Adenosine is used therapeutically in the treatment of narrow complex tachycardias and diagnostically in the management of broad complex tachycardias.
It has a very short half life and needs to be given rapidly as a bolus. The recommended initial dose is 6 mg. If this is unsuccessful, increase the dose to 12 mg. This may be repeated a further two times if necessary. Wait at least 2 minutes between successive doses. It is not recommended to increase the dose beyond 12 mg. Alternative therapies are indicated instead.
Caution is required in patients on dipyradamole or aminophylline - which decrease the response to adenosine - and patients with asthma or atrial fibrillation.
It is contraindicated in second and third degree heart block, or sick sinus sydrome, except where a functioning pacemaker is in situ.
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