Adenosine is allowed to be used only for inpatient treatment using equipment that is used for cardiopulmonary resuscitation. During the application of adenosine, it is necessary to monitor the ECG continuously, since there is a risk of arrhythmias.
The first dose is 3 mg; if the tachycardia continues after 1-2 min, a second dose (6 mg) is given; if after another 1-2 minutes no improvement is observed, the third dose (9 mg) is administered; if cessation of tachycardia did not occur after 1-2 min, a fourth dose (12 mg) was administered.
Since the first dose (3 mg) has poor efficacy, adenosine therapy usually begins with the second dose (6 mg).
If the 4th dose (12 mg) did not give the desired result, the solution can be administered again in the same dosage, or increasing it to 18 mg. After this, administer the drug at the same dose or higher is not recommended.
All the above dosages should be reduced if treatment is performed after cardiac transplantation or in combination with dipyridamole. But with treatment in combination with methylxanthine, the dosage of adenosine should be increased.
Adenosine is administered by a bolus injection, which lasts 1-2 sec. It should be inserted into the large peripheral veins, and then it is recommended to immediately inject 0.9% NaCl solution (10 ml).
Use of adenosine in the process of diagnosis of cardiac ischemia.
Radioisotopes and adenosine should be poured into different veins - this is necessary in order to avoid a bolus effect.
In the SPECT process using thallium-201, intravenous adenosine is administered in 6 minutes (the rate is 140 μg / kgCmin). Thallium-201 in this case should be rapidly introduced into the vein 3 minutes after the introduction of adenosine.
To avoid the appearance of a bolus effect, during the adenosine maintenance it is necessary to monitor the blood pressure in the other hand.