adenosine

Disclaimer to the Online Edition

This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

adenosine

Indication

  • For conversion of paroxysmal supraventricular tachycardia (PSVT), including that associated with accessory bypass tracts (Wolff-Parkinson-White Syndrome), to normal sinus rhythm.

Dosage Guidelines

  • 0.05 mg/kg/dose
  • If conversion to sinus rhythm does not occur in 1-2 minutes; increase by 0.05 mg/kg/dose every 1 to 2 minutes until SVT resolves or to a maximum of 0.3 mg/kg/dose

Administration

  • IV rapid push over 1-2 seconds at IV site closest to the patient’s heart by MD or NP only
  • Follow each dose with a rapid saline flush of at least twice the volume of the line
  • To prepare a 0.3 mg/mL solution (for doses less than 0.6 mg):
    1. Draw up 1 mL of the 3 mg/mL injection
    2. Add 9 mL of normal saline to make a total volume of 10 mL

Adverse Effects

  • Flushing, bronchospasm, irritability, sinus bradycardia, transient rhythm disturbances (premature ectopic beats, AV block)

Comments

  • Adenosine is contraindicated in second- or third-degree A-V block 
  • Monitor heart rate, respirations, blood pressure and ECG
  • Caffeine antagonizes the actions of adenosine; larger doses of adenosine may be required, or an alternative agent may be required for those on caffeine
  • Half-life is less than 10 seconds
  • Have emergency resuscitation equipment on hand prior to administration
  • Store at room temperature, precipitation may occur if refrigerated

Supplied As

  • 3 mg/mL, 2 mL vial
References

LexiDrug Pediatric and Neonatal