Adenosine (tachyban)-2ml Inj.

(ah-DEN-oh-seen) Adenocard, Adenoscan Class: Antiarrhythmic Action Slows conduction through atrioventricular (AV) node; can interrupt reentry pathways through AV node and restore normal sinus rhythm. Indications Conversion to sinus rhythm of paroxysmal supraventricular tachycardia (PSVT), including that associated with Wolff-Parkinson-White syndrome. Unlabeled use (s): Noninvasive assessment of patients with suspected coronary artery disease in conjunction with thallium tomography. Used with BCNU for treatment of brain tumors. Contraindications Second- or third-degree AV block or sick sinus syndrome (except in patients with functioning artificial pacemaker); atrial flutter; atrial fibrillation; ventricular tachycardia. Route/Dosage ADULTS: Initial dose: IV 6 mg as rapid IV bolus (over 1 to 2 sec). REPEAT ADMINISTRATION: If first dose does not eliminate PSVT within 1 to 2 min, give 12 mg as rapid IV bolus; 12 mg dose may be repeated a second time if necessary. Doses > 12 mg are not recommended. Interactions Caffeine, theophylline: Antagonize effects of adenosine; larger doses of adenosine may be needed. Carbamazepine: May produce higher degrees of heart block. Dipyridamole: Potentiates effects of adenosine; smaller doses may be adequate. Lab Test Interferences None well documented. Adverse Reactions CV: Facial flushing; headache; chest pain; hypotension. CNS: Lightheadedness, dizziness, tingling in arms; numbness. GI: Nausea. RESP: Dyspnea; shortness of breath; chest pressure. Precautions Pregnancy: Category C. Lactation: Undetermined. Arrhythmias: At time of conversion to normal sinus rhythm, new arrhythmias may appear on ECG; these are usually self-limiting. Asthma: Adenosine may cause bronchoconstriction. Heart block: Drug may produce short-lasting heart block. Patients in whom high-level heart block (eg, third-degree) develops after one dose should not receive repeat doses. PATIENT CARE CONSIDERATIONS Administration/Storage Administer by rapid IV bolus only. Administer either directly into vein or, if given into IV line, in most proximal IV line and follow with rapid saline solution flush. Do not administer if solution is cloudy or if sediment is present. Discard unused portion. Store at room temperature. Do not refrigerate because crystallization may occur. If crystallization has occurred, dissolve crystals by warming to room temperature. Assessment/Interventions Obtain patient history, including drug history and any known allergies or asthma. Monitor BP and cardiac rhythm during and after administration. Monitor for transient asystole, which may develop during administration. Patient/Family Education Inform patient to report the following symptoms to physician: Facial flushing, headache, shortness of breath, chest pressure, lightheadedness, dizziness, tingling in arms, numbness or nausea.