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The Drug-Induced Respiratory Disease Website and App

Crack cocaine

See also under cocaine and levamisole, a common adulterant of cocaine from the 2000s. PMID 8874270, 1731605, 17620460, 24429586

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.a

Pneumonitis (ILD), acute and/or severe (may produce the ARDS pattern)
I.b

Pneumonitis (interstitial lung disease/ILD)
I.c

Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)
I.d

Organizing pneumonia pattern (an area or areas of consolidation on imaging)
I.e

Acute eosinophilic pneumonia (AEP)
I.g

Pulmonary fibrosis

II - Pulmonary edema - Acute lung injury - ARDS

II.a

Pulmonary edema, noncardiogenic (NCPE)
II.b

ARDS - Acute lung injury
II.j

Transient pulmonary opacities/infiltrates (see also under Iav)

III - Pulmonary/alveolar/airway hemorrhage/bleeding

III.a

Alveolar hemorrhage (AH), diffuse AH (DAH)

IV - Airway involvement

IV.a

Bronchospasm - Wheezing - Asthma
IV.c

Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx)
IV.e

Cough (acute, violent, explosive)
IV.f

Severe or catastrophic bronchospasm or asthma attack (can be fatal)

V - Pleural and/or pericardial involvement

V.b

Eosinophilic pleural effusion
V.f

Pneumothorax
V.x

Black pleural effusion

VI - Pulmonary vasculopathy

VI.a

Pulmonary embolism - Venous thrombosis/thromboembolism

VII - Mediastinal involvement

VII.h

Pneumomediastinum

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

VIII.a

Angioedema (may cause UAO, asphyxia and death)
VIII.d

Thermal (burns, frostbite), chemical or caustic injury on the face, mouth, tongue, pharynx or upper airway
VIII.m

Drug foreign body in the airway
VIII.ac

Retropharyngeal emphysema
VIII.ap

Airway foreign body
VIII.aw

Foreign body in the airway

X - Systemic/Distant conditions, syndromes and reactions

X.ac

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

XI - Miscellaneous

XI.b

Chest pain (acute or subacute), lone or prominent
XI.c

Pleuritic chest pain
XI.bp

Lung herniation

XII - Cardiovascular involvement / toxicity

XII.g

Coronary artery disease (acute) - Myocardial ischemia/infarction
XII.l

Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)
XII.aa

Arterial (aorta, limb) vasoconstriction and/or ischemia, acute
XII.ae

Aortic dissection

XV - Pathology

XV.b

Path: Eosinophilic pneumonia (subacute or acute) (see also Ic)
XV.e

Path: ILD with a granulomatous component (see also Im)
XV.g

Path: Alveolar hemorrhage (see also IIIa)
XV.q

Path: Foreign body deposits/granulomatous reaction
XV.s

Path: Pneumoconiosis (silicosis, talcosis, talcoma)
XV.bb

Path: Airway inflammation
XV.bj

Path: Alveolar carbonaceous material or deposits

XVI - Imaging

XVI.b

Imaging: Ground-glass opacities (GGO) / shadowing
XVI.d

Imaging: Alveolar opacities or haze with a batwing or butterfly distribution
XVI.k

Imaging: An area or areas of consolidation

XVIII - Distinctive patterns - 'Eye-catchers'

XVIII.l

Eye catcher: Candy-cane esophagus