Adenosine

CLASS

  • short acting anti-arrhythmic
  • naturally occurring purine nucleoside

MECHANISM OF ACTION

  • depression of SA & AV nodal activity
  • antagonises cAMP-mediated catecholamine stimulation of ventricular muscle

-> negative chronotropy & dromotropy

  • direct agonist at specific cell membrane receptors (A1 & A2)
  • A1 = coupled to K+ channels by a guanine nucleotide-binding protein in supraventricular tissue.

PHARMACEUTICS

  • clear, colourless
  • 3mg/mL
  • in saline

DOSE

  • rapid IV bolus followed by saline flush
  • 3mg -> 6mg -> 12mg (adult)
  • 0.04 to 0.25mg/kg (children)

INDICATIONS

  • diagnosis and treatment of paroxysmal SVT

ADVERSE EFFECTS

  • bronchospasm
  • flushing
  • SOB
  • chest pain

CONTRAINDICATIONS

  • second and third degree AV block
  • allergy
  • care with asthma and COPD

PHARMACOKINETICS

  • Onset – 10 seconds
  • Duration – 10 seconds
  • Absorption – must be given IV
  • Distribution
  • Metabolism – absorbed by RBC’s and endothelium
  • Elimination – t ½ = 10 seconds

CCC Pharmacology Series

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the  Clinician Educator Incubator programme, and a CICM First Part Examiner.

He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.

His one great achievement is being the father of three amazing children.

On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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