The first drug used in Advanced Cardiac Life Support (ACLS) is adenosine. Adenosine is an anti-arrhythmic medication that is commonly used for the treatment of supraventricular tachycardia (SVT). SVT is a rapid heart rhythm originating from the upper chambers of the heart.
When administering adenosine, it is important to give the medication rapidly for the first dose. This is because adenosine has a very short half-life, meaning it is quickly metabolized and eliminated by the body. Rapid administration helps to ensure that the medication reaches the heart and effectively terminates the arrhythmia.
In most cases, adenosine is given as a rapid intravenous bolus. The recommended initial dose is typically 6 mg, which is administered as a fast push through a peripheral intravenous line. It is important to use a large-bore IV catheter to ensure the medication is delivered quickly. Following the rapid administration, a saline flush is often given to ensure the medication reaches the heart.
After the initial dose, if the SVT does not resolve, a second dose of adenosine may be administered. The second dose is often increased to 12 mg, again given as a rapid IV bolus. It is important to note that the second dose should only be given if the first dose is ineffective, and if the patient does not experience any adverse effects from the medication.
Adenosine works by temporarily blocking the conduction of electrical impulses through the AV node of the heart. This brief interruption in conduction can help to restore normal sinus rhythm in cases of SVT. However, it is important to monitor the patient closely during and after administration of adenosine, as it can cause transient side effects such as flushing, chest discomfort, shortness of breath, and a sense of impending doom. These side effects are usually short-lived and resolve quickly.
Adenosine is the first drug used in ACLS for the treatment of supraventricular tachycardia. It is administered as a rapid IV bolus, with the initial dose typically being 6 mg. If the arrhythmia does not resolve, a second dose of 12 mg may be given. Adenosine works by temporarily blocking conduction through the AV node, and it is important to monitor the patient closely for any side effects.