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Adenosine has uses as both a diagnostic and therapeutic agent. Adenosine’s use as a pharmacological drug works through receptors called purinergic adenosine receptors found throughout the body. As a diagnostic agent, adenosine can be utilized in myocardial perfusion stress imaging due to its vasodilatory effects. As a therapeutic agent, adenosine can be used due to its antiarrhythmic properties in supraventricular tachycardia (SVT). This activity reviews the indications, contraindications, activity, adverse events, and other critical elements of adenosine use and highlights the role of the interprofessional team in managing the care of patients receiving adenosine. Objectives: Identify the mechanism of action of adenosine, and explain how it works in treating paroxysmal supraventricular tachycardia. Outline the diagnostic significance of adenosine in cardiac stress testing. Summarize the most common adverse events associated with adenosine. Review the importance of coordinating and collaborating among various disciplines in an interprofessional health team to coordinate care and management to enhance outcomes for patients receiving adenosine. Access free multiple choice questions on this topic.

Due to the rapidly short half-life of adenosine, the toxic effects of adenosine are kept to a minimum. However, there have been reports of severe effects involving prolonged asystole, development of heart block, and cardiac ischemia with adenosine. Unless the patient sustains a permanent injury, these effects are transient, and patients should receive appropriate supportive measures.

Healthcare workers, including cardiologists, nurse practitioners, and pharmacists, who plan to use adenosine, should be very familiar with the indications and contraindications. Any patient receiving adenosine should be on a form of cardiac monitoring. Patients receiving treatment for supraventricular tachycardia (SVT) are often on a 12-lead electrocardiogram rhythm monitoring to assess the underlying rhythm, while adenosine actively affects the AV node. In cases of Wolf-Parkinson-White (WPW) syndrome, a defibrillator should be available in case of rapid decompensation. If one has never used adenosine before, it is important to first speak to a cardiologist. It would also benefit the clinician to consult a cardiology board-certified pharmacist to ensure proper dosing for the application at hand. Cardiology specialty-trained nurses can also assist in administering the drug, helping during a pharmacological stress test, or following up when using adenosine therapeutically. Open communication must exist between the clinician, cardiologist, nurses, and pharmacists so that an interprofessional team works on the case and the patient receives the optimal benefit. [Level 5]