Which best describes the initial dose administration for Adenosine in adults?

• A. Rapid IVP followed immediately by 20 cc NS bolus, and Adenosine, 6 mg rapid IVP followed immediately by 20 cc NS bolus if patient does not convert. May repeat one (1) time.
• B. Slow IV infusion over 2 minutes
• C. Oral administration
• D. Subcutaneous injection

Answer: (A)

Adenosine must be given as a rapid IV push with a saline flush because it has an extremely short half-life and acts only while it is in the heart. Delivering it quickly ensures it reaches the AV node to transiently block conduction and terminate the SVT. The recommended approach starts with a rapid 6 mg IV bolus, immediately followed by a 20 mL saline flush to push the drug into the central circulation. If the patient does not convert, you can give a higher dose (typically 12 mg) with another saline flush, and you may repeat once. This approach contrasts with slow infusions, oral dosing, or subcutaneous injections, which do not deliver the drug to the heart quickly enough or at the right site to be effective.