← Back to Session

Time Completed: 01:08:33

Final Score 46%

83
97

Questions

  • Q1. Correct
  • Q2. X Incorrect
  • Q3. Correct
  • Q4. Correct
  • Q5. X Incorrect
  • Q6. Correct
  • Q7. X Incorrect
  • Q8. Correct
  • Q9. X Incorrect
  • Q10. Correct
  • Q11. Correct
  • Q12. Correct
  • Q13. Correct
  • Q14. Correct
  • Q15. X Incorrect
  • Q16. X Incorrect
  • Q17. Correct
  • Q18. X Incorrect
  • Q19. Correct
  • Q20. X Incorrect
  • Q21. X Incorrect
  • Q22. Correct
  • Q23. Correct
  • Q24. X Incorrect
  • Q25. Correct
  • Q26. Correct
  • Q27. Correct
  • Q28. X Incorrect
  • Q29. X Incorrect
  • Q30. X Incorrect
  • Q31. Correct
  • Q32. X Incorrect
  • Q33. X Incorrect
  • Q34. Correct
  • Q35. X Incorrect
  • Q36. X Incorrect
  • Q37. Correct
  • Q38. X Incorrect
  • Q39. X Incorrect
  • Q40. X Incorrect
  • Q41. Correct
  • Q42. X Incorrect
  • Q43. Correct
  • Q44. X Incorrect
  • Q45. Correct
  • Q46. X Incorrect
  • Q47. X Incorrect
  • Q48. X Incorrect
  • Q49. X Incorrect
  • Q50. Correct
  • Q51. Correct
  • Q52. Correct
  • Q53. Correct
  • Q54. Correct
  • Q55. X Incorrect
  • Q56. Correct
  • Q57. Correct
  • Q58. X Incorrect
  • Q59. Correct
  • Q60. Correct
  • Q61. X Incorrect
  • Q62. X Incorrect
  • Q63. X Incorrect
  • Q64. X Incorrect
  • Q65. X Incorrect
  • Q66. X Incorrect
  • Q67. Correct
  • Q68. X Incorrect
  • Q69. Correct
  • Q70. X Incorrect
  • Q71. Correct
  • Q72. Correct
  • Q73. X Incorrect
  • Q74. Correct
  • Q75. X Incorrect
  • Q76. X Incorrect
  • Q77. Correct
  • Q78. Correct
  • Q79. X Incorrect
  • Q80. X Incorrect
  • Q81. Correct
  • Q82. X Incorrect
  • Q83. X Incorrect
  • Q84. Correct
  • Q85. X Incorrect
  • Q86. X Incorrect
  • Q87. Correct
  • Q88. X Incorrect
  • Q89. Correct
  • Q90. Correct
  • Q91. X Incorrect
  • Q92. Correct
  • Q93. X Incorrect
  • Q94. X Incorrect
  • Q95. X Incorrect
  • Q96. Correct
  • Q97. X Incorrect
  • Q98. Correct
  • Q99. X Incorrect
  • Q100. Correct
  • Q101. X Incorrect
  • Q102. Correct
  • Q103. X Incorrect
  • Q104. X Incorrect
  • Q105. X Incorrect
  • Q106. X Incorrect
  • Q107. Correct
  • Q108. X Incorrect
  • Q109. Correct
  • Q110. X Incorrect
  • Q111. X Incorrect
  • Q112. Correct
  • Q113. X Incorrect
  • Q114. Correct
  • Q115. Correct
  • Q116. Correct
  • Q117. X Incorrect
  • Q118. Correct
  • Q119. X Incorrect
  • Q120. Correct
  • Q121. Correct
  • Q122. Correct
  • Q123. Correct
  • Q124. Correct
  • Q125. X Incorrect
  • Q126. Correct
  • Q127. X Incorrect
  • Q128. X Incorrect
  • Q129. Correct
  • Q130. Correct
  • Q131. X Incorrect
  • Q132. X Incorrect
  • Q133. X Incorrect
  • Q134. X Incorrect
  • Q135. X Incorrect
  • Q136. Correct
  • Q137. Correct
  • Q138. X Incorrect
  • Q139. X Incorrect
  • Q140. Correct
  • Q141. Correct
  • Q142. X Incorrect
  • Q143. Correct
  • Q144. X Incorrect
  • Q145. X Incorrect
  • Q146. X Incorrect
  • Q147. X Incorrect
  • Q148. X Incorrect
  • Q149. X Incorrect
  • Q150. Correct
  • Q151. X Incorrect
  • Q152. X Incorrect
  • Q153. Correct
  • Q154. X Incorrect
  • Q155. X Incorrect
  • Q156. X Incorrect
  • Q157. Correct
  • Q158. Correct
  • Q159. X Incorrect
  • Q160. X Incorrect
  • Q161. Correct
  • Q162. X Incorrect
  • Q163. X Incorrect
  • Q164. Correct
  • Q165. X Incorrect
  • Q166. X Incorrect
  • Q167. Correct
  • Q168. Correct
  • Q169. X Incorrect
  • Q170. X Incorrect
  • Q171. Correct
  • Q172. Correct
  • Q173. Correct
  • Q174. X Incorrect
  • Q175. Correct
  • Q176. Correct
  • Q177. Correct
  • Q178. X Incorrect
  • Q179. X Incorrect
  • Q180. X Incorrect

