RNEXPLAINED
ADENOSINE
CLASS V ANTIARRHYTHMIC
THERAPEUTIC USE Adenosine may also be utilized
diagnostically. How? Because narrow
Primary medication of choice for paroxysmal complex tachycardias are difficult to analyze
supraventricular tachycardia when vagal due to the high rate, adenosine may be used
maneuvers have failed to slow the heart rate enough that the
SVT: A narrow complex rhythm with a heart underlying arrhythmia can be identified!
rate >150bpm
A D
R
ENOSINE
O
P HR
MODE OF ACTION
Momentarily slows down conduction in the AV node by
interrupting the AV nodal circuit (driving potassium out of
the cell and inhibiting the influx of calcium into the cell)
and converting SVT into *hopefully* sinus rhythm!
Valsalva
A DENOSINE = AV NODE
maneuver ex:
Push out
breath and
strain for
15-20
seconds
SIDE EFFECTS
Transient asystole (temporary
stopping of the heart)
Chest pain (angina) ROUTE OF ADMINISTRATION:
A sense of impending doom Try valsalva maneuver (bear down, blow into syringe,
Flushing etc.) If unsuccessful, prepare for adenosine
SOB (dyspnea) administration Administer as close to the heart as
possible. M!
1. 6mg rapid IV push
SLA
Adenosine has an
extremely short Over 1-3 seconds followed by 20mL NS flush
half-life of <10 Immediately raise arm
seconds 2. If unsuccessful: 12mg rapid IV push
NCLEX TIPS
Continuous EKG monitoring; place defibrillator pads on patient just in case
Capture EKG before and after administration of adenosine
Warn the patient about the scary feeling of dying/impending doom!
Do NOT use with 2nd or 3rd-degree heart block, drug-induced tachycardia, or
known hypersensitivity
OTHER Amiodarone - Antiarrhythmic
MED TO MOA: Slows down nerve activity in the heart and relaxes an overactive heart
USE: Stable monomorphic ventricular tachycardia, stable supraventricular
HR tachycardia, ventricular fibrillation, cardiac arrest (after epinephrine is given)173
