Drug Induced Pulmonary Disorders Flashcards
Adverse Drug Reaction
an unwanted or harmful reaction experienced following the administration of a drug or combination of drugs under normal conditions of use
Type A ADR
Predictable. Expected extension of known drug properties.
Type B ADR
Idiosyncratic reactions, immunologic or allergic rxn and carcinogenic/teratogenic events
Limitations of Premarketing Clinical Trials
- Short Duration
- Narrow Population
- Narrow set of indications
- Small size
Lung is the only organ of the body that:
receives the entire circulation
Adverse pulmonary reactions are (common/uncommon) but are usually (severe/ not severe).
Uncommon and severe
Types of Drug- Iduced Pulmonary Diseases
- Drug-induced apnea
- Drug- induced bronchospasm
- Narcotic- induced pulmonary edema
- Pulmonary Eosinophilia (Loffler’s syndrome)
- Pulmonary Fibrosis
Drug Induced Apnea Causes
- CNS depression (IV benzos)
2. Neuromuscular blockade (vecuronium, cisatracurium, rocuronium, succinylcholine) + Aminoglycosides
Most common drug-induced respiratory problem
Bronchoconstriction
Causes of bronchoconstriction
(almost always a problem of pts with preexisting bronchial hyperreactivity) Aspirin, NSAIDs, Antibiotics, Beta-Blockers, contrast media, latex
Most common cause of drug induced noncardiogenic pulmonary edema?
Narcotic Analgesics
Therapy for Narcotic induced pulmonary edema?
Naloxone, supplemental oxygen, mechanical ventilation if necessary
Symptoms of Loffler’s syndrome
fever, nonproductive cough, dyspea, cyanosis, bilateral pulmonary infiltrates, eosinophilia in the blood
Treatment for Loffler’s syndrome
discontinue offending drug, steroids may be considered
Drugs that cause Loffler’s syndrome
Nitrofurantoin, methotrexate, sulfonamides, tetracycline, chlorpropamide, phenytoin, NSAIDs and imipramine (maybe daptomycin and ceftaroloine)
