Pdf with an increasing number of therapeutic drugs, the list of drugs that is responsible for severe pulmonary disease also grows. There are also numerous drugs and medications, including certain antibiotics, cardiovascular drugs, chemotherapy agents, and illicit drugs, among others, that are known to cause lung disease in some people. The most common presentations of drug induced pulmonary disease are an abnormality on a chest radiograph or a symptom complex. Multiple mechanisms may be responsible for drug inducedpulmonary injury. The main value of hrct is in the depiction of parenchymal abnormalities in symptomatic patients who have normal or questionable findings on chest radiography. Drug induced pulmonary disease is not a single disorder. Industrial exposure to flavouring agents, particularly diacetyl, has recently been associated with bronchiolitis obliterans, a severe respiratory illness producing fibrosis and obstruction of the small airways. Pathologic characteristics of druginduced lung disease. Druginduced pulmonary diseases types, symptoms and treatment. Drug related pleural disease it has an extensive sideeffect pro. Differentiating connective tissue diseaseassociated interstitial lung disease from idiopathic pulmonary fibrosis jonathan h. Jul 27, 2012 recognition of drug induced lung disease, however, is difficult because the clinical, radiological, and histological findings are nonspecific. Druginduced interstitial lung disease dild is not uncommon and has many clinical patterns, ranging from benign infiltrates to lifethreatening.
Oct 23, 2012 investigation of a case of suspected drug induced lung disease begins with a high index of clinical suspicion and thereafter involves demonstration of the operation of one or more of the basic mechanisms described above. Druginduced lung disease radiology reference article. Drug induced pulmonary disease is defined as any lung disease caused by a drug or medication 3. Pathologic characteristics of drug induced lung disease douglas b. The most common druginduced noncardiogenic pulmonary edema is produced by the narcotic analgesics table e304. In addition, the true incidence of druginduced pulmonary disease is difficult to assess as a result of the pathological nonspecificity and the interaction between. Druginduced lung disease dild carries a significant morbidity and mortality. There are no distinct physiologic, radiographic or pathologic patterns of dild, and the diagnosis is usually made when a patient with interstitial lung disease ild is exposed to a medication known to result in lung disease.
Drug induced interstitial lung disease dild is a rare, but potentially fatal toxicity. Oral and parenteral administration are most often implicated as causing lung damage, with nebulized and intrathecal routes implicated to a lesser extent. Pathologic characteristics of druginduced lung disease douglas b. The type of problem depends on the drug involved, but many of the drugs are thought to cause an allergictype reaction. The most common form of drug induced lung injury dli is interstitial lung disease also called interstitial pneumonia or interstitial pneumonitis 1. Click download or read online button to get drug induced diseases book now. Jun 19, 2017 pulmonary function measurements are important when studying respiratory disease models. Interstitial lung disease ild is an umbrella term for a large group of lung diseases that cause scarring of lung tissue through inflammation and fibrosis 2. Drug induced interstitial lung disease dild can be caused by chemotherapeutic agents, antibiotics, antiarrhythmic drugs, and immunosuppressive agents. As with most drug induced diseases, the pathological changes are nonspecifi c. Clinical and radiological features of dild in the early experimental setting are poorly described. Interstitial lung disease interstitial lung disease ild is a broad category of lung diseases that includes more than disorders which are characterized by scarring i. It is usually impossible to predict who will develop lung disease from a medicine. Pdf on dec 1, 1995, m k benson and others published lung disease induced by drug addiction find, read and cite all the research you need on researchgate.
Nitrofurantoininduced lung disease and prophylaxis of. Cytotoxic lung injury may result from direct injury to. Drug induced pulmonary disease interstitial lung disease drug induced. Yet, it is not always clear how these parameters relate to forced expiration ferelated parameters, most commonly used in humans. Druginduced pulmonary disease msd manual professional edition. Depending on the specific disease, other compartments of the lung. It is also highly probable that the syndrome is misdiagnosed and underreported. The different types of lung or pulmonary diseases caused by drugs are. Schindel presents a provocative summary of placebo induced reactions. The most common presentations of druginduced pulmonary disease are an abnor mality on a chest radiograph or a symptom complex. Amiodarone pulmonary toxicity apt was recognized in 1980, and remains a significant.
