Drug-induced lung diseases

Adverse effects of drug therapy may induce a wide variety of bronchopulmonary disorders. The spectrum of drug induced lung and bronchial diseases include simple cough, bronchial obstruction, and obstructive bronchiolitis. Lung parenchyma may be affected by alveolitis/pneumonitis or lung fibrosis. Further damage patterns are noncardiac pulmonary oedema, diffuse alveolar damage, diffuse alveolar haemorrhage, eosinophilic lung diseases, pulmonary vascular disorders as well as pleural affections. These side effects rarely have pathognomonic features. Therefore they are relevant differential diagnoses of genuine pulmonary diseases. Diagnostics is based mainly on the verification of a compatible disease pattern, exclusion of differential diagnoses, and assessment of the temporal relationship and the consequences of drug abstention. Reexposure is rarely indicated. Strict elimination of the responsible drugs is the most important therapeutic measure. Additional drug therapy, mostly with glucocorticosteroids, may be indicated. © 2011 Georg Thieme Verlag KG Stuttgart · New York.