Prescribing information
Termination/diagnosis of SVT
- By rapid intravenous injection into a central or large peripheral vein.
- The recommended initial dose is 3 mg, but many patients do not respond to this, so some doctors begin with 6 mg.
- If the first dose is ineffective, repeat after 1-2 minutes with 6 mg and then 12 mg.
- Follow each dose with a large (10-20 mL) saline flush to ensure rapid delivery to the heart.
- Do not increase the dose if high-degree AV block develops at any dose.
- If adenosine is ineffective after 12 mg, stop and consider another drug (see box above) or direct current (DC) cardioversion.
Myocardial nuclear imaging (specialized use)
- By continuous intravenous infusion. Suggested dosage 140 micrograms/kg/min for 6 minutes.
Termination/diagnosis of SVT
- Adenosine works by causing temporary complete sinoatrial (SA) and atrioventricular (AV) block. This can allow normal sinus rhythm to resume.
- Obtain a 12-lead electocardiogram before treatment, to confirm the diagnosis.
- In particular, this may well help distinguish an SVT with aberrant conduction from VT.
- If the patient is compromised and you suspect VT, do not delay treatment by using adenosine for diagnostic purposes.
- Ensure that there are adequate facilities for resuscitation, and that the patient has continuous cardiac monitoring.
- Adenosine is given by intravenous bolus only. See below for a suggested regimen.
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