Stress Pharmaceuticals Used in PET MPI
| Agent | Dose and administration | Timing of radiotracer injection | Route of radiotracer administration |
| Adenosine | 140 mg/kg/min intravenous infusion for 4–6 min | Mid infusion | Two intravenous lines are preferred to prevent mid-infusion interruption of adenosine |
| Dipyridamole | 0.56 mg/kg intravenous infusion over 4 min | 3–5 min after completion of infusion | Single intravenous line for both stress agent and radioisotope |
| Regadenoson | 0.4-mg rapid intravenous bolus (over 10 s) | Immediately after 10-mL saline flush* | Single intravenous line for both stress agent and radioisotope |
| Dobutamine | Stepwise increase in infusion from 5 or 10 μg/kg/min up to 40 μg/kg/min to achieve >85% predicted heart rate; atropine boluses may be used to augment heart rate response | Once target heart rate is achieved; continue dobutamine infusion for 1–2 min after radiotracer injection | Single intravenous line for both stress agent and radioisotope |
↵* One recent study has suggested that injection of 82Rb at 55 s, compared with 10 s, after injection of regadenoson resulted in greater maximal hyperemic MBF (2.33 ± 0.57 vs. 1.79 ± 0.44 mL/min/g) and correlated better with hyperemic MBF with dipyridamole (2.27 ± 0.57 mL/min/g) (211).