Intravenous adenosine and dyspnea in humans

Abstract

Intravenous adenosine for the treatment of supraventricular tachycardia is reported to cause bronchospasm and dyspnea and to increase ventilation in humans, but these effects have not been systematically studied. We therefore compared the effects of 10 mg of intravenous adenosine with placebo in 21 normal subjects under normoxic conditions and evaluated the temporal sequence of the effects of adenosine on ventilation, dyspnea, and heart rate. The study was repeated in 11 of these subjects during hyperoxia. In all subjects, adenosine resulted in the development of dyspnea, assessed by handgrip dynamometry, without any significant change (P > 0.1) in lung resistance as measured by the interrupter technique. There were significant increases (P < 0.05) in ventilation and heart rate in response to adenosine. The dyspneic response occurred slightly before the ventilatory or heart rate responses in every subject, but the timing of the dyspneic, ventilatory, and heart rate responses was not significantly different when the group data were analyzed (18.9 +/- 5.8, 20.3 +/- 5.5, and 19.7 +/- 4.5 s, respectively). During hyperoxia, adenosine resulted in similar effects, with no significant differences in the magnitude of the ventilatory response; however, compared with the normoxic state, the intensity of the dyspneic response was significantly (P < 0.05) reduced, whereas the heart rate response increased significantly (P < 0.05). These data indicate that intravenous adenosine-induced dyspnea is not associated with bronchospasm in normal subjects. The time latency of the response indicates that the dyspnea is probably not a consequence of peripheral chemoreceptor or brain stem respiratory center stimulation, suggesting that it is most likely secondary to stimulation of receptors in the lungs, most likely vagal C fibers.

Carotid body function in aged rats: responses to hypoxia, ischemia, dopamine, and adenosine

“…Despite its dyspnoeic effect mediated by chemoreceptor activation (Burki et al 2005), adenosine is a clinically useful tool to treat supraventricular tachycardia (Biaggioni et al 1987;Riccardi et al 2008), a common cardiac rhythm disturbance more frequently observed in the elderly (Medi et al 2009). However, studies about this effect on aged subjects are yet to be made.…”

Purinergic Signaling in the Airways

“…Adenosine cooperates with inflammatory cytokines to stimulate mucin production in the asthmatic airway (McNamara et al, 2004). Intravenous adenosine in healthy subjects does not induce bronchospasm, but causes dyspnea, most likely by an effect on vagal C fibers in the lungs (Burki et al, 2005). A more recent article claimed that all four P1 receptor subtypes play various roles in the airway responses to inhaled 5Ј-AMP in sensitized guinea pigs (Smith and Broadley, 2008).…”

The Role of Vagal Afferent Nerves in Chronic Obstructive Pulmonary Disease

“…Conversely, drugs known to stimulate airway nociceptors have been shown to cause dyspnea in humans without affecting airway resistance. Drugs in this category include prostaglandin E 2 and adenosine (52,53).…”