Pulmonary reactions

Nitrofurantoin administration may result in nausea, vomiting, anorexia, rash, peripheral neuropathy, headache, brown discoloration of the urine, and hypersensitivity reactions, which may range from mild to severe Acute and chronic pulmonary reactions also have been seen. 

URINARY ANTI-IN FECTIVES. The nurse observes the patient for adverse drug reactions. If an adverse reaction occurs, the nurse contacts the primary health care provider before the next dose of the drug is due However, serious drug reactions, such as a pulmonary reaction, are reported immediately. 

Sjogren B, Plato N, Alexandersson R, et al. 1991. Pulmonary reactions caused by welding-induced decomposed trichloroethylene. Chest 99 237-238. 

This agent is effective as both a therapeutic and prophylactic agent in patients with recurrent UTIs. Main advantage is the lack of resistance even after long courses of therapy. Adverse effects may limit use (Gl intolerance, neuropathies, pulmonary reactions). 

Gross P, Harley RA Jr, deTreville RTP Pulmonary reaction to metallic aluminum powders. Arch Environ Health 26 277-236, 1973... 

An immunologic basis for chronic beryllium disease has been postulated and a hypersensitivity phenomenon demonstrated. Consistent with the concept of chronic berylliosis as a hypersensitivity pulmonary reaction are the following Persons with berylliosis also show delayed cutaneous hypersensitivity reactions to beryllium compounds their peripheral blood lymphocytes undergo blast transformation and release of macrophage inhibition factor after exposure to beryllium in vitro helper/suppressor T-cell ratios are depressed and there is lack of a dose-response relationship in chronic beryllium cases. Hypersensitization may lead to berylliosis in people with relatively low exposures, whereas nonsensitized individuals with higher exposures may have no effects. 

Puimonary reactions Pulmonary reactions characterized by acute dyspnea, hypoxemia, and interstitial infiltrates have been observed in neutropenic patients receiving amphotericin B and leukocyte transfusions. Separate the infusion as far as possible from the time of a leukocyte transfusion. 

Pulmonary reactions Acute, subacute, or chronic pulmonary reactions have been observed in patients treated with nitrofurantoin. 

Acute - Acute pulmonary reactions are commonly manifested by fever, chills. 

Subacute - In subacute pulmonary reactions, fever and eosinophilia occur less often than in the acute form. Upon cessation of therapy, recovery may require several months. 

Chronic - Chronic pulmonary reactions generally occur in patients who have received continuous treatment for 6 months or longer. 

Elderly Spontaneous reports suggest a higher proportion of pulmonary reactions, including fatalities, in elderly patients. 

Cardiovascular - Benign intracranial hypertension (pseudotumor cerebri) has been reported rarely. Bulging fontanels, as a sign of benign intracranial hypertension in infants, have been reported rarely. Changes in electrocardiogram (eg, nonspecific ST/T wave changes, bundle branch block) have been reported in association with pulmonary reactions. 

Hypersensitivity Anaphylaxis angioedema arthralgia chills drug fever eczematous, erythematous, or maculopapular eruptions lupus-like syndrome associated with pulmonary reactions myalgia pruritus urticaria. 

Zanamivir is contraindicated in individuals with severe or decompensated chronic obstructive lung disease or asthma because it has not been shown to be effective in these individuals and can cause serious adverse pulmonary reactions. Individuals with mild to moderate asthma may have a decline in lung function when taking zanamivir. The safety and efficacy of this medication have not been determined in individuals with severe renal insufficiency. No clinically significant drug interactions have been reported. Zanamivir does not decrease the effectiveness of the influenza vaccine. 

Belin L, Hjortsberg Ulf, Wass U. 1981. Life threatening pulmonary reaction to car paint containing a prepolymerized isocyanate. Scand J Work Environ Health 7 310-311. 

