What is the maximum first-dose adenosine amount for pediatric SVT?

• A. 6 mg
• B. 12 mg
• C. 4 mg
• D. 9 mg

Answer: (A)

Adenosine for pediatric SVT is given as a rapid IV bolus with a dose of 0.1 mg/kg, but the first dose is capped at 6 mg. This limit keeps the initial dose within a safe range while still providing a high likelihood of terminating the reentrant SVT, since adenosine acts extremely quickly and its effects are short-lived. If the first dose doesn’t terminate the tachycardia, a second dose can be given at 0.2 mg/kg (up to 12 mg). Administer with a rapid flush, monitor the ECG continuously, and be prepared for brief pauses in rhythm or other transient side effects. If the patient is unstable, proceed with cardioversion rather than waiting for dosing. Thus, the maximum first-dose amount is 6 mg.