A question about Adenosine

[Aerin]

Just a quick question.

Does Adenosine always stop your heart? I had a friend who had SVT and a HR of 280 and took it and she said she remembered feeling like something was pulling out of her body, limb pain, but stayed conscious. Her pulse went down to 125 in 10 seconds. Then she got started on Cardizem.

Is that abnormal?

Thanks for reading.

[GHGoonette, BSN, RN]

Thanks for that question, it's an interesting one. I have never seen adenosine administered, but your query prompted me to look it up.

http://www.google.co.za/url?sa=t&source=web&cd=2&ved=0CDgQFjAB&url=http%3A%2F%2Fwww.drugs.com%2Fpro%2Fadenosine.html&ei=pvRDTeKBOYyCvgOHlenKAQ&usg=AFQjCNE6bhNsRBXZ_4en0ruhvFxi_XmbFQ&sig2=o2abwig7HJHt-OCrY-_F0w

[caroladybelle, BSN, RN]

No it does not.

Some people will have a brief (few seconds or even just a pause) asystole before capture back into a slower rhythm. And I have seen a few that didn't really pause, the rhythm just slowed over a few seconds and captured into a rhythm slower than SVT.

Once in while, it won't do anything, a slight slowing and then back to SVT.

[DeadHeadRN, BSN, RN]

No. It's not supposed to "stop" the heart. I've administered Adenosine numerous times and have not ever had a problem. I've seen people have a pause during administration, but a very brief pause, before the pt converts back to a sinus rhythm. I have never personally given Cardizem given for SVT, only to pts for rapid Afib, at least in the ED. Adenosine acts on the AV node, so it is the drug of choice for SVT, unless the pt has contraindications.

As an emergency RN, I've seen a LOT of people get Adenosine. It's very effective when given for SVT. I can't speak to the feeling of pulling out the body or the limb pain, as I've never been given Adenosine, nor have I ever had a pt describe those feelings to me.

[GilaRRT]

Give adenosine slow? Never seen it "stop" the heart? Are we talking about the same medication?

[DeadHeadRN, BSN, RN]

Once in while, it won't do anything, a slight slowing and then back to SVT.

This is true also. Sometimes it takes multiple doses to convert the pt back to sinus. We have a lady who comes into my ED periodically and she always needs 18mg of Adenosine to convert. She knows it too. The first time I triaged her, she walked up to my triage and window and said "I'm in SVT and I need 18mg of Adenosine to convert." We all thought she was a kook, but she was absolutely right. Now we see her coming and we get out the correct dose for her, give it to her and send her on her way.

[DeadHeadRN, BSN, RN]

I have edited this post. Please refer to my later post, since I made an error and everyone yelled at me.

[IVRUS, BSN, RN]

In all my years of nursing... I've NEVER seen Adenosine pushed SLOWLY... It has a half life of approx. 5 seconds.. So if you push it slowly, or push it into a side port of a slow running IV catheter, it will not do its job (especially if you don't chase it afterwards)... Push it over 2-3 seconds.

[Penelope_Pitstop, BSN, RN]

It has to be given VERY slow IVP and you must watch the heart rate carefully while pushing it.

Hmm, not in my neck of the woods...we slam it in and then slam in the flush, too!

And yes, Cardizem can be given for SVT.

[Flames9_RN, BSN, RN, EMT-B]

Slow??? It has a very short life--suppose to be given fast and then flushed with saline, and an IV site as closer to the heart!

[mcleanl]

Deadhead...adenosine is given rapid IV push...followed by a very rapid and large flush (10cc or so). The half-life of adenosine is very, very short...this drug would never be pushed slowly.

[GilaRRT]

Adenosine has a t1/2 that is less than 10 seconds. It is recommended that adenosine is given as a rapid IV bolus in 1-3 seconds followed by a rapid flush. You better make sure we are talking about the same medication.

Edit: Are you thinking of amiodarone?