This fundamental building block of life will stop your heart – just long enough to be useful - Christina Shenvi MD PhD
image by: Medthusiast
Adenosine is one of components of RNA, but given intravenously, it works to terminate SVTs by binding to the AV node’s A1 receptors. This inhibits adenylyl cyclase, ultimately increasing potassium efflux from the cell, causing hyperpolarization, and thereby “blocking” the AV node. This prevents atrial impulses from reaching the ventricles through the AV node, and also blocks re-entrant tachycardias that rely on conduction through the AV node.
Typical doses for terminating SVT are 6mg rapid IV push and flush in a proximal, large bore IV. If this is ineffective, then two subsequent doses of 12mg can be attempted. In children under 50kg, the dose is 0.05-0.1mg/kg. This dose can be increased by 0.05-0.1mg/kg and attempted twice more, with a maximum dose of 0.3mg/kg or 12mg. There are no dosing adjustments needed for patients with renal or liver disease.
If the first dose does not result in elimination of the supraventricular tachycardia within 1-2 minutes, 12 mg should be given as a rapid intravenous bolus. This 12 mg dose may be repeated a second time if required.
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