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The Drug-Induced Respiratory Disease Website and App

Chemicals

See also under 'gases' and 'chemical weapons'. PMID 31018070. This is not (yet) a comprehensive review of all chemical-related adverse respiratory effects. We plan to subsume the 'chemical' group in the future. Numerous nontherapeutic chemicals (hydrocarbons, solvents, insecticides, pesticides, rodenticides, herbicides (paraquat, glyphosate), solvents, alcohols, fuels, glues, household compounds, diacetyl, fluoroethane, pool disinfectants (sodium dichloroisocyanurate, HBr) have a propensity to cause airways, lung (chemical pneumonitis and ARDS) or pleural injury. Careful history taking is indicaded. These substances can injure the lung via inhalation, aspiration, transdermally or parenterally. See PMID 14973213, 21896525, 21972388, 22045882. 24275172, 30608256, 31018070

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.d

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

Exogenous lipoid pneumonia (subacute, acute)
I.af

Chemical (toxic) pneumonitis

II - Pulmonary edema - Acute lung injury - ARDS

II.a

Pulmonary edema, noncardiogenic (NCPE)
II.b

ARDS - Acute lung injury

III - Pulmonary/alveolar/airway hemorrhage/bleeding

III.a

Alveolar hemorrhage (AH), diffuse AH (DAH)
III.b

Pneumorenal syndrome (w/wo ANCAs)

IV - Airway involvement

IV.c

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

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

Reactive airway dysfunction syndrome (RADS)

V - Pleural and/or pericardial involvement

V.a

Pleural effusion (uni- or bilateral) (can accompany DI-LDs)

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

VIII.c

Upper airway obstruction other than angioedema or hematoma
VIII.h

Vocal cord dysfunction, adduction, closure, injury

X - Systemic/Distant conditions, syndromes and reactions

X.m

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

Multiple organ dysfunction/failure (MODS/MOF)
X.ac

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

XI - Miscellaneous

XI.s

Sniffing death - Death from inhalation of compound

XII - Cardiovascular involvement / toxicity

XII.m

Cardiac- cardiorespiratory/pulmonary arrest

XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)

XIV.a

Methemoglobinemia
XIV.b

Sulfhemoglobinemia

XV - Pathology

XV.x

Path: Acute/subacute bronchiolitis (see also IVc, IVi)

XVI - Imaging

XVI.ab

Imaging: Cavitating/cavitary lung nodule, mass or nodules (see also Iq, XIs, XIIi, XVIaa and XVIIp)

XVII - Infections & related conditions

XVII.p

Lung abscess/abscesses (see also VIr)