Adult Dosing
Paroxysmal supraventricular tachycardia
- Initial: 6 mg IV bolus over 1-2 secs
- If PSVT not eliminated in 1-2 min, give 12 mg IV rapid bolus. May repeat additional 12 mg dose if needed
- Note: Should be given as a rapid bolus by the peripheral intravenous route, either directly into a vein or, if given into an IV line, it should be given as close to the patient as possible and followed by a rapid saline flush
Myocardial perfusion scintigraphy
- 140 mcg/kg/min IV infusion over 6 minutes (total dose of 0.84 mg/kg)
- Thallium-201 should be injected at the midpoint of the Adenosine infusion
Pediatric Dosing
Paroxysmal supraventricular tachycardia
- Initial: 0.05-0.1 mg/kg IV bolus given either centrally or peripherally followed by saline flush
- If PSVT not eliminated in 1-2 mins, give incrementally higher doses, 0.05-0.1 mg/kg until sinus rhythm is established
- Max: 0.3 mg/kg or Max 12mg
- Pediatric patients with a body weight
50 kg: Adult dose
[Outline]
- Adenosine infusion can case fatal cardiac arrest, sustained ventricular tachycardia and nonfatal myocardial infarction, incidence is more in patients with unstable angina, appropriate resuscitative measures should be readily available
- Adenosine exerts direct depressant effect on the SA and AV nodes and can result in first-, second- or third-degree AV block, or sinus bradycardia, use cautiously in patients with pre-existing first-degree AV block or bundle branch block and avoid in high-grade AV block or sinus node dysfunction
- Transient or prolonged episodes of asystole and ventricular fibrillation has been reported following adinosine administration, incidence is more with concomitant use of digoxin or digoxin and verapamil, use cautiously in these patients and provide appropriate resuscitative therapy
- Ventricular premature contractions, atrial premature contractions, atrial fibrillation, sinus bradycardia, sinus tachycardia, skipped beats, and varying degrees of A-V nodal block generally lasting only a few seconds may appear on the ECG
- Adenosine infusion increase minute ventilation (Ve) and reduce arterial PCO2 causing respiratory alkalosis
- Adenosine inhalation causes bronchoconstriction, use cautiously in obstructive lung disease not associated with bronchoconstriction and avoid in patients with bronchoconstriction or bronchospasm
- Adenosine causes significant hypotension as it is a potent vasodilator, discontinue the therapy if patient develops persistent or symptomatic hypotension
- Increases in systolic and diastolic pressure have occurred with adenosine infusion
Cautions: Use cautiously in
- Obstructive lung disease not associated with bronchoconstriction
- Concomitant use of digoxin or digoxin and verapamil
- Autonomic dysfunction
- Stenotic valvular heart disease
- Pericarditis or pericardial effusions
- Stenotic carotid artery disease
- Hypovolemia
Pregnancy Category:C
Breastfeeding: Safety Unknown.
