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Diagnosing DIRD
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The Drug-Induced Respiratory Disease Website
Philippe Camus, M.D.
Dijon, France
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Drugs
Patterns
General anesthesia
3
VIII.f
Central airway instability - Tracheomalacia
1
Last update :
16/04/2014
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Identify causative drugs
Diagnosing DIRD
1
Drug and radiation history
2
Drug singularity - Correct identification of the drug
3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Colloids
Crystalloids
Dyes
Ethosuximide
Ethylene-vinyl alcohol copolymer (e.g. Onyx (R))
Fentanyl
Fluorescein
Forceful inspiration against a closed glottis or airway
Fresh frozen plasma
Gases
Gelatin
Hemotherapy (transfusion/infusion of whole blood, red cells, platelets, or blood products)
Heparin
Inhalants (volatile substances)
Ketamine
Lepirudin
Lipiodol - Iodinated/iodized oil (RCM)
Liposuction
Macro-aggregated albumin (& 99Tc tagged)
Methacrylate - Methylmethacrylate
Methylene blue
Microspheres
Morphine
Neuromuscular blocking agents (NMBA-NMBD)
Nitric oxide (NO)
Nitrites - Nitrates ('Poppers')
Opiates - Opioids - Opium
Oxygen (dioxygen, O2)
Pancuronium
Patent blue
Plasma
Pulmonary hypertension therapy
Sevoflurane
Sufentanil
Sugammadex
Thiopental
Thrombolytic (fibrinolytic) agents
Transhepatic arterial chemoembolization (TACE)
Vertebroplasty (kyphoplasty)
Publications
Tracheobronchomalacia-like lung collapse during three separate trials of general anesthesia.