Druginduced lung injury may involve the airways, lung parenchyma, mediastinum, pleura, pulmonary vasculature, andor the neuromuscular. Drug induced lung disease can result from a number of agents and may have a myriad of presentations, ranging from an adult respiratory distress syndrome type picture to established pulmonary fibrosis. The table below lists some drugs known to cause drug induced lung disease. Identify the components of the history required to rule inout a drug causation. The manifestations of druginduced pulmonary diseases span the entire spectrum of pathophysiologic conditions of the respiratory tract. Interstitial lung disease induced by drugs respiration 2004. The chest radiograph may show a fine stippling which lasts several days. Literature on druginduced eosinophilia is sparse and mainly consists of individual case reports. A human disease model of drug toxicityinduced pulmonary.
Many types of lung injury can result from medicines. Consequently, the diagnosis of drug induced lung disease is based on a combination of radiologic, clinical, and histologic when imperative findings in a patient who has received a drug known to cause the abnormalities. Pleuro pulmonary adverse reactions occur in approximately 510% of patients, and most often manifested as alveolar and interstitial in. Amiodarone pulmonary toxicity apt was recognized in 1980, and remains a significant cause of di. Lung, respiratory system, ct, cthigh resolution, contrast agentintravenous, drugs reactions any information contained in this pdf file is automatically generated from digital material. This has been most commonly reported in the microwave popcorn production. We aimed to characterize fe measurements in four wellestablished mouse models of lung diseases. The many faces of druginduced organizing pneumonia in. Identify an approach to incorporating did wi the differential. Drug induced interstitial lung disease pulmonary alveolar proteinosis constrictive bronchiolitis idiopathic and toxic exposure induced. Jul 26, 2012 acute nitrofurantoin induced lung disease nild nild was first reported by fisk in 1957 who described an acute reaction. These include both cytotoxic and noncytocytoxic drugs. District court chapter 11 motion to file exhibit re press release and executive summary re caterbone v.
Since the first edition of this book was published in 2005, numerous drugs have been withdrawn from the market in the united states as a result of morbidity andor mortality associated with drug induced diseases. Drug induced pulmonary disease is lung disease brought on by a bad reaction to a medicine. We performed a systematic literature search for articles published in english and french from 1987 to september 2007 using pubmed and the search terms hmgcoa reductase inhibitors or statins in combination with the terms drug induced interstitial lung disease, pulmonary fibrosis, interstitial pneumonitis, or parenchymal lung disease. Interstitial pneumonitis and fibrosis result in groundglass opacities, focal areas of consolidation, and irregular linear opacities that tend to involve the lower zones of the lungs fig.
Drug induced pulmonary disease is not a single disorder, but rather a common clinical problem in which a patient without previous pulmonary disease develops respiratory symptoms, chest xray changes, deterioration of pulmonary function, histologic changes, or several of these findings in association with drug therapy. Druginduced pulmonary disease pulmonary disorders msd. Aug 23, 2012 diacetyl is a diketone flavouring agent that is commonly employed for buttery taste as well as other purposes. Penicillin, 11 paraaminosalicylic acid 12 and the sulfonamides have all been reported to cause acute drug induced lung disease. Drugs principally cause allergic untoward reactions in the lung by immediate hypersensitivity e. The highresolution ct findings of chemotherapeutic druginduced lung disease reflect the histologic findings 3. Travis, mdb adepartment of pathology and laboratory medicine, new yorkpresbyterian hospital, weill cornell medical center, starr 1015, 525 east 68th street, new york, ny 10021, usa bdepartment of pulmonary and mediastinal pathology, armed forces institute of pathology, 6825 northwest 16th street. Interstitial lung disease induced by drugs and radiation. Now in its third edition, this comprehensive guide provides a detailed overview of diseases that result from drug therapy, arming healthcare professionals with critical knowledge to protect the health and welfare of their patients. Interstitial lung disease ild, or diffuse parenchymal lung disease dpld, is a group of lung diseases affecting the interstitium the tissue and space around the alveoli air sacs of the lungs. Both resistance and compliance have been used to assess lung function in mice. Drug induced lung disease dild is an iatrogenic lung injury secondary to drug. Identify the laboratory tests required to rule inout as drug induced causation.
