Supraventricular Tachycardia Management

Medication Administration

The American Heart Association recommends administering metoprolol intravenously at 5 mg over 1-2 minutes, which can be repeated at 5-minute intervals up to a maximum total dose of 15 mg for patients with supraventricular tachycardia (SVT) 1, 2
For patients with SVT, adenosine can be administered as a 6 mg rapid IV bolus followed by saline flush; if ineffective, 12 mg can be given, repeated once if necessary 1, 2
Esmolol can be used as an alternative beta blocker, administered as a 500 mcg/kg IV bolus over 1 minute, followed by infusion at 50-300 mcg/kg/min for patients with SVT 2
The American College of Cardiology recommends using diltiazem as a calcium channel blocker, administered at 0.25 mg/kg IV over 2 minutes, followed by infusion at 5-10 mg/hour for patients with SVT 1, 2

Beta blockers should be avoided in patients with pre-excited atrial fibrillation/flutter, as they can potentially accelerate ventricular response in patients with accessory pathways 1
Combining beta blockers with other AV nodal blocking agents with longer half-lives should be avoided due to the risk of profound bradycardia 1
Metoprolol should be used with caution in patients with reactive airway disease, although its cardioselectivity makes it safer than non-selective beta blockers 1, 2

Blood pressure should be monitored closely during metoprolol administration due to the risk of hypotension 1, 2