Drug doses and cautions

Adenosine 3mg IV as a rapid bolus. If no response in 1min give 6mg followed by 12mg.

Verapamil 2.5mg IV slowly. If no response repeat to a maximum of 20mg. An intravenous infusion of 1-10mg may be used. 10ml CaCl 10% should be available to treat hypotension associated with verapamil. Verapamil should be avoided in re-entry tachyarrhythmias since ventricular response may increase. Life threatening hypotension may occur in misdiagnosed ventricular tachycardia and life threatening bradycardia may occur if the patient has been p-blocked.

Lidocaine

1mg/kg intravenously as a bolus followed by an infusion of 2-4mg/min.

Amiodarone

5mg/kg over 20min then infused at up to 15mg/kg/24h in 5% glucose via a central vein. Avoid with other class III agents (e.g. sotalol) since QT interval may be severely prolonged.

Magnesium 20mmol MgSO4 over 2-3h. In an emergency it may be given over 5min

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