Meylers classification of drug reactions, a discussion of drugs in relation to traffic safety, and consideration of special hazards in the elderly. Oct 19, 2017 druginduced pulmonary diseases can be present in a variety of syndromes, clinical presentations and radiographic patterns. This report provides members of these communities with much needed health information that can be used in the fight against lung disease and risk factors that cause or contribute. These diseases are classified together because they all affect the tissue and space around the alveoli air sacs, called the interstitium. There have been no reports of severe asthma or respiratory failure similar to that reported with the beta blockers, casting doubt on the role of bronchial hyperreactivity in ace inhibitorrelated lung disease.
There is a broad overlap between computed tomography ct patterns known from interstitial lung diseases and the findings seen in druginduced lung disease. Drug induced lung injury 2018 pdf hanaoka, masayuki. Considering the physiologic and metabolic capacity of the lung, it is surprising that drug induced pulmonary disease is not more common. Druginduced lung disease can result from a number of agents and may have a myriad of presentations, ranging from an adult respiratory distress syndrome type picture to established pulmonary fibrosis due to this, it can be extremely difficult to pinpoint the offending agent on imaging appearances alone and correlation with the medical history is mandatory. Due to the volume of content, cystic fibrosis and idiopathic pulmonary fibrosis are not referenced in this guide. Pulmonary function tests pft are sometimes monitored during treatment with known pulmonary toxic drugs to detect asymptomatic drug induced interstitial lung disease dild. The syndrome is identical with each drug and is characterized by the presence of fever, cough, and shortness of breath associated with pulmonary infiltrates and eosinophilia. Jul 14, 2016 adverse drug reactions adrs have been estimated to be the third leading cause of death in the united states, following heart disease and cancer. Lung association state of lung disease in diverse communities. The diffuse parenchymal lung diseases are divided into those that are associated with known causes and those that are idiopathic. Drug induced interstitial lung disease dild is not uncommon and has many clinical patterns, ranging from benign infiltrates to lifethreatening acute respiratory distress syndrome. It is often impossible to confirm whether the eosinophilia is truly drug induced because ethical and practical considerations make rechallenge unwarranted. Types of lung problems or diseases that may be caused by medicines include.
Ct features of the usual interstitial pneumonia pattern. Travis, mdb adepartment of pathology and laboratory medicine, new yorkpresbyterian hospital, weill cornell medical center. Drug induced pulmonary diseases linkedin slideshare. However, this condition is on the increase again, as the drug regains popularity as a urinary antiseptic. Drug induced disease is defined as the unintended effect of a drug that results in mortality or morbidity with symptoms sufficient to prompt a patient to seek medical attention andor to require. The exact frequency of dild is unknown, although is estimated that 2. Interstitial lung disease american thoracic society. Forced expiration measurements in mouse models of obstructive. The most common form of pulmonary drug toxicity is drug induced interstitial lung disease. Despite best efforts to assure that all drugs are safe and effective, millions of patients each year develop drug induced diseases. This site is like a library, use search box in the widget to get ebook that you want. However, the need for an established treatment continues to grow due to the introduction of many new drugs, such as antineoplastic drugs, biological products, and molecular target drugs, the adverse effects of which are difficult to differentiate from those of other lung diseases, such as lung infectious diseases. The treatment choices and prognosis vary among the different causes and types of ild, so ascertaining the correct diagnosis is important.
