Conversion to a normal sinus rhythm of paroxysmal supraventricular tachycardias (PSVT), including those associated w/ accessory by-pass tracts (Wolff-Parkinson-White Syndrome). Aid to diagnosis of broad or narrow complex supraventricular tachycardias. Sensitisation of intra-cavitary electrophysiological investigations.
Adult Initially 3 mg given as rapid IV bolus (over 2 sec) followed by 6 mg IV bolus as 2nd dose if 1st dose does not result in supraventricular tachycardia elimination w/in 1-2 min, or 12 mg IV bolus as 3rd dose if 2nd dose does not result in supraventricular tachycardia elimination w/in 1-2 min. Childn <50 kg Initially 0.05-0.1 mg/kg IV bolus given centrally or peripherally, followed by 2nd dose as additional bolus inj administer at incrementally higher doses by 0.05-0.1 mg/kg if PSVT conversion does not occur w/in 1-2 min, continue until sinus rhythm is established. Max dose: 0.3 mg/kg single dose (up to 12 mg).
Discontinue in patients who develop persistent or symptomatic hypotension, & severe resp difficulties. Patients w/ recent MI, severe heart failure, or minor conduction defects (1st degree AV block, bundle branch block); obstructive lung disease not associated w/ bronchoconstriction (eg, bronchitis, emphysema). Cardiac denervation in patients who have undergone cardiac transplantation. Avoid use in patients w/ bronchoconstriction or bronchospasm (eg, asthma). Possible transient cardiac arrhythmias. May develop increased conduction down the anomalous pathway in patients w/ atrial fibrillation or flutter & especially in those w/ an accessory by-pass tract. Continuous ECG monitoring during administration. Not recommended during pregnancy. Not to be used during lactation. Childn 0-18 yr.
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