CodeBlue
Drug Reference

Rhythm

Adenosine

Endogenous purine nucleoside (AV nodal blocker)

SVTAdult6 mg rapid IV push + 20 mL NS flush; then 12 mgPeds0.1 mg/kg (max 6 mg); then 0.2 mg/kg (max 12 mg)

Indications

  • Stable regular narrow-complex SVT
  • Regular monomorphic wide-complex tachycardia (diagnostic/therapeutic)

Contraindications & cautions

  • 2nd/3rd degree AV block or sick sinus without pacer
  • Irregular or polymorphic wide-complex tachycardia
  • Pre-excited AFib
  • Severe asthma / active bronchospasm (relative)

Key pearls

  • Half-life < 10 s: use the most proximal IV with a stopcock flush
  • Reduce to 3 mg via central line, with dipyridamole or carbamazepine, or after heart transplant
  • Theophylline/caffeine blunt the effect
  • Expect transient asystole, flushing, chest tightness

Used in

Adult Tachycardia with a Pulse Pediatric Tachycardia