Just Plain Ruff Posted October 24, 2007 Posted October 24, 2007 Please define the following and please do not go right to google for the answers. By the end of these education pieces you will have a excellent reference packet for your flash cards. Indications: Contraindications: Dosage How Supplied Side Effects Drug interactions Warnings: Precautions: Pregnancy: Overdose and treatment of: Description: Clinical Pharmacology:
spenac Posted October 24, 2007 Posted October 24, 2007 Thanks Ruff. I'm working on cards right now for Paramedic class.
AnthonyM83 Posted February 2, 2008 Posted February 2, 2008 Indications: PSVT including those associated with Wolf-Parkinson-White Syndrome, when vagal manuevers are ineffective. Will not work on A-Fib or A-Flutter. Contraindications: Second and third degree AV blocks. Sick sinus syndrome Dosage: Adult: Initital 6mg. May repeat within 1 - 2 minutes at 12mg. Repeat again after 1 - 2 minutes at 12mg. Peds: Initital 0.1mg/kg. Double if no effect. Max out at 12mg. Immediately flush 2 - 3 mL saline. How Supplied: Rapid IV bolus at port closest to patient (IV access near heart preferred). Administer over 1 - 3 seconds with immediate 20mL saline flush. Side Effects: Light-headedness, hypotension, parasthesia, dyspnea, headache, transient bradycardia and ventricular ectopy, palpitations, nausea, chest pain, flushing. Drug interactions: Methylxanthines (caffeine, theophylline, aminophyle) antagonize adenosine and may decrease effectiveness requiring larger dose. Dipyridamole potentiates adenosine and may require smaller dose. Carbamazepine may potentiate AV-nodal blocking effect and may require decreased dose. Warnings: May cause asystole, bradycardia, ventricular fibrillation, ventricular tachycardia, atrial fibrillation, comple heart block, and broncospasms. Short periods of asystole are common (up to 15 seconds). Patient should be in secure position. Precautions: May cause other arrhythmias. Be prepared to treat if not transient. Use caution with asthma and lung disease patients, as adenosine may cause bronchospasms. Pregnancy: No clear risk in human studies. Overdose and treatment of: Overdose rare, due to short half-life. Persistant effects may be treated with methylxanthines. Use appropriate drugs based on presenting patient and rhythm. Description: Adenosine is an endogenous nucleotide and class IV antiarrhythmic used to slow tachycardias associated with the AV Node, such as AV re-entry tachycardia. It slows AV node conduction time and interrupts AV node re-entry pathways, converting to sinus rhythm. Onset within 30 seconds with half-life of 10 seconds. Clinical Pharmacology: Activates A1 receptors which activates inward potassium channels and inactivates inward slow calcium channels. This leads to hyperpolarization.
AnthonyM83 Posted February 2, 2008 Posted February 2, 2008 Someone double check me. I had to get this offline using three sources, plus occasional google. Wish I had a PDR for more consistent information (and OD info).
tskstorm Posted February 3, 2008 Posted February 3, 2008 How Supplied: 6mg/2ml vial Side Effects: Light-headedness, hypotension, parasthesia, dyspnea, headache, transient bradycardia and ventricular ectopy, palpitations, nausea, chest pain, flushing. metalic taste, bronchoconstriction in asthma pt Warnings: access vitals often, pts who develop high-grade av heart block should not be given additional doses Precautions: May cause other arrhythmias. Be prepared to treat if not transient. Use caution with asthma and lung disease patients, as adenosine may cause bronchospasms. Arrhythmias likely to develop include pvc's pac's sinus brady, and sinus tach Pregnancy: class c Rest i agree with.
AZCEP Posted February 3, 2008 Posted February 3, 2008 Sinus tachycardia is not a transient dysrhythmia that is caused by adenosine. Most of the dysrhythmias caused by administration of adenosine are self-limiting by the half-life of the medication. Sinus tachycardia is a result of the heart's compensation for decreased cardiac output from the SVT episode. The adenosine allows the SA node to resume the pacemaker duties, and the tachycardia results.
tskstorm Posted February 3, 2008 Posted February 3, 2008 Sinus tachycardia is not a transient dysrhythmia that is caused by adenosine. Most of the dysrhythmias caused by administration of adenosine are self-limiting by the half-life of the medication. Sinus tachycardia is a result of the heart's compensation for decreased cardiac output from the SVT episode. The adenosine allows the SA node to resume the pacemaker duties, and the tachycardia results. my pharm book disagrees with you but okie dokie
EMS49393 Posted February 3, 2008 Posted February 3, 2008 If memory serves... Back in the day when I had my pick of the litter for anti-arrhythmics, WPW was a contraindication for adenosine. Procainamide was the drug of choice at my particular service. If immediate cardioversion wasn't necessary, a 12-lead was obtained prior to any drug therapy to better determine if the arrhythmia was atrial or ventricular in nature. Of course, I have an aging memory. I also have my pick of lidocaine and lidocaine for antiarrhythmics at my current service. -'93
hammerpcp Posted February 3, 2008 Posted February 3, 2008 LMAO at "ensure pt is in secure location". I have a mental image of getting Pt's to stand at the top of a long stair case prior to Adenosine admin. (AZCEP Is right about the sinus tach thing) Adenosine has a nasty habit of causing sudden death in pt's who are in Atrial Fib w RVR. So make sure the rhythm is regular! I had a pt who i suspected to be in an SVT, however the QRS complexes were wide. I thought this was due to a BBB..........the Dr rather than take a chance on Adenosine (althought the half life is so short it is relatively safe) he administered Amiodarone which is useful in both ventricular and superventricular tachicardias. Just a little tidbit for ya'll.
AnthonyM83 Posted February 3, 2008 Posted February 3, 2008 LMAO at "ensure pt is in secure location". LOL I added that one myself RVR?
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