BDC bolus. Resuscitation equipment should be on hand. Lynne Kelly, Pharmacist, CCTC Brenda Morgan, Clinical Nurse Specialist, CCTC Last Update: September 17, 2018
