Medication-induced Lung Disease

Question 1

Pulmonary injury due to medications occurs as a result of

Answer 1

• allergic reactions
• idiosyncratic reactions
• overdose
• undesirable side effects
• in most, mechanism of injury is unknown

Question 2

Precise diagnosis of medication induced pulmonary disease is

Answer 2

• difficult bc routine lab studies to helpful and radiographic findings not specific
• need high index of suspicion and thorough history of medication use
• response to cessation of med is helpful in Dx

Question 3

Acute episodes of medication induced pulmonary disease vs chronic

Answer 3

• acute: disappear 24-48 hrs after med discontinued
• chronic: longer to resolve
• challenge tests to confirm Dx are risky and rarely performed

Question 4

Treatment of medication induced lung disease

Answer 4

discontinue offending agent immediately and manage pulmonary symptoms

Question 5

Inhalation of crack cocain–pulmonary syndromes

Answer 5

-pulmonary infiltration with eosinophilia, pneumothorax, pneumomediastinum, bronchiolitis obliterates and acute respiratory failure associated with DAD and alveolar hemorrhage

Question 6

Alveolar hemorrhage treatment

Answer 6

Corticosteroids

-Variable success

Question 7

Medications that can cause asthma

Answer 7

• Beta-blockers
• Aspirin
• NSAIDs
• Histamine
• Methacholine
• Acetylcysteine
• Aerosolized pentamidine
• Any nebulized medication

Question 8

Medications that cause chronic cough

Answer 8

-ACEIs

Question 9

Medications that cause pulmonary infiltration WITHOUT eiosinophilia

Answer 9

• Amitriptyline
• Azathioprine
• Amiodarone

Question 10

Medications that cause pulmonary infiltration WITH eiosinophilia

Answer 10

• Sulfonamides
• L-Tryptophan
• Nitrofurantoin
• Penicillin
• Methotrexate
• Crack cocaine

Question 11

Drug induced systemic lupus erythematosus

Answer 11

• Hydralizine
• Procainamide
• Isoniazid
• Chlorpromazine
• Phenytoin

Question 12

Medications that cause interstitial pneumonitis fibrosis

Answer 12

• Nitrofurantoin
• Bleomycin
• Busulfan
• Cyclophosphamide
• Methysergide
• Phenytoin

Question 13

Drugs that cause NONCARDIOGENIC pulmonary edema

Answer 13

• Aspirin
• Chlordiazepoxide
• Cocaine
• Ethchlorvynol
• Heroin

Question 14

Drugs that cause CARIOGENIC pulmonary edema

Answer 14

-Beta blockers

Question 15

Drugs that cause pleural effusion

Answer 15

• Bromocriptine
• Nitrofurantoin
• Any drug inducing SLE
• Methysergide
• Chemotherapeutic agents (e.g. carmustine, cyclophosphamide, dasatinib, docetaxel, GM-CSF, methotrexate)

Question 16

Drugs that cause mediastinal widening

Answer 16

• Phenytoin
• Corticosteroids
• Methotrexate

Question 17

Drugs that cause respiratory failure—Neuromuscular blockade

Answer 17

• Aminoglycosides
• Succinylcholine
• Gallamine
• Dimethyltubocurarine (metocurine)

Question 18

Drugs that cause respiratory failure–CNS depressants

Answer 18

• Sedatives
• Hypnotics
• Opioids
• Alcohol
• TCAs
• Oxygen