Pneumotox » Drug » Nitrosoureas (suffixes '-NU', '-mustine')

Nitrosoureas (suffixes '-NU', '-mustine')

Include bendamustine, carmustine (BCNU-BiCNU), fotemustine, lomustine (CCNU), semustine (MCCNU). See under all nitrosoureas and under suffix -mustine, which may produce similar reactions reflective of a class effect

Last update : 19/04/2019

I.b Pneumonitis (ILD)

I.g Pulmonary fibrosis

I.l Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf)

I.x Pleuroparenchymal fibroelastosis (PPFE)

II.b ARDS - Acute lung injury

V.f Pneumothorax

V.ab Pneumothorax, bilateral

VI.c Pulmonary veno-occlusive disease

XV.f Path: Diffuse alveolar damage (DAD-pattern) (see also IL)

XV.h Path: NSIP-fibrotic pattern

XVII.e Pneumocystis jiroveci pneumonia

XXIV.a Veterinary: Pneumonitis - Interstitial lung disease

XXIV.b Veterinary: Pulmonary fibrosis

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

More detailed checklist

The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France