Drug-induced pulmonary disease

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

  • 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 sacs (pneumonitis or infiltration)
      • Lung vasculitis (inflammation of lung blood vessels)
      • Lymph node swelling
      • Swelling and irritation (inflammation) of the chest area between the lungs (mediastinitis)
      • Abnormal buildup of fluid in the lungs (pulmonary edema)
      • Buildup of fluid between the layers of tissue that line the lungs and chest cavity (pleural effusion)

      Many medicines are known to cause lung disease in some people. These include:

      • Antibiotics, such as nitrofurantoin and sulfa drugs
      • Heart medicines, such as amiodarone
      • Chemotherapy drugs such as bleomycin, cyclophosphamide, and methotrexate
      • Illegal drugs
  • Symptoms
  • Exams and Tests
  • 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 most often 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
  • When to Contact a Medical Professional
    • Call your 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 drug-induced lung diseases.

  • References
    • Dulohery MM, Maldonado F, Limper AH. Drug-induced pulmonary disease. Judson MA, Morgehthau AS, Baughman RP. Sarcoidosis. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 71.