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About these monographs





Antiarrhythmic (Singh Vaughan Williams Class V) neurotransmitter


Narrow complex tachycardias (Supraventricular Tachycardia or SVT)

Mechanism of Action:

Slows the action potential conduction through the AV node.  Inhibits slow inward calcium movement and activation of adenylate cyclase in smooth muscle causing relaxation  Increases coronary blood flow and mild vasodilation

Pharmacokinetics: (intravenous)

Onset: 5-20 seconds

Peak Effects: 10-15 seconds

Duration: <30 seconds


Hypersensitivity to adenosine. Sick sinus syndrome, or previous 2nd or 3rd degree heart blocks, or heart transplant, without internal pacemaker.

Adverse Effects:

Flushing, dyspnoea, chest pain, nausea, headache, dizziness, hypotension, transient arrhythmias, weakness, sense of impending doom.

Precautions and Facts:

Caution with Asthma or COPD history.

WPW syndrome may present as fast atrial fibrillation, administration in this setting may precipitate VF Reduce effect in distal or low flow IV lines.

Each administration is followed by 10-20 mL fluid flush


6 or 12 mg in 2 mL ampoules


Route: IV


Age: Adult

Initial Dose: 6 mg rapid push,  subsequent 12 mg.

Dose Intervals: 1-2 minutes

Volume/Dilution: n/a

Maximum Dose: 3 doses

Age: Paediatric

Initial Dose: 0 1 mg/kg, subsequent 0.2 mg/kg

Dose Intervals: 1-2 minutes

Volume/Dilution: n/a

Maximum Dose: 3 doses

Cite as: Maria, S., Colbeck, M., & Caffey, M. (Eds.). (2020). Adenosine. In Paramedic & Emergency Pharmacology Guidelines (2nd ed.). Melbourne, Victoria: Pearson.

This book is for information purposes only and is designed as a general reference for paramedics, students and healthcare professionals  No responsibility will be taken for inaccuracies, omissions or errors  The authors do not accept liability to any person or organization for the information that may result in loss or damages incurred as a result of reliance upon the material in this guide While every effort has been made to ensure that the information in this text is up to date, accurate and in accordance with current clinical recommendations and practice, the dynamic nature of healthcare and pharmaceutical information requires any student or health professional to exercise independent clinical judgement when referring, using or providing information from this book


A body of evidence for the development of this guide has been collected by the authors to support the pharmacokinetics, indication, contraindications, adverse effects and dosage behind each medication  This body reflects information provided by Australia’s Therapeutic Goods Administration, Monthly Index of Medical Specialities, the United States’ Food and Drug Administration, and both peer-reviewed studies and clinical trials demonstrating the approved efficacy, usage and current understanding of each medication  Additionally, the Australian Resuscitation Council guidelines and each state ambulance service’s clinical practice guidelines in Australia and New Zealand were reviewed and applied in order to maximize the clinical application of this reference guide  Lastly, this guide’s information is not endorsed, nor does it reflect preferences by any particular pharmaceutical company or ambulance service as this reference was compiled only to the most current and universal information available from the above listed, publicly available resources

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