Brooks SM. 1986. Pulmonary reactions to miscellaneous mineral dusts, man-made mineral fibers, and miscellaneous pneumoconioses. In Merchant JA, ed. Occupational respiratory diseases. Morgantown, WV US Department of Health and Human Services, Division of Respiratory Disease Studies, 401-458. 

More serious injuries involve peroxidation of intra- and extracellular phospholipids and inhibition of surfactant synthesis by lung tissue. The pulmonary reaction following paraquat ingestion is frequently fatal or permanently injurious. 

Huston J Jr, Wallach DP, Cunningham GJ. 1952. Pulmonary reaction to barium sulfate in rats. AMA Archives of Pathology 54 430-438. 

Adamson lYR, Bowden DH. 1990. Pulmonary reaction to long and short asbestos fibers is independent of fibroblast growth factor production by alveolar macrophages. Am J Pathol 137 523-529... 

Trasuizumab (Herceptin) Fever chills nausea and vomiting pain hypersensitivity and pulmonary reactions Bone marrow depression cardiomyopathy ventricular dysfunction congestive cardiac failure diarrhoea... 

Inhaled DAMB, and to a lesser extent inhaled liposomal amphotericin, can provoke pulmonary reactions, including bronchospasm, cough, and dyspnea (74—77). 

Original suggestions that DAMB in combination with granulocyte transfusions (78) result in pulmonary toxicity have subsequently not been confirmed in prospective observations (62,79). Pulmonary reactions, including dyspnea, hemoptysis, and new infiltrates, have also been suspected to be caused by the combined use of blood platelet transfusions and DAMB (SEDA-12, 227). It therefore appears advisable to space transfusions of blood products and amphotericin if possible (80). 

Intravenous administration of DAMB has been associated with pulmonary reactions, including dyspnea, bronchospasm, fever, and chills in contrast to rare reports of dyspnea after liposomal amphotericin (5), dyspnea was not associated with general toxic reactions. The possibility that liposome overload is the explanation of this reaction should be considered. 

Wright DG, Robichaud KJ, Pizzo PA, Deisseroth AB. Lethal pulmonary reactions associated with the combined use of amphotericin B and leukocyte transfusions. N Engl J Med 1981 304(20) 1185-9. 

Pulmonary reactions are rare. Pleural thickening and effusions and pleuropulmonary fibrosis have been observed in a few cases (SEDA-11,130). 

Pleuropericardial reactions, with sterile effusions and eosinophilia, have also rarely been reported in patients taking 225-400 mg/day for 3 months to 4 years (5). There is no proof of a causal relation, but the chemically related nitrofurantoin has also been associated with pulmonary reactions. Patients taking dantrolene should be screened periodically. 

Rosenow EC 3rd, DeRemee RA, Dines DE. Chronic nitrofurantoin pulmonary reaction. Report of 5 cases. N Engl J Med 1968 279(23) 1258-62. 

Smith GJ. The histopathology of pulmonary reactions to drugs. Clin Chest Med 1990 11(1) 95-117. 

Larsson S, Cronberg S, Denneberg T, Ohlsson NM. Pulmonary reaction to nitrofurantoin. Scand J Respir Dis 1973 54(2) 103-10. 

Selroos O, Edgren J. Lupus-like syndrome associated with pulmonary reaction to nitrofurantoin. Report of three cases. Acta Med Scand 1975 197(l-2) 125-9. 

Pulmonary reactions have been described with most sulfonamides. Pyrimethamine -I- sulfadoxine, used in malaria prophylaxis and treatment, also rarely causes pulmonary reactions (17-19). The sulfapyridine moiety of sulfasalazine, used in inflammatory bowel disease, can produce adverse pulmonary reactions (20). 

Svanbom M, Rombo L, Gustafsson L. Unusual pulmonary reaction during short term prophylaxis with pyrimetha-mine-sulfadoxine (Fansidar). BMJ (Clin Res Ed) 1984 288(6434) 1876. 

Be 0.002 Produces severe pulmonary reaction (beryllosis) and body-wide morbidity carcinogenic to rats... 

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