Which statement is true about adenosine use for SVT in patients with asthma or COPD?

• A. Adenosine is safe in asthma
• B. Adenosine always causes chest pain
• C. Adenosine can cause bronchospasm in asthma/COPD; monitor
• D. Adenosine markedly raises BP

Answer: (C)

Adenosine is used for SVT because it briefly blocks AV nodal conduction, often terminating the tachycardia within seconds. In patients with asthma or COPD, the same drug can provoke bronchospasm. This happens because adenosine can stimulate airway receptors (particularly A2B-mediated pathways) and trigger bronchoconstriction in reactive airways. That makes airway status a key concern when treating SVT in these patients, so you must monitor the patient closely, watch for wheeze or increasing work of breathing, and have bronchodilators and ready airway support available. If bronchospasm occurs, treat promptly with appropriate inhaled bronchodilators and consider alternative antiarrhythmic strategies if airway disease is significant or bronchospasm is severe. The statement reflects the real clinical risk in this population, and it’s why adenosine is used with caution in asthma or COPD.