NEODOSE

INDICATIONS

• Acute treatment of sustained paroxysmal supraventricular tachycardia.
• It may also be useful in establishing the cause of the SVT.

CONTRAINDICATIONS/PRECAUTIONS

Contraindicated in patients with second- or third-degree AV block and patients with sinus node disease, such as sick sinus syndrome or symptomatic bradycardia (except patients with functioning pacemaker). Cardiac arrest, in some cases fatal, sustained ventricular tachycardia (requiring resuscitation), and myocardial infarction have been reported following adenosine infusion. Patients with signs or symptoms of acute myocardial ischemia (eg, unstable angina or cardiovascular instability) have an increased risk for serious cardiovascular reactions with adenosine administration; therefore, avoid use in these patients. Cardiac resuscitative measures should be available prior to infusion. Hemorrhagic and ischemic cerebrovascular accidents have been reported. Seizures (new or recurrent) have been reported and may require emergent management. Concomitant use of aminophylline increases the risk of seizures. Hypersensitivity reactions, including dyspnea, tightening of the throat, flushing, erythema, rash, and chest discomfort, have been reported and may require symptomatic treatment or resuscitative measures.

ADVERSE EFFECTS

Flushing, dyspnea, and irritability occur frequently, but usually resolve within 1 minute. Transient (duration less than 1 minute) arrhythmias may occur between termination of SVT and onset of normal sinus rhythm. Apnea has been reported in one preterm infant. Recurrence of SVT occurs in approximately 30% of treated patients. Aminophylline/Theophylline and caffeine diminish adenosine’s effect by competitive antagonism.

ADMINISTRATION

Administer as a rapid IV bolus over 1 to 2 seconds. Infuse directly into a vein or as close to the patient as possible. Follow with a rapid saline flush of 5 to 10 mL after each bolus. Concentration: Dilutions of a 3 mg/mL vial can be made with NS for doses less than 0.2 mL (600 mcg). Use 1 mL (3000 mcg) with 9 mL NS to make a solution with a final concentration of 300 mcg/mL.

MONITORING

Continuous EKG and blood pressure monitoring.