Sunday, 6 July 2014

Treatment for tachycardia: adenosine know, their contraindications

Adenosine is a cardiac antiarrhythmic that can be found in the form of injectable solution under the trade name Adenocard, indicated for the treatment of tachycardia paroxysmal supraventricular.

In medicine, adenosine is used by intravenous for the reversal of tachyarrhythmias with narrow QRS complex or as a pharmacological agent to cause stress in certain complementary examinations.

Contraindications of adenosine   

Treatment with adenosine is contraindicated in cases of atrioventricular block second or third degree, except for patients with pacemakers, atrial flutter, atrial fibrillation, sick sinus syndrome, ventricular tachycardia , broncoconstritiva or bronchospastic lung disease and during pregnancy .

During the period of breastfeeding , the drug brings no risk, since it ends up being eliminated quickly.
Side effects of adenosine

Although it is an effective method for treating tachycardia , adenosine may cause some side effects. Among them may be mentioned the headache, nausea, pressure in the chest, shortness of breath, a cardiac arrhythmia , the redness on the face and the feeling of imminent fall.

During the medication, there is the possibility of occurrence of episodes of asystole and transient or prolonged ventricular fibrillation. In patients with tachycardia of unknown origin, their use can lead to the manifestation of severe arrhythmias. In patients with angina, unstable, adenosine can cause increased risk of events.   

The side effects do not stop there. The use of adenosine should be avoided by individuals who have autonomic dysfunction, heart disease valvular stenosis, pericarditis or pericardial effusion, carotid stenosis, cerebrovascular insufficiency, hypovolemia, patients with bronchoconstriction or bronchospasm. In all these cases, the end product may exacerbate the symptoms of the diseases described.

It is also important to be very careful when administering other drugs in conjunction with adenosine. The use of dipyridamole, for example, may have potentiated its action. Besides him, caffeine and theophylline may antagonize adenosine. Have carbamazepine may increase the potential for heart block.

During the use of adenosine, is also indicated that patients monitor their blood pressure , heart rate, and if possible, do an electrocardiogram to check the effectiveness of the product.
Using adenosine   

After the drug is opened, it should be used immediately, discarding possible remains. The solution must be clear at the time of use. The injection time should be between one and two seconds (rapid injection), the closest possible location in the body of the patient. Adenosine should not be administered into the veins of the hands or feet.

The correct dose for adults is 6 milligrams. If supraventricular tachycardia paroxysmal is not cleared in one to two minutes, administration of 12 milligrams more of the product is planned. One can also repeat the dose of 12 milligrams is required, but with medical prescription and orientation.

In children, a dose of adenosine should be at 0.05 to 0.1 milligram per kilogram of body weight. If necessary, the dose may be increased every two minutes by 0.05 milligram per kilogram of body weight up to a maximum dose of 0.3 milligram per kilogram of body weight.

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