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The Drug-Induced Respiratory Disease Website and App

Tobacco smoke - Cigarette smoking

And/or tobacco substitutes. PMID 22365253, 23001806, 23999882. Passive smoking (secondhand smoke) may cause part of these manifestations, particularly in children. Review on imaging of smoking-related ILD: PMID 24480144. Tobacco smoking may alter the pharmacokinetics of anticancer agents, being detrimental in terms of therapeutic efficacy (PMID: 24926542). Smoking in survivors of Hodgkin's and other malignant lymphomas should be discouraged, as risk of developing lung cancer is makedly increased. Reviews at PMID 25415179, 25415179, 25498399, 29222007. Imaging and pathology at PMID 26479130.

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)
I.e

Acute eosinophilic pneumonia (AEP)
I.g

Pulmonary fibrosis
I.h

Subclinical pulmonary infiltrates/ILD
I.j

Exogenous lipoid pneumonia (subacute, acute)
I.r

An imaging pattern consistent with DIP
I.ai

Combined pulmonary fibrosis and emphysema syndrome (CPFE)

IV - Airway involvement

IV.a

Bronchospasm - Wheezing - Asthma
IV.d

Cough (lone)
IV.g

Cough syncope
IV.n

Obstructive airway dysfunction (see also IVc, XVx)
IV.u

Endobronchial (eosinophilic) nodules on bronchoscopy
IV.ad

Large airway inflammation - Tracheitis (w/wo tissue eosinophilia)

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

VIII.ay

Tracheal injury
VIII.bb

Tracheitis including eosinophilic tracheal inflammation

IX - Neuromuscular / CNS involvement - Disordered breathing (during sleep)

IX.q

Obstructive sleep apnea

X - Systemic/Distant conditions, syndromes and reactions

X.m

Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative)
X.x

ANCA positivity. Subclinical or with clinical manifestations
X.ac

Anti-GBM antibody disease (Goodpasture-like or flare of preexisting GS)
X.ah

Granulomatosis with polyangiitis (typically ANCA pos.) - GPA flare

XI - Miscellaneous

XI.m

Pulmonary emphysema - Lung cysts or bullae
XI.ag

Vertebral compression fracture
XI.ah

Fainting
XI.an

Disrupted lung surfactant function

XIII - Neoplastic conditions

XIII.a

Lung cancer

XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)

XIV.c

Carboxyhemoglobinemia

XV - Pathology

XV.k

Path: Desquamative interstitial pneumonia (DIP-pattern)
XV.y

Path: Respiratory bronchiolitis (w/wo the RB-ILD-pattern)
XV.z

Path: Obliterative (constrictive) bronchiolitis (see also IVc, IVn)
XV.ay

Path: Smoking-related interstitial fibrosis (SRIF). Respiratory bronchiolitis with fibrosis
XV.bw

Path: Airspace enlargement with fibrosis

XVI - Imaging

XVI.g

Imaging: Diffuse whiteout/alveolar shadowing (see also under IIb-ARDS)
XVI.p

Imaging: Small irregular opacities - ILA - Diffuse reticulation - 'Dirty lung'
XVI.ac

Imaging: A generalized increase in lung density

XVII - Infections & related conditions

XVII.a

Respiratory tract infection incl. pneumonia