Composition
lnj: Adenosine 6 mg/2 ml pre-filled syringes
Indications & Dosage
Rapid reversion to sinus rhythm of paroxysmal supraventricular tachycardias, including those associated with accessory conducting pathways (e.g. Wolff-Parkinson-White syndrome), Aid to diagnosis of broad or narrow complex supraventricular tachycardias: BY RAPID IV INJ: Adult: Initially 6 mg, administer into central or large peripheral vein and give over 2 seconds, cardiac monitoring required, followed by 12 mg after 1–2 minutes if required, then 12 mg after 1–2 minutes if required, increments should not be given if high level AV block develops at any particular dose. Rapid reversion to sinus rhythm of paroxysmal supraventricular tachycardias, including those associated with accessory conducting pathways (e.g. Wolff-Parkinson-White syndrome) in patients with a heart transplant, Aid to diagnosis of broad or narrow complex supraventricular tachycardias in patients with a heart transplant: BY RAPID IV INJ: Adult: Initially 3 mg, administer into a central or large peripheral vein and give over 2 seconds, followed by 6 mg after 1–2 minutes if required, then 12 mg after 1–2 minutes if required, patients with a heart transplant are very sensitive to the effects of adenosine In conjunction with radionuclide myocardial perfusion imaging in patients who cannot exercise adequately or for whom exercise is inappropriate: BY IV INF: Adult: (consult product literature)
Administration
For rapid IV injection, expert sources advise give over 2 seconds into central or large peripheral vein followed by rapid Sodium Chloride 0.9% flush; injection solution may be diluted with Sodium Chloride 0.9% if required.
Contraindications
Decompensated heart failure, asthma, chronic obstructive lung disease, long QT syndrome, second- or third-degree AV block and sick sinus syndrome (unless pacemaker fitted), severe hypotension
Precautions
Atrial fibrillation and atrial flutter (conduction down anomalous pathway may increase), autonomic dysfunction, bundle branch block, first-degree AV block, heart transplant, left main coronary artery stenosis, left to right shunt, pericardial effusion, pericarditis, QT-interval prolongation, recent myocardial infarction, severe heart failure, stenotic carotid artery disease with cerebrovascular insufficiency, stenotic valvular heart disease, uncorrected hypovolaemia
Pregnancy
Positive evidence of risk, use only if potential benefit outweighs risk.
Lactation
Caution advised
Side Effects
Arrhythmias, atrioventricular block, chest pain and discomfort, dizziness, dry mouth, dyspnoea, Flushing, headache, hypotension (discontinue if severe), pain, paraesthesia, throat discomfort, asthenia, bradycardia (discontinue if asystole or severe bradycardia occur), hyperhidrosis, back and limb discomfort, nervousness, metallic taste, nausea, vomiting. Rare: Apnoea, cardiac arrest, respiratory disorders, respiratory failure (discontinue), tinnitus, tremor, urinary urgency, vision blurred, loss of consciousness, seizure, syncope.