In addition to drugs, biomolecules such as proteins and cytokines, and medicinal plants are also capable of inducing respiratory disease, some being severe andor irreversible. B is a patient with chronic obstructive lung disease whose fev1fvc ratio is low but whose lung volumes are increased. Drugs can injure airways, lung parenchyma, mediastinum, the neuromuscular system, pleura, or pulmonary vasculature, but most often they cause drug induced interstitial lung disease dild. For several reasons it is difficult to estimate the exact frequency of druginduced infiltrative lung disease di. A variety of infections can cause interstitial opacities on chest radiograph. Imaging of druginduced lung disease poster no e0083 congress. Drug induced diseases download ebook pdf, epub, tuebl, mobi. The connection with drug use and the development of related inflammatory damage or idiosyncratic toxicities is hard to recognize and objectify, especially in those cases using multiple drugs. Rarely, pulmonary nodules or pleural effusions occur. Bioengineering a human disease model of drug toxicityinduced pulmonary edema in a lungonachip microdevice dongeun huh,1,2,3 daniel c. According to the authors, a drug induced disease as an unintended effect of a drug, which results in mortality or morbidity with symptoms sufficient to prompt a patient to seek medical attention andor require hospitalization. Jul 07, 2016 the diagnosis of drug induced lung disease is often made on the basis of a history of drug exposure, histologic evidence of lung injury, and the exclusion of other causes of lung injury.
The incidence is increasing with approximately 400 drugs known to potentially cause dild. Some drugs or therapeutic agents cause undesirable reactions in the lungs known as drug induced pulmonary diseases,which sometimes could be serious enough to cause. The diagnosis is based on a history of drug exposure, histologic evidence of lung damage, and exclusion of other causes of lung injury. Therefore, the diagnosis is often diffi cult and, in most cases, is based on exclusion of all other possible causes. There are two mechanisms involved in dild, which are probably interdependent. Pulmonary disease induced by cardiovascular drugs uptodate. Full text full text is available as a scanned copy of the original print version. Druginduced pulmonary disease is not a single disorder, but rather a common clinical problem in which a patient without previous pulmonary disease develops respiratory symptoms, chest xray changes, deterioration of pulmonary function, histologic changes, or several of these findings in association with drug. Causes many types of lung injury can result from medicines. Interstitial lung disease 10 interstitial lung disease is a term that broadly describes a diverse collection of more than 200 lung disorders. Get a printable copy pdf file of the complete article 1. Management of this condition generally includes immediate cessation of the offending agent and treatment with systemic corticosteroids.
Druginduced pulmonary disease pulmonary disorders merck. Many drugs can cause lung problems in people who have no other lung disorders. Drug induced interstitial lung disease pubmed central pmc. Druginduced interstitial lung disease dild can be caused by chemotherapeutic agents, antibiotics, antiarrhythmic drugs, and immunosuppressive agents. Psychiatric drugs, druginduced interstitial lung disease, p450 enzymes. Druginduced interstitial lung disease dild is not uncommon and has many clinical patterns, ranging from benign infiltrates to lifethreatening acute respiratory distress syndrome. Drug induced pulmonary disease 04152016 chief fellow. Druginduced interstitial lung disease diild, defined as an interstitial abnormality secondary to administration of a drug, can be acute or chronic. The condition is usually symptomless, but there may be dyspnoea and cough pro ductive of sputum which is sometimes bloodstained. Ild accounts for 15 percent of the cases seen by pulmonologists lung specialists. The list of search terms was developed using the american thoracic societys breathing in america and the office of rare disease research, national institutes of health center for advancing translational sciences, as content references.
Drug induced pulmonary disease is a potential adverse effect associated with a number of medications, most notably amiodarone and bleomycin. May 04, 2016 none of these histologic patterns is specific for either drug reaction in general or the reaction to a particular drug. Sep 22, 2007 there are numerous lung diseases that are caused by an adverse reaction to a medication. Any information contained in this pdf file is automatically generated from. Pulmonary function testing for the early detection of drug. Drug induced interstitial lung disease diild occurs as a result of numerous agents, but the risk often only becomes apparent after the marketing authorisation of such agents. Pdf druginduced lung disease is a major source of iatrogenic injury. Interstitial lung disease caused by psychiatric drug therapy. The clinical manifestations, diagnosis, and management of pulmonary toxicity due to amiodarone and an approach to the diagnosis of interstitial lung disease are discussed separately. Pdf drug induced interstitial lung disease researchgate. It concerns alveolar epithelium, pulmonary capillary endothelium, basement membrane, and perivascular and perilymphatic tissues. Druginduced pulmonary diseases bronchoconstriction mostly affecting patients with underlying bronchial hyperreactivity, e. No related items previous abstract next abstract 25 broadway.
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