Pharmacology

Cardiovascular

Question 177 of 180

Which of the following is NOT a common side effect of adenosine:

Answer:

Common side effects of adenosine include:
  • Apprehension
  • Dizziness, flushing, headache, nausea, dyspnoea
  • Angina (discontinue)
  • AV block, sinus pause and arrhythmia (discontinue if asystole or severe bradycardia occur)

Adenosine is usually the treatment of choice for terminating paroxysmal supraventricular tachycardia.

Mechanism of Action

Adenosine stimulates A1-adenosine receptors and opens acetylcholine sensitive K+ channels, increasing K+ efflux. This hyperpolarises the cell membrane in the atrioventricular node and, by inhibiting the calcium channels, slows conduction in the AVN. As it has a very short duration of action (half-life only about 8 - 10 seconds), most side effects are short lived.

Administration

For a regular narrow-complex tachycardia the first step is to attempt vagal manoeuvres. If this is unsuccessful and the tachyarrhythmia persists, 6 mg intravenous adenosine should be administered into a central/large vein over 2 seconds, followed by 12 mg after 1 - 2 minutes if required, then a further 18 mg after 1 - 2 minutes if required (max 36 mg, as per the 2021 ALS Guidelines).

The effects of adenosine are potentiated by dipyridamole, therefore if it is essential to give adenosine in a patient taking dipyridamole the dose should be quartered.

The patient should be warned that they will feel unwell and may experience chest discomfort for a few seconds following the injection. An ECG (preferably multi-lead) should be recorded during the injection. If adenosine is contraindicated, or fails to terminate a regular narrow-complex tachycardia, the administration of verapamil 2.5 - 5 mg IV over 2 mins should be considered.

Contraindications

Adenosine is contraindicated in:

  • Asthma and COPD (can cause bronchospasm)
  • Decompensated heart failure
  • Long QT syndrome
  • Second- or third-degree AV block and sick sinus syndrome (unless pacemaker fitted)
  • Severe hypotension

Side Effects

Common side effects of adenosine include:

  • Apprehension
  • Dizziness, flushing, headache, nausea, dyspnoea
  • Angina (discontinue)
  • AV block, sinus pause and arrhythmia (discontinue if asystole or severe bradycardia occur)

Report A Problem

Is there something wrong with this question? Let us know and we’ll fix it as soon as possible.

Loading Form...

Close
  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

Join our Newsletter

Stay updated with free revision resources and exclusive discounts

©2017 - 2024 MRCEM Success