OVERVIEW

What is drug-induced lung disease?

As the name suggests, it refers to lung diseases caused by medications. Some drugs used during illness may cause lung damage, leading to corresponding pulmonary symptoms, and may also affect other parts of the body. The severity can range from mild to severe, and the onset may be acute or gradual. The effects can be temporary or permanent, depending largely on the nature of the drug, dosage, duration of use, timeliness of medical intervention, and individual differences.
The pathogenesis of this disease is relatively complex, but it can generally be understood as an adverse drug reaction. In most cases, discontinuing the medication promptly can lead to improvement and recovery.

Is drug-induced lung disease common?

It is relatively common in daily life. However, because lung lesions often lack distinctive features, they can be difficult to identify. Therefore, both doctors and patients should exercise sufficient caution and remain vigilant when using medications.

SYMPTOMS

What are the common manifestations of drug-induced lung disease?

The main symptoms are pulmonary manifestations, such as cough, frothy pink sputum, hemoptysis, chest tightness, shortness of breath, progressively worsening dyspnea, and chest pain.

However, the drugs may also damage other organs, leading to systemic manifestations. For example, kidney involvement may cause oliguria, anuria, systemic edema, and other signs of renal insufficiency, while liver involvement may manifest as jaundice and dark urine.

What serious consequences can drug-induced lung disease cause?

Lung function impairment affects respiratory function, and severe consequences such as respiratory failure or massive pulmonary hemorrhage with shock may occur.

Delayed treatment can easily lead to simultaneous failure of multiple vital organs, including the heart, lungs, liver, and kidneys, posing a critical condition. Without prompt and effective treatment, it can be life-threatening.

CAUSES

Which drugs can cause drug-induced lung disease?

Although more than 200 drugs are known to cause lung injury, this does not mean they cannot be taken. They can be used under medical supervision with appropriate monitoring. Common categories include:

• Cardiovascular drugs: Captopril, Hydrochlorothiazide, Nifedipine, Diltiazem, Propranolol, Amiodarone, etc.;
• Antibiotics: Streptomycin, Kanamycin, Gentamicin, Nitrofurantoin, Sulfasalazine, Polymyxin, etc.;
• Anti-inflammatory drugs: Aspirin, Penicillamine, Gold preparations, etc.;
• Contraceptives;
• Cytotoxic drugs (commonly used in the treatment of diseases such as cancer): Methotrexate, Cytarabine, Azathioprine, Vinblastine, Busulfan, Cyclophosphamide, Bleomycin, Mitomycin, Carmustine, etc.;
• Sedatives and hypnotics: Chlordiazepoxide, Diazepam, Chlorpromazine, etc.

DIAGNOSIS

How to self-detect drug-induced lung disease?

Currently, pulmonary changes in this disease are often atypical, and there is a lack of targeted diagnostic methods. It mainly relies on a detailed medication history for judgment. If symptoms such as coughing, hemoptysis, or difficulty breathing appear immediately after taking medication, you should be highly alert and seek medical attention promptly to let doctors or other professionals help confirm the diagnosis.

What tests are needed for suspected drug-induced lung disease?

Diagnosing drug-induced lung disease is challenging, as there are no highly specific tests available. If suspicious symptoms occur, it is recommended to visit a reputable large hospital as soon as possible. Tests may include blood tests, urine tests, biochemical tests, antinuclear antibodies, and imaging studies such as CT scans. In some cases, blood drug concentration levels may also be measured for assessment.

TREATMENT

How to treat drug-induced lung disease?

• Discontinuation of the drug: In many cases, the most effective treatment is to stop the medication as soon as possible, eliminate the ingested drug, induce vomiting, and seek immediate medical attention. Gastric lavage may be necessary in some cases.
• Hormone/plasma exchange therapy: For cases caused by inflammatory reactions or allergies, early administration of high-dose hormones can help control inflammation and counteract allergic reactions. In severe cases of drug-induced lung injury, plasma exchange may be required to quickly reduce drug concentration in the blood and minimize further organ damage.
• Treatment of complications: This mainly involves managing symptoms such as hemoptysis, respiratory failure, pulmonary edema, renal failure, and liver failure. Patients should seek prompt treatment at a well-equipped, reputable hospital where doctors can provide appropriate care based on the specific condition.

Can drug-induced lung disease recover after stopping the medication?

Whether recovery occurs after stopping the medication depends on factors such as the type of drug, dosage, duration of use, timing of treatment, and the patient's individual condition.
If the drug is discontinued early, most symptoms can be alleviated, and gradual recovery is possible. The later the diagnosis, the lower the chance of recovery. Some drug-induced lung injuries are irreversible and severe, potentially requiring lung transplantation as the only solution.

DIET & LIFESTYLE

What should patients with drug-induced lung disease pay attention to in their diet?

If there are no other special circumstances, a normal healthy diet is sufficient.

What should patients with drug-induced lung disease pay attention to in daily life?

The most important thing is to avoid taking such drugs again. When purchasing medication at a pharmacy or receiving prescriptions from a doctor, inform the pharmacist and physician about your history of drug-induced lung disease so they can prescribe appropriate medication based on your condition.

Engage in moderate physical activity, maintain a positive mood, get sufficient sleep, and quit smoking and alcohol. Breathe fresh air outdoors and strengthen respiratory rehabilitation exercises, such as blowing bubbles into mineral water through a straw for training. Some patients may have irreversible lung damage and require home oxygen therapy or assisted ventilation, so having an oxygen concentrator or home ventilator on hand may be necessary.

What should patients with drug-induced lung disease consider when choosing an oxygen concentrator or home ventilator?

The current market for oxygen concentrators and home ventilators is quite chaotic, and most patients—as well as non-respiratory medical professionals—lack sufficient understanding of these devices. This has led to some patients experiencing adverse effects due to improper use after purchasing oxygen concentrators or ventilators.

In particular, there are many models of home ventilators, each designed to treat different conditions. Using them indiscriminately without proper guidance may not only fail to solve the problem but could also worsen the condition.

Therefore, it is essential to consult a respiratory specialist to select the appropriate model of non-invasive ventilator based on the specific disease condition and to regularly adjust the ventilator treatment parameters.

PREVENTION

Which medications should patients recovered from drug-induced lung disease avoid?

For patients who have had drug-induced lung disease, the medications to avoid primarily depend on the specific drug that originally caused the condition. For example, if gentamicin previously caused respiratory muscle paralysis and breathing difficulties, then antibiotics in the same class—such as streptomycin and kanamycin—should also be avoided.

Patients with a history of drug-induced lung disease should always consult medical professionals, such as doctors or clinical pharmacists, before taking any medication. They must disclose their medical history to prevent a recurrence of the condition due to medication use.

How to prevent drug-induced lung disease?

The most important thing is to recognize that medications are a double-edged sword. While they play a crucial role in disease prevention, treatment, and improving patients' quality of life, they can also be pathogenic—as the saying goes, "All medicines have some toxicity." Therefore, rational medication use should be promoted in daily life. Avoid drug abuse and refrain from using medications of unknown origin.