Adenosine? That is my question

Eirene, ASN, RN · Dec 10, 2008

I have to admit that I think adenosine is the COOLEST cardiac drug-- ever!

We use it for SVT. It is pushed super fast. I've seen the patient flatline for a few seconds and then pick up a normal sinus rhythm.

Adenosine is a normal chemical in the body. Muscles produce adenosine from exercising. It helps you sleep; relaxing the body. It slows down the nerve cell activity.

We had a construction worker come in a few weeks ago with CP. Very young guy. Hooked him up to a monitor and it showed SVT! Turns out he was drinking way too much Mountain Dew because he was working overtime and wanted to stay awake. Caffiene also binds to the adenosine receptors (they fit into that lock-and-key receptor sites), which in turn clocks the natural "slow me down" neurotransmitter. That's why you shouldn't drink coffee close to bedtime.

I hope that helps.

NYCRN6 · Dec 10, 2008

Thanks for the reply! That helped me a little bit. So if a patient flatlines... and the drug adenosine is given.. i thoguht it was supposed to slow the AV node conduction. I understand about the Vtach and I know you give it with SVT but they are still living with their heart rate going fast.

Also how is Adenosine applied in Adeno-Mibi stress test?

I thought a chemical was injected and it mimicked exercise which increased your BP/HR and they check for EKG changes.

I hvae to run but I will await your response thanks!

Eirene, ASN, RN · Dec 10, 2008

Hello there,

I should have been more specific in my original reply. I re-read it and I can see it was confusing!

The contruction guy was in SVT. After adenosine was given-- he flatlined for a few seconds and then picked up a normal sinus rhythm. The flatline was a result of administering adenosine; it totally blocked the AV conduction for a few seconds.

I hope that made more sense.

As for the Adenosine stress test-- there is a common misconception that Adenosine increases the HR and BP because it "mimics" exercise. It does not increase the HR or BP (it's not supposed to, anyway). All it does is dilates the blood vessels into the heart (increasing blood flow), which in turn makes the patient look as if they are exercising. If I remember correctly, it is given in a much lower dose during the stress test than in an emergency as SVT.

I hope that helps!

NYCRN6 · Dec 11, 2008

ok i understand that now!!!!!!! thanks

CRIMSON · Dec 11, 2008

Adenosine stress test, given in 4 or 6 minute drips mimics exercise by vasodilation. Not advised for use in pt. w/chronic lung dx (asthma, COPD). And on occassion has dropped HR to 0 during stress test but if you catch on way down can have swing legs and that usually brings back up and you can dc test otherwise break out the atropine.

COLPN · Dec 12, 2008

The contruction guy was in V-tach. After adenosine was given-- he flatlined for a few seconds and then picked up a normal sinus rhythm. The flatline was a result of administering adenosine; it totally blocked the AV conduction for a few seconds.

I didn't think you gave Adenosine for VTach. I thought it was only for SVT. Correct me if I'm wrong.

Eirene, ASN, RN · Dec 12, 2008

COLPN--

You are absolutely correct. I am so sorry for the incorrect information. I was having a major brain fart! The guy was in SVT.

SVT: Adenosine

V-tach: lidocaine and Amiodarone.

I'll go and edit my original reply. I am so sorry for the confusion!

NurseJeanB · Dec 12, 2008

I had SVT myself and was given Adenosine and it stopped it instantly. Way cool. Also it has to be given quickly, it has a short half life.