adenosine in cardiac resuscitation

Last reviewed 01/2018

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.