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Adenosine Injection Drug Class Antiarrhythmic (Class V) Endogenous nucleoside Mechanism of Action Acts on A1 receptors in the AV node Increases potassium efflux and decreases calcium influx Causes temporary AV nodal block Interrupts re-entry circuits involving the AV node Indications Paroxysmal supraventricular tachycardia (PSVT) AV nodal re-entrant tachycardia (AVNRT) AV re-entrant tachycardia (AVRT) Diagnostic use in regular narrow-complex tachycardia Dosage (Adults) First dose: 6 mg IV rapid bolus If no response after 12 minutes: 12 mg IV May repeat 12 mg once if needed Administration tips Give via large-bore IV (preferably antecubital) Follow immediately with normal saline flush Continuous ECG monitoring required Onset and Duration Onset: seconds Half-life: 48 h Coagulopathy, severe illness Note: IV pantoprazole should be limited to patients who cannot take oral therapy or need urgent acid suppression