Core pharmacology

Class Group

Antiarrhythmic –
Vaughan Williams Class V
Other

Legacy Cicm Level

Level 2

Introduction

natural purine nucleoside

slows conduction through the AV node

Indications Uses

e¬ffective treatment for the termination of paroxysmal SVT.
Used for slowing rapid atrial arrhythmias to aid diagnosis.

Presentation

IV: clear liquid with 6mg in 2mL

Mechanism of action

acts on the A1 adenosine receptors found in the SA and AV
markedly slows or
completely blocks conduction in the AV node, probably by hyperpolarizing this tissue (through increased IK1) and by reducing calcium current

Onset Peak Duration

onset / duration seconds / seconds

Physiological effects

Effects: causes a temporary heart block and/or asystolic pause which acts to terminate SVT

Adverse Effects Toxicity

side effects are transient but can be distressing for
patients (sense of impending doom).
May induce AF/AFL due to ↓ refractory period.
Contraindicated in sick sinus syndrome. Avoid in asthma/ COPD - may cause bronchospasm.

Absorption

IV only

Protein binding

NA

Volume of distribution

NA

Metabolism

Rapidly deaminated in plasma and taken up by RBCs

Half-life

<10 seconds

Route And Dose

IV.
doses 3-6mg bolus