What is the sequence of administering adenosine for a regular narrow tachyarrhythmia?

The progression of administering adenosine for a regular narrow tachyarrhythmia is critical for effective treatment. The correct sequence begins with a dose of 6 mg, which is the initial recommended dose. If the first dose does not achieve the desired effect—meaning that return to normal sinus rhythm is not observed—an increased dose of 12 mg is then given as a second attempt. This approach stems from the need to start with a smaller dose to minimize potential side effects and to gauge the patient's response to treatment. In cases where the first two doses do not result in a therapeutic effect, escalating the dose further, such as to 18 mg, is not part of the standard procedure. Typically, 6 mg and then 12 mg are the recommended increments before considering further interventions or alternative treatments. This rationale ensures that the administration of adenosine is both efficient and safe, adhering to guidelines that focus on patient care.