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Adenosine

SVT (supraventricular tachycardia), Diagnostic aid for wide-complex tachycardia

Indications

  • SVT (supraventricular tachycardia)
  • Diagnostic aid for wide-complex tachycardia

Adult dosing

  • svt first: dose: 6; unit: mg; route: rapid IV push + flush; fixed: true; svt second: dose: 12; unit: mg; route: rapid IV push + flush; interval: may repeat x1; fixed: true

Pediatric dosing

  • svt first: dose: 0.1; unit: mg/kg; maxDose: 6; maxDoseAbsolute: true; route: rapid IV push; weightBased: true; svt second: dose: 0.2; unit: mg/kg; maxDose: 12; maxDoseAbsolute: true; route: rapid IV push; weightBased: true

Contraindications

  • Second/third degree AV block (without pacemaker)
  • Sick sinus syndrome (without pacemaker)
  • Known or suspected bronchospastic disease

Clinical pearls

  • Must be given as rapid IV push followed by immediate 20mL NS flush
  • Use proximal IV — most antecubital or above; wrist IVs will not work
  • Half dose (3mg) if patient on carbamazepine or dipyridamole, or via central line
  • Warn patient they will feel brief chest pressure/dread — lasts < 10 seconds

Source and review

  • ACLS Guidelines 2020, AHA. Last reviewed: 2024-10-15