Medicinal lung lesions
Last reviewed: 23.04.2024
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Medicinal lesions of the lungs are not an independent nosological unit, but represent a common clinical problem when a patient who has not previously suffered from lung disease begins to detect clinical manifestations from these organs, or he has changes in the chest radiograph, pulmonary function impairment and / or histological changes in the background of drug therapy.
[What causes lung damage?
More than 150 individual drugs or their classes are known to cause lung damage; The mechanism of lesion is rarely known, but many drugs probably cause a hypersensitivity reaction.
| Bronchial asthma | Aspirin, beta-blockers (timolol), cocaine, dipyridamole, hydrocortisone, IL-2, methylphenidate, nitrofurantoin, protamine, sulfasalazine, vinca alkaloids pink (in combination with mitomycin) |
| Obliterating bronchiolitis with organizing pneumonia | Amiodarone, bleomycin, cocaine, cyclophosphamide, methotrexate, minocycline, mitomycin C, penicillamine, sulfasalazine, tetracycline |
| Pneumonitis of hypersensitivity | Azathioprine in combination with 6-mercaptopurine, busulfan, fluoxetine, irradiation |
| Interstitial pneumonia or fibrosis | Amphotericin B, bleomycin, busulfan, carbamazepine, chlorambucil, cocaine, cyclophosphamide, phenytoin, flecainide, heroin, melphalan, methadone, methotrexate, methylphenidate, methylside, mineral oil, nitrofurantoin, nitrates, procarbazine, silicone, tokainide, vinca alkaloids pink (in combination with mitomycin) |
| Noncardiogenic pulmonary edema | Terbutaline, ritodrin, chlordiazepoxide, cocaine, cytarabine, ethylated oils, gemcitabine, heroin, hydrochlorothiazide, methadone, mitomycin C, phenothiazines, protamine, sulfasalazine, tocolytics, tricyclic antidepressants, tumor necrosis factor, vinca alkaloids pink (in combination with mitomycin) |
| Parenchymal hemorrhage | Anticoagulants, azathioprine in combination with 6-mercaptopurine, cocaine, mineral oils, nitrofurantoin, irradiation |
| Pleural effusion | Amiodarone, anticoagulants, bleomycin, bromocriptine, busulfan, colony-stimulating factor of granulocytes and macrophages, IL-2, methotrexate, methylsigide, mitomycin C, nitrofurantoin, paraaminosalicylic acid, procarbazine, radiation, tocolytic agents |
| Pulmonary eosinophilic infiltrate | Amiodarone, amphotericin B, bleomycin, carbamazepine, phenytoin, ethambutol, etoposide, colony-stimulating factor of granulocytes and macrophages, isoniazid, methotrexate, minocycline, mitomycin C, nitrofurantoin, paraaminosalicylic acid, procarbazine, radiation, sulfasalazine, sulfonamides, tetracycline, trazodone |
| Pulmonary vasculitis | Anorectics (dexfenfluramine, fenfluramine, phentermine), busulfan, cocaine, heroin, methadone, methylphenidate, nitrates, irradiation |
Symptoms of medicinal lesions of the lungs
Depending on the type of drug, pulmonary medications may resemble interstitial fibrosis, obliterating bronchiolitis with arranging pneumonia, bronchial asthma, noncardiogenic pulmonary edema, pleural effusion, eosinophilic pulmonary infiltration, pulmonary hemorrhage, or veno-occlusive disease with appropriate changes in the chest radiograph or CT and results lung function tests.
Treatment of medicinal lesions of the lungs
Treatment of medicinal lesions of the lung consists in stopping the medication. Screening of pulmonary function is usually performed in patients before or at the time of therapy with drugs that can cause pulmonary toxicity, but the effectiveness of screening in predicting or early detection of toxicity has not been proven.