Merck Manual

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Drug-Induced Pulmonary Disease

By

Joyce Lee

, MD, MAS, University of Colorado School of Medicine

Reviewed/Revised Jul 2023
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Topic Resources

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 x-ray changes, deterioration of pulmonary function, histologic changes, or several of these findings in association with medication therapy or illicit drug use. Here we use the term "drug" to include medications and illicit drugs that can cause the disorder. Over 150 drugs or categories of drugs have been reported to cause pulmonary disease; the mechanism is rarely known, but many drugs are thought to provoke a hypersensitivity response Drug Hypersensitivity Drug hypersensitivity is an immune-mediated reaction to a drug. Symptoms range from mild to severe and include rash, anaphylaxis, and serum sickness. Diagnosis is clinical; skin testing is occasionally... read more . Some drugs (eg, nitrofurantoin) can cause different injury patterns in different patients.

Table

Diagnosis is based on observation of responses to withdrawal from and, if practical, reintroduction to the suspected drug.

Treatment of Drug-Induced Pulmonary Disease

  • Stopping the drug

Treatment is stopping the drug that is causing pulmonary disease.

Prevention of Drug-Induced Pulmonary Disease

A screening pulmonary function test Overview of Tests of Pulmonary Function Pulmonary function tests provide measures of airflow, lung volumes, gas exchange, response to bronchodilators, and respiratory muscle function. Basic pulmonary function tests available in the... read more is commonly done in patients about to begin or already taking drugs with pulmonary toxicities, but the benefits of screening for prediction or early detection of toxicity are unproved.

Drugs Mentioned In This Article

Drug Name Select Trade
Furadantin, Macrobid, Macrodantin, Urotoin
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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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