A patient in the ED presents with supra ventricular tachycardia and low blood pressure. After failing vagal maneuvers, what medication should be administered first?

Study for the Board Certified Cardiology Pharmacist Exam. Utilize flashcards and answer multiple-choice questions with detailed explanations. Prepare efficiently for your certification!

Adenosine is the appropriate first medication to administer in a patient with supraventricular tachycardia (SVT) who is experiencing low blood pressure and has not responded to vagal maneuvers. Adenosine is a highly effective and fast-acting agent that works by interrupting the reentrant pathways in the atrioventricular (AV) node, which can restore normal sinus rhythm quickly.

In the context of an emergency department setting, the rapid onset of action and short half-life of adenosine make it particularly suitable for acute management of SVT. It is typically administered as a rapid intravenous push, and its effects can be seen almost immediately, making it an ideal choice for symptomatic patients who are unstable due to their tachycardia, such as those presenting with low blood pressure.

The other medications listed have different mechanisms and indications. Atropine is mainly used for bradycardia rather than SVT and would not be appropriate in this scenario. Diltiazem, a calcium channel blocker, can be useful for rate control in certain types of SVT but is generally not the first-line agent in an acute setting, especially when the patient is unstable. Amiodarone, while effective for a variety

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