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What are the recommendations for use of adenosine?
Adenosine is the drug of choice in the acute management of supraventricular tachycardia. It is a short-acting agent (half-life of approximately 10 seconds) that slows atrioventricular node conduction. The initial dose is 0.1 mg/kg, given as a rapid intravascular push with an immediate saline flush. If the drug is not given rapidly, its effectiveness is diminished. If the first dose is properly administered but ineffective, give a larger second dose of 0.2 mg/kg. Usual adult doses are 6 mg (first dose), followed by 12 mg (second dose). Expect that the first dose might be completely ineffective or only transiently effective. Administration of subsequent higher doses generally yields success.
Sources
Dixon J, Foster K, Wyllie J, Wren C: Guidelines and adenosine dosing in supraventricular tachycardia. Arch Dis Child 2005;90:1190-1191.
