Adenosine is an antiarrhythmic drug that is used in the clinical setting to treat supraventricular tachycardia or SVT. In today's mnemonic video, we're heading to the Deno's Diner where I'll teach you my mnemonic to remember adenosine, including its mechanism, clinical uses, and side effects. Everybody loves a good meal from Deno's. This Deno's Diner reminds me of the drug adenosine.
Because adenosine sounds a lot like denos, right? You can even remember it by thinking adenosine. Now let's take a look at how adenosine works.
This denos uses an iPad system to allow customers to view the menu and pay for their meal. Except it looks like their system has run into a bit of a malfunction. See how there's static covering the iPad screen? Here at Pixerize, we use static on a screen as our symbol for arrhythmia. Because that irregular static line looks a lot like the rhythm strip of an arrhythmia, right?
Adenosine is an antiarrhythmic medication, meaning that it is used to treat certain arrhythmias, which we'll cover next. Adenosine works to slow the electrical conduction through the AV node, slowing down the heart. Next, let's talk about when adenosine is used.
With the restaurant's system not working, there's a big backup here at Denno's. This man sitting at the table has been waiting a really long time for his food. And, like most people who are tired of waiting, he's rapidly tapping his fingers on the table.
These fast-tapping fingers remind me of supraventricular tachycardia, also called SVT, because SVT is really just a fast heart rhythm, and these fingers are tapping really fast. Get it? Adenosine is the first-line medication used to treat SVT in the clinical setting.
By slowing down conduction through the AV node, adenosine can break down the electrical circuits that cause SVT, restoring the heart to a normal sinus rhythm. So, just remember that adenosine can be used to treat SVT. Got that? It looks like the waitress was so behind that she was running around with this push cart. As she stops momentarily to catch her breath, that push cart speeds away from her grasp.
This fast-moving push cart reminds me of the ultra-fast action of adenosine. As such, we need to administer adenosine extra fast via rapid IV push. Get it? A fast push cart for rapid IV push. Let me explain.
Adenosine has a very short half-life, and by short, we're talking less than 10 seconds. Because of this, adenosine has to be given quickly in the hospital setting via rapid IV push. This is something that's unique to adenosine, because with most other medications, you give them slowly, over 1-2 minutes. But with adenosine, the drug basically goes away within 10 seconds. So to get the whole dose working in the body, you've got to administer it extra fast.
There's a chance that the NCLEX will ask you about how to administer adenosine. Remember to give it via rapid IV push immediately followed by a saline flush. This way, all the medication can get into the bloodstream and have its full effect on the body before it disappears. This short half-life also means that the side effects of adenosine will also only last for a couple of seconds.
So let's quickly cover those next. This Deno's diner is getting out of control. Good thing the manager is here. See him there in the back?
He's rushing into the restaurant signaling time out. He needs all the employees to stop for a couple of seconds so that he can get things organized and help his employees manage without their ordering system. This is actually really similar to how adenosine works. I mentioned earlier that adenosine slows down the electrical impulses in the heart, but to take it one step further, adenosine can actually completely stop the heart for a few seconds before it is able to convert to a normal sinus rhythm.
This is what we call transient asystole. Transient meaning temporary and asystole meaning a flatline heart rhythm while the heart isn't beating. When giving adenosine, the patient should always have heart monitoring in place.
As the nurse, don't be too alarmed if the patient goes into asystole after administration. The heart should restart on its own after a couple of seconds. If the adenosine administration is successful, when the heart restarts, it will be in normal sinus rhythm. If it is not successful, the heart will continue to be in SVT and additional measures such as cardioversion might be needed. But that's getting a little ahead of ourselves.
Just remember that adenosine can cause transient asystole, or temporary flatline, and you'll be set for test day. Remember that runaway push cart from earlier? Well… not only is it rolling away from the waitress, but it's actually slammed into our customer right in the chest. Oof, that's gotta hurt.
Which reminds me, another side effect of adenosine is chest pain. Get it? It in the chest for chest pain?
Like you could imagine, having your heart stop for a few seconds is not a pleasant experience. The patient will most likely experience chest pain for a couple seconds after the adenosine is administered. Turns out that man isn't just any old customer.
He's an important restaurant critic. Yeah, things are not looking good here. And you can see it all on the waitress's face. She has a feeling things are not going to end well. On that note, another feeling that accompanies transient asystole is a sense of impending doom.
Believe it or not, that is actually a medical term. And it's pretty self-explanatory. The patient will have a feeling of dread or a feeling that something really bad is about to happen.
This is thought to be related to the transient asystole we talked about earlier. A sense of doom, just like how this waitress feels. Easy, right?
It's pretty apparent this waitress has been running around all day by how red her face is. Because faces often turn red when we're pushing ourselves extra hard, right? Speaking of red faces, another side effect of adenosine is flushing of the face. So, you can use this waitress's red face to help you remember that flushing is another side effect of adenosine. Adenosine causes vasodilation and flushing occurs when that vasodilation happens close to the surface of the skin.
And not only does this waitress have a flushed face, but she is obviously out of breath. See how her tongue is out and she's bent over like that? The final side effect of adenosine that you need to remember on test day is dyspnea.
Just like this waitress here, patients who receive adenosine may feel like they can't catch their breath or that they are having trouble breathing. Just like with all medications, some patients are able to tolerate adenosine better than others, and these side effects are less severe. However, for others, receiving adenosine will be an extremely uncomfortable experience. Because of this, it is important to explain and teach these possible side effects to the patient before administering adenosine, so the patient doesn't completely panic when they can't breathe and they feel like they're dying.
Alright, that's everything you gotta know about adenosine. Let's recap and get you on your way. Adenosine is an antiarrhythmic drug that is used to treat supraventricular tachycardia, or SVT.
By slowing down conduction in the AV node, adenosine can convert SVT into a normal sinus rhythm. Importantly, adenosine has an extremely short half-life of less than 10 seconds, so it needs to be given via a rapid IV push. While its side effects only last for a few seconds, these side effects are very notable and include transient asystole, often accompanied by chest pain, a sense of impending doom, flushing, and dyspnea.
And that's a wrap! Hopefully the manager can put a stop to this crazy mess and get this denno's restaurant back to its normal rhythm. Get it? You know, like a denno scene puts a stop to… Okay, yeah yeah, you get it. I'll see you in the next one.
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