A 4-year-old child presents with intermittent palpitations. ECG shows a narrow QRS tachycardia at 230 bpm with no visible P waves before the QRS and abrupt onset. After vagal maneuvers fail, the drug of choice for acute termination of this likely SVT is:
- A IV adenosine 0.1 mg/kg rapid push ✓
- B IV verapamil 0.1 mg/kg
- C IV digoxin 0.02 mg/kg
- D IV amiodarone 5 mg/kg over 30 minutes
Correct answer: A. IV adenosine 0.1 mg/kg rapid push
Explanation
Adenosine is the drug of choice for acute termination of SVT in children. It is given as a rapid IV bolus at 0.1 mg/kg (max 6 mg first dose; can escalate to 0.2 mg/kg/12 mg if no response) due to its extremely short half-life (< 10 seconds). It terminates most re-entrant SVTs by transiently blocking the AV node. Verapamil is contraindicated in infants and toddlers under 1 year due to risk of cardiovascular collapse. Amiodarone is reserved for hemodynamically unstable tachycardias.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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