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What is the mechanism of action of Adenosine in AVNRT ?

Posted Apr 22 2011 11:29am

Adenosine is a  purine analogue. Acts by stimulating outward K+ channel  of AV nodal tissue, more specifically  in the posteriorly   located  slow pathway in the vicinity of  coronary sinus.

Another action of adenosine is inhibition of cAMP , which is similar to beta blocking action may also help in terminating the tachycardia.

Adenosine : A 10 second cardiac miracle

  • 12mg bolus is administered , preferably in a central vein (Not mandatory  though)
  • Termination is usually abrupt . Transient VPDs are observed during termination.
  • Transient flushing may occur.
  • If the patient is taking Aminophylline group of drugs (Which are adenosine antagonists) the AV nodal blocking action may be neutralised .

(It may be apt to recall  at this juncture ,  Aminophylline is used in sinus node dysfunction or AV block to increase heart rate )

Reference

A good one from Medscape http://www.medscape.com/viewarticle/585287_2


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