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Adenosine เป็นยาอีกตัวหนึ่งที่มีความจำเพาะตัวค่อนข้าง สูง ประเภทมาเร็วต้องไล่ไปให้เร็วเพราะครึ่งชีวิตของยา (half life) สั้นมากเหลือเกินในร่างกายคน การฉีดยาตัวนี้จึงต้องเน้นเป็นพิเศษว่าต้องเร็ว เร็วมาก และ ผลที่ได้ก็ทันใจ อยู่ไม่นาน คนไข้หลายคนเล่าว่า รู้สึกเหมือนตก ตึกสูง,ลงรถไฟเหาะ, เหมือนหล่นลงมาแล้วมีใครปิดไฟ (มันมืด) หวิว ๆ ถ้าดูจากจอ monitor จะเห็นเป็น asystole เป็นช่วงสั้น ๆ ได้เลย จนพยาบาล แพทย์บางคนรู้สึกเสียว ไม่กล้าใช้ แต่อย่างไรก็ตาม ยานี้ก็เป็นยาตัวแรกที่แนะนำให้ใช้ในภาวะ Stable Narrow complex Regular tachycardia เช่น Supraventricular tachycardia (SVT) ด้วยความที่ออกฤทธิ์เร็ว และสั้น การเฝ้าระวังหลังฉีดแทบไม่ต้องกังวล จึงเหมาะกับการใช้ ที่ห้องฉุกเฉินเป็นอย่างยิ่ง มีคำแนะนำในการฉีด ดังนี้

1. เปิด IV ใกล้ ๆ heart เช่นบริเวณข้อพับแขน

2. เตรียมต่อ 3-way ซึ่งใช้ syringe 20 ml ที่ใส่ saline ไว้คอย flush ตามยาที่ฉีดอย่างรวดเร็ว

3. ยกแขนข้างนั้นขึ้นสูง

4. ติด monitor EKG

5. ผู้ฉีดหายใจเข้าลึก ๆ ทำใจให้สงบ (ไม่ต้องครับ แซวเล่น) เริ่มต้นฉีดครั้งแรกที่ 6 mg(1 vial) ถ้าไม่ตอบสนอง เพิ่มยา เป็น 12 mg (2 vial) หากไม่ตอบสนองอีกให้ขนาด 12 mg ซ้ำได้อีก 1 ครั้ง

6. กรณีที่ได้ยาแล้วไม่ตอบสนองให้ลองทบทวนหาสาเหตุดังนี้ เช่น วิธีการฉีดไม่ถูกต้อง (ฉีดยาหรือ flush saline ตามไม่ เร็วพอ, เปิดเส้นที่แขนส่วนปลาย(ข้อมือ) ทำให้ยาหมดฤทธิ์ ก่อน), วินิจฉัย EKG ผิด เช่น rate regular แต่เป็น Sinus tachycardia (ให้หาสาเหตุและแก้ไขต่อไป), rate irregular เช่น Atrial fibrillation with rapid ventricular response (AF with RVR), Multifocal atrial tachycardia (MAT)

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