ايه الدوا الى بنديه للعيان عشان نوقف قلبه ADENOSINE – COMPLETE NURSING GUIDE 1. Generic Name: Adenosine 2. Drug Class: Antiarrhythmic agent 3. Main Indication: Termination of certain types of supraventricular tachycardia (SVT). 4. Mechanism of Action: Temporarily blocks conduction through the AV node, interrupting AV node-dependent re-entry circuits. 5. Onset: Almost immediate. 6. Half-life: Less than 10 seconds. 7. Route: Rapid IV bolus. 8. Common Concentration: 6 mg/2 mL; always verify the actual product label. 9. Indications: Regular narrow-complex SVT, especially AVNRT and orthodromic AVRT. Selected stable, regular, monomorphic wide-complex tachycardias under the appropriate ACLS protocol. Diagnostic aid in selected tachyarrhythmias to reveal underlying atrial activity. Adenosine does not routinely terminate atrial fibrillation, atrial flutter, or ventricular tachycardia. 10. Adult ACLS Dosing: First dose: 6 mg rapid IV push over 1–2 seconds. Immediately follow with a rapid normal saline flush. If tachycardia persists, administer 12 mg rapidly according to the ACLS algorithm. Further dosing depends on the specific product instructions and institutional protocol. Reassess the rhythm and the patient after every dose. 11. How to Administer Adenosine: Confirm the rhythm and assess hemodynamic stability. Assess pulse, blood pressure, mental status, chest pain, and signs of shock or acute heart failure. Apply continuous ECG monitoring. Ensure a defibrillator and resuscitation equipment are immediately available. Establish patent IV access, preferably a suitable proximal peripheral vein, such as the antecubital vein. Prepare the prescribed adenosine dose and a normal saline flush. Administer adenosine as a rapid IV push over approximately 1–2 seconds. Immediately administer a rapid normal saline flush. A commonly used adult flush volume is 10-20 mL, but follow the institutional protocol and IV access setup. Monitor the ECG continuously during and after administration. Assess whether sinus rhythm has returned and whether the patient remains stable. If tachycardia persists, reassess the rhythm and follow the ACLS algorithm. Document the dose, time, rhythm, vital signs, clinical response, and adverse effects. 12. Contraindications: Second-degree AV block, unless a functioning pacemaker is present. Third-degree AV block, unless a functioning pacemaker is present. Sick sinus syndrome or symptomatic bradycardia, unless a functioning pacemaker is present. Known hypersensitivity to adenosine. Active bronchospasm or asthma requires particular caution because bronchoconstriction may occur; follow product labeling and local protocol. 13. Precautions: First-degree AV block. Bundle branch block. History of conduction abnormalities. History of seizures. Heart transplantation. Concurrent medications affecting AV nodal conduction. Severe cardiovascular disease. Pregnancy: may be used for selected SVT under appropriate clinical supervision. 14. Common Side Effects: Facial flushing. Chest discomfort or pressure. Shortness of breath. Dizziness. Headache. Nausea. Feeling of impending doom or anxiety. Throat, neck, or jaw discomfort. Brief bradycardia or a transient pause on the ECG. 15. Serious Adverse Effects: Prolonged bradycardia. High-grade AV block. Prolonged asystole. Ventricular arrhythmias. Severe hypotension. Bronchospasm. Respiratory compromise. Rarely, seizures or severe hypersensitivity reactions. A brief pause may occur, but prolonged asystole, persistent hypotension, severe respiratory distress, or clinical deterioration requires immediate assessment and management. follow for more #السعودى_الالمانى #البورد_الامريكي_للتمريض #تمريض #اخصائى_تمريض #نكلكس - @bassamabdelraoof