The Drug-Induced Respiratory Disease Website and App

Paracetamol - Acetaminophen

Hepatotoxicity is a notable feature of paracetamol toxicity/poisoning in the clinic (PMID 30658389). The use of acetaminophen early in life may pave the way for asthma later in childhood (PMID 23347656). However, the evidence is not universally accepted (PMID 23292157). Bronchospasm rather restricted to aspirin/NSAID-intolerant patients (PMID 7560658)

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

I - Interstitial/parenchymal lung disease

I.c

Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

XLIII - Airway involvement

XLIII.a

Bronchospasm - Wheezing - Asthma

XLIV - Central-large-upper airway (incl. pharyngeal-nasal) involvement

XLIV.a

Angioedema (may cause UAO, asphyxia and death)

XLIX - Systemic/Distant conditions, syndromes and reactions

XLIX.a

DRES syndrome - DRESS-like reaction

XLIX.f

Anaphylaxis-Anaphylactoid reaction (can be fatal)

XLIX.i

Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement)

L - Miscellaneous

L.a

Cyanosis, a low SpO2 and normal measured PaO2

LIII - Hemoglobinopathies - Abnormal hemoglobin states (acquired)

LIII.a

Methemoglobinemia