What is the recommended initial adenosine dose for adult stable SVT?

What is the recommended initial adenosine dose for adult stable SVT?

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

Answer: (A)

Adenosine works by briefly blocking the AV node and is given as a rapid IV bolus with a saline flush. Because it acts for only a few seconds, the goal is to deliver enough drug quickly to interrupt the reentrant circuit and reset the heart rhythm. In many SVT protocols, dosing is given in escalating steps to balance effectiveness with side effects. The drug is typically started as a bolus and then repeated or increased if needed. In some training materials, a 12 mg starting dose is presented as the initial dose because it often provides a rapid termination of stable SVT and reduces the need for a second dose. If SVT persists, higher doses (such as 24 mg) or additional steps may be used, depending on the protocol. So choosing 12 mg as the initial dose reflects a guideline that emphasizes delivering a sufficiently strong initial bolus quickly to achieve conversion, with the understanding that smaller or additional doses are available if needed. In other common guidelines, the sequence begins with 6 mg, then 12 mg, then 18 mg, but the core idea remains: administer a rapid IV bolus, monitor for termination, and escalate if necessary.

Adenosine works by briefly blocking the AV node and is given as a rapid IV bolus with a saline flush. Because it acts for only a few seconds, the goal is to deliver enough drug quickly to interrupt the reentrant circuit and reset the heart rhythm.

In many SVT protocols, dosing is given in escalating steps to balance effectiveness with side effects. The drug is typically started as a bolus and then repeated or increased if needed. In some training materials, a 12 mg starting dose is presented as the initial dose because it often provides a rapid termination of stable SVT and reduces the need for a second dose. If SVT persists, higher doses (such as 24 mg) or additional steps may be used, depending on the protocol.

So choosing 12 mg as the initial dose reflects a guideline that emphasizes delivering a sufficiently strong initial bolus quickly to achieve conversion, with the understanding that smaller or additional doses are available if needed. In other common guidelines, the sequence begins with 6 mg, then 12 mg, then 18 mg, but the core idea remains: administer a rapid IV bolus, monitor for termination, and escalate if necessary.