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Question :

Posted On : 15 May 2017

HOW MANY DOSES OF Adenosine IDEALLY RECOMONDED TO ABORT SVT_?
WHEN TO GO FOR SECOND LINE DRUG_?WHICH DRUG IS PREFFRED AMINODARONE OR B-BLOCKER.
IS THERE VERPAMIN IS SAFE IN CHILDREN WITH SVT_?

Expert Answer :

Answer Discussion :

T

Thiago Barboza

0

one dose. amiodqrone is preferred for less risk of AV BLOQ.

7 years ago

R

reda dabish

0

3 doses
amiodarone
unsafe

7 years ago

A

ApoorvaT Raju

0

10 doses.. b blocker...not safe

7 years ago

A

Alish Rajesh Mehta

0

2 doses of Adenosine.
Amiodarone.
Verapamil is not safe.

7 years ago

K

Kailash

0

two
amiodarone
no

7 years ago

Answer 1

Give 0.05 to 0.1 mg, kg as a rapid IV bolus given either centrally or peripherally. A saline flush should follow.

Repeat administration: If conversion of PSVT does not occur within 1-2 minutes, additional bolus injections of Adenosine can be administered at incrementally higher doses, increasing the amount given by 0.05 to 0.1 mg, kg. Follow each bolus with a saline flush. This process should continue until sinus rhythm is established or a maximum single dose of 0.3 mg, kg is used.
If LV function is not too bad and if there is no wheeze, you could certainly consider beta blockers.
Amiodarone can also be used in chldren. It takes time to act even when given IV due to its peculiar pharmacokinetics. It is reasonably safe in children but if one decides to give it long term in children, they need to be monitored closely. Thus, patients could be converted with Amiodarone iif the need be and subsequently could be maintained on beta blcokers or Digoxin for preventing the recurrence.
We have not been using IV Verapamil in infants and small chldren for the fear of asystole.

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