ADENOSINE (Adenocard)

• Produces short acting AV block to aid in the diagnosis of supraventricular tachycardias
• Drug of choice for acute conversion of SVT (all ages).

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.

• Not given by IV infusion

• Atrial flutter or fibrillation
• Ventricular tachycardia
• Known bronchospastic/bronchoconstrictive diseases (e.g. asthma)
• Symptomatic bradycardia, sick sinus syndrome, second or complete AV block (unless a functioning pacemaker)

• cardiovascular
  • Symptoms associated with brief ventricular standstill (lightheaded, hypotension, flushing, nausea)
  • Sinus bradycardia, sinus arrest, atrial fibrillation, AV block (usually < 1 minute)
• non-cardiovascular
  • Metallic taste
  • Blurred vision
  • Dyspnea, shortness of breath, hyperventilation, bronchospasm

• 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

• Continuous heart rate and cardiac rhythm
• Blood pressure

• 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 IV direct bolus with immediate flush. 
• Resuscitation equipment must be available.