Alternate Name(s):
Adenocard
Classification:
Antiarrhythmic
Original Date:
March 1993
Revised Date:
November 2012
Indications:
- Treatment of paroxysmal supraventricular tachycardia (PSVT)
Administration:
- Rapid IV direct: by physician only, administer over 1 - 2 seconds at peripheral IV site closest to patient's heart (IV administration into lower extremeties may result in therapeutic failure or requirement of higher doses)
- Slow administration has been associated with treatment failure
Dosage:
- 0.1 mg/kg. If not effective within 1 - 2 minutes, increase dose by 0.05 - 0.1 mg/kg increments every 1 - 2 minutes to a maximum single dose of 0.3 mg/kg or until termination of PSVT
- Follow each dose with a 0.9% NaCl flush
Side Effects:
- CVS: AV block, sinus bradycardia, atrial flutter/fibrillation, ventricular extrasystole, facial flushing, hypotension
- Respiratory: bronchospasm
Parameters to Monitor:
- BP
- ECG
- RR
Reconstitution and Stability:
- Dilution can be made with 0.9% NaCl for doses < 0.2 mL (600 mcg or 0.6 mg). Use 1 mL (3000 mcg or 3 mg) with 9 mL of 0.9% NaCl to make a solution with a final concentration of 300 mcg/mL or 0.3 mg/mL
Compatibility:
- Do not mix with other drugs
Notes:
- Higher doses may be required in the presence of caffeine or aminophylline
- For serious adverse effects (ie. atrio-ventricular block, severe bronchospasm) treat with aminophyline 6 mg/kg IV over 20 minutes
- Defibrillator and personnel competent with procedures requiring such equipment are required at bedside for the safe administration of adenosine. Areas outside critical care and ED will activate the SPOT Team/PICU who will bring the Code Blue Cart. The SPOT Team/PICU will remain on site until the SPOT Team and Primary Care Team determine that the defribillator and personnel are no longer required.
References:
- Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 19th Edition. Hudson: Lexi-Comp Inc.; 2012
- Lau E. (Editor). Drug Handbook and Formulary- The Hospital for Sick Children. Toronto: 2012-13.