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 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

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

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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