It's half life is 8 to 15 seconds, and it works by activating potassium channels which decreases AVN conduction.
The effect of adenosine is increased by dipridamol and carbamezepine.
The effect of adenosine is decreased by aminophylline.
A positive of adenosine is that it has no significant negatively inotropic effects.
Risks associated with its use include:
- enhancing conduction through the accessory pathway in Wolff-Parkinson-White
- causing a dangerously fast ventricular response in pre-excited AF/flutter
The side effects include:
- chest tightness
- bronchospasm (avoid in asthma)
- facial flushing
The usual dosing regime is 6mg, then if unsuccessful 12mg 2 mins later and if still unsuccessful another 12mg 2 mins after that. Ensure cardiac monitoring is in place when it is given (it can cause cardiac standstill) and remember that given its short halflife it must be given as a rapid bolus, flushed instantly with saline.
So to the final revision battle of the day, with that most feared ECG pattern: the broad complex tachycardia.