Adenosine is contraindicated for patients with which condition?

Adenosine is contraindicated for patients with chronic obstructive pulmonary disease (COPD) primarily due to its potential to cause bronchoconstriction. Adenosine has a physiological role as a potent bronchoconstrictor, and in patients with COPD, whose airways are already compromised, this can lead to significant respiratory distress and exacerbation of their underlying condition.

In the context of the other options, while adenosine can have effects in various cardiovascular and metabolic conditions, it is generally used with caution rather than being outright contraindicated. For instance, stress-induced myocardial ischemia is often evaluated with adenosine stress testing, whereas diabetes and peripheral vascular disease do not specifically provoke the same immediate respiratory concerns. Therefore, the risk associated with the use of adenosine in patients with COPD due to potential respiratory complications is the main reason for its contraindication in this patient population.