NAME OF DRUG
adenosine

CLASSIFICATION

Antiarrhythmic

ALTERNATE NAME

ADENOCARD

INDICATIONS

• conversion to sinus rhythm of narrow-complex paroxysmal supraventricular tachycardia (PSVT)
• diagnosis of broad-complex tachycardia in the emergency setting
• pharmacologic stress for myocardial perfusion imaging

RECONSTITUTION AND STABILITY

• stable at room temperature; DO NOT refrigerate as crystallization may occur
• discard if there is cloudiness or precipitation

COMPATIBILITY

• compatible with NS only

ROUTES OF ADMINISTRATION

• IV direct 
  • over 1-2 seconds immediately followed by 20 mL of NS flush if administered through tubing
  • myocardial perfusion imaging: dilute dosage to 40 mL with NS and administer over 6 minutes
                    

VH & HSC ADMINISTRATION POLICY

ECG monitoring required during IV administration.

B - Direct IV route restricted to nurses in special and critical care areas. On general nursing units the direct IV route must be administered by a physician. Nuclear medicine technologists may administer under the supervision of a physician following a written prescription and provided full resuscitative equipment is readily available.

DOSAGE

Arrhythmias:

• 6 mg IV; may repeat 12 mg IV in 1-2 minutes if no response

Myocardial perfusion imaging:

• 0.14mg/kg/minute administered for 6 minutes

POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION

• flushing, dyspnea, nausea, chest discomfort - usually resolve within one minute due to short half-life of adenosine (10 seconds); patients should be warned that these symptoms will occur and are self-limited
• sinus bradycardia/arrest, atrial fibrillation and AV block - generally self-limiting

IMPORTANT IMPLICATIONS

• use with caution in asthmatic patients as may cause bronchoconstriction
• contraindicated in patients with second or third-degree AV block (except where a pacemaker has been placed)

Rev. May 1998