What is the maximum single dose of adenosine for the first dose in pediatric stable SVT?

What is the maximum single dose of adenosine for the first dose in pediatric stable SVT?

• A. 6 mg
• B. 12 mg
• C. 18 mg
• D. 24 mg

Answer: (A)

Adenosine works by briefly blocking conduction through the AV node, which can interrupt the reentrant loop causing SVT and reset the heart’s rhythm. Because it acts very quickly and has a very short half-life, it’s given as a rapid IV push with a saline flush to ensure it reaches the heart fast and clears quickly. In children, the first dose is started at about 0.1 mg/kg, but it’s capped to a safe maximum to minimize risks like excessive AV block or bronchospasm. That safe maximum for the initial dose is six milligrams. If the first dose doesn’t terminate the tachycardia, a second dose can be given at a higher dose (0.2 mg/kg, up to a total of twelve milligrams for the second dose). The higher numbers listed are associated with the second dose, not the initial one, and aren’t used as the first bolus.

Adenosine works by briefly blocking conduction through the AV node, which can interrupt the reentrant loop causing SVT and reset the heart’s rhythm. Because it acts very quickly and has a very short half-life, it’s given as a rapid IV push with a saline flush to ensure it reaches the heart fast and clears quickly.

In children, the first dose is started at about 0.1 mg/kg, but it’s capped to a safe maximum to minimize risks like excessive AV block or bronchospasm. That safe maximum for the initial dose is six milligrams. If the first dose doesn’t terminate the tachycardia, a second dose can be given at a higher dose (0.2 mg/kg, up to a total of twelve milligrams for the second dose). The higher numbers listed are associated with the second dose, not the initial one, and aren’t used as the first bolus.