Pharmacologic Therapy of Supraventricular Tachycardia

-Adenosine (Adenocard) 6 mg rapid IV over 1-2 sec, followed by saline flush, may repeat 12 mg IV after 2-3 min, up to max of 30 mg total OR -Verapamil (Isoptin) 2.5-5 mg IV over 2-3min (may give calcium gluconate 1 gm IV over 3-6 min prior to verapamil); then 40-120 mg PO q8h [40, 80, 120 mg] or verapamil SR 120-240 mg PO qd [120, 180, 240 mg] OR -Esmolol hydrochloride (Brevibloc) 500 mcg/kg IV over 1 min, then 50 mcg/kg/min IV infusion titrated to HR of <60 (max of 300 mcg/kg/min) OR -Diltiazem (Cardizem) 0.25 mg/kg IV over 2-5 minutes OR -Propranolol 1-5 mg (0.15 mg/kg) given IV in 1 mg aliquots; then propranolol-

LA 60-320 mg PO qd [60, 80, 120, 160 mg] OR -Digoxin 0.25 mg q4h as needed; up to 1.0-1.5 mg; then 0.125-0.25 mg PO qd.

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