Neonatal Drug Therapy Manual


Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Original Date: 
March 1993
Revised Date: 
November 2012
  • Treatment of  paroxysmal supraventricular tachycardia (PSVT)
  • Rapid IV direct: by physician only, administer over 1 - 2 seconds at peripheral IV site closest to patient's heart (IV administration into lower extremeties may result in therapeutic failure or requirement of higher doses) 
  • Slow administration has been associated with treatment failure
  • 0.1 mg/kg. If not effective within 1 - 2 minutes, increase dose by 0.05 - 0.1 mg/kg increments every 1 - 2 minutes to a maximum single dose of 0.3 mg/kg or until termination of PSVT
  • Follow each dose with a 0.9% NaCl flush
Side Effects: 
  • CVS: AV block, sinus bradycardia, atrial flutter/fibrillation, ventricular extrasystole, facial flushing, hypotension
  • Respiratory: bronchospasm
Parameters to Monitor: 
  • BP
  • ECG
  • RR
Reconstitution and Stability: 
  • Dilution can be made with 0.9% NaCl for doses < 0.2 mL (600 mcg or 0.6 mg). Use 1 mL (3000 mcg or 3 mg) with 9 mL of 0.9% NaCl to make a solution with a final concentration of 300 mcg/mL or 0.3 mg/mL
  • Do not mix with other drugs
  • Higher doses may be required in the presence of caffeine or aminophylline
  • For serious adverse effects (ie. atrio-ventricular block, severe bronchospasm) treat with aminophyline 6 mg/kg IV over 20 minutes
  • Defibrillator and personnel competent with procedures requiring such equipment are required at bedside for the safe administration of adenosine.  Areas outside critical care and ED will activate the SPOT Team/PICU who will bring the Code Blue Cart.  The SPOT Team/PICU will remain on site until the SPOT Team and Primary Care Team determine that the defribillator and personnel are no longer required.

- Taketomo CK, Hodding JH, Kraus DM.  Pediatric Dosage Handbook 19th Edition. Hudson: Lexi-Comp Inc.; 2012 

-  Lau E. (Editor). Drug Handbook and Formulary- The Hospital for Sick Children.  Toronto: 2012-13.



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