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Drug-induced pulmonary disease
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Drug-induced pulmonary disease

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Drug-induced pulmonary disease is lung disease brought on by a bad reaction to a medicine.

Many types of lung injury can result from medicines. It is usually impossible to predict who will develop lung disease from a medicine.

Types of lung problems or diseases that may be caused by medicines include:

  • Allergic reactions -- asthma, hypersensitivity pneumonitis, or eosinophilic pneumonia
  • Bleeding into the lung air sacks, called alveoli (alveolar hemorrhage)
  • Bronchitis
  • Damage to lung tissue (interstitial fibrosis)
  • Drugs that cause the immune system to mistakenly attack and destroy healthy body tissue, such as drug-induced lupus erythematosus
  • Granulomatous lung disease -- a type of inflammation in the lungs
  • Inflammation of the lung air sacks (pneumonitis or infiltration)
  • Lung vasculitis (inflammation of lung blood vessels)
  • Lymph node swelling
  • Mediastinitis
  • Pulmonary edema
  • Pleural effusion

Many medicines are known to cause lung disease in some people, including:

  • Antibiotics, such as nitrofurantoin and sulfa drugs
  • Heart medicines, such as amiodarone
  • Chemotherapy drugs such as bleomycin, cyclophosphamide, and methotrexate
  • Illegal drugs

I Would Like to Learn About:

  • Causes

    Many types of lung injury can result from medicines. It is usually impossible to predict who will develop lung disease from a medicine.

    Types of lung problems or diseases that may be caused by medicines include:

    • Allergic reactions -- asthma, hypersensitivity pneumonitis, or eosinophilic pneumonia
    • Bleeding into the lung air sacks, called alveoli (alveolar hemorrhage)
    • Bronchitis
    • Damage to lung tissue (interstitial fibrosis)
    • Drugs that cause the immune system to mistakenly attack and destroy healthy body tissue, such as drug-induced lupus erythematosus
    • Granulomatous lung disease -- a type of inflammation in the lungs
    • Inflammation of the lung air sacks (pneumonitis or infiltration)
    • Lung vasculitis (inflammation of lung blood vessels)
    • Lymph node swelling
    • Mediastinitis
    • Pulmonary edema
    • Pleural effusion

    Many medicines are known to cause lung disease in some people, including:

    • Antibiotics, such as nitrofurantoin and sulfa drugs
    • Heart medicines, such as amiodarone
    • Chemotherapy drugs such as bleomycin, cyclophosphamide, and methotrexate
    • Illegal drugs
  • Symptoms

    • Bloody sputum
    • Chest pain
    • Cough
    • Fever
    • Shortness of breath
    • Wheezing

    Note: Symptoms may vary from person to person.

  • Exams and Tests

    The doctor will perform a physical exam and listen to your chest and lungs with a stethoscope. Abnormal breath sounds may be heard.

    Tests that may be done include:

    • Arterial blood gases
    • Autoimmune blood tests
    • Blood chemistry
    • Bronchoscopy
    • Complete blood count with blood differential
    • Chest CT scan
    • Chest x-ray
    • Lung biopsy (in rare cases)
    • Lung function tests
    • Thoracentesis (if pleural effusion is present)
  • Treatment

    The first step is to stop the medicine that is causing the problem. Other treatments depend on your specific symptoms. For example, you may need oxygen until the drug-induced lung disease improves. Anti-inflammatory medicines called steroids are sometimes used to quickly reverse the lung inflammation.

  • Outlook (Prognosis)

    Acute episodes usually go away within 48 to 72 hours after the medicine has been stopped. Chronic symptoms may take longer to improve.

    Some drug-induced lung diseases, such as pulmonary fibrosis, may never go away.

  • Possible Complications

    • Diffuse interstitial pulmonary fibrosis
    • Hypoxemia (low blood oxygen)
    • Respiratory failure
  • When to Contact a Medical Professional

    Call your health care provider if you develop symptoms of this disorder.

  • Prevention

    Note any past reaction you have had to a medicine, so that you can avoid the medicine in the future. Wear a medical alert bracelet if you have known drug reactions. Stay away from illegal drugs to prevent many drug-induced lung diseases.

Related Information

  Allergic reactions...Interstitial lung ...Pulmonary edemaPleural effusion...RespiratorySystemic lupus ery...ChemotherapyCardiovascular   Interstitial lung ...   Systemic lupus ery...

References

Maldonado F, Limper AH. Drug-induced pulmonary disease. In: Mason RJ, Broaddus VC, Martin TR, et al., eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 72.

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Review Date: 5/30/2013  

Reviewed By: Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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