Drug-induced respiratory system toxicity

ABSTRACT

During current COVID-19 pandemic health care professionals as well as general communities all over the world have become much more aware about the importance of such basic physiological functions as breathing and the essential nature of intact respiratory system for our proper functioning and survival. Treatment of severe forms of respiratory failure puts enormous personal, material as well as financial strains on health care systems even in countries of the developed world. Since the beginning of COVID-19 pandemic scientists and physicians alike are putting vast efforts into developing effective treatment plans to fight this new disease, yet many times with dubious effect. With repurposing old drugs and development of new ones, concerns of potential lung toxicity as a side effect of medication use pose a serious concern. Currently there are several hundred medications known to us which can exert various toxic effects on the respiratory system. As such, in every day clinical practice it is extremely important to identify and minimize the chances of morbidity and mortality induced by medications used in treatment of pulmonary diseases as well as non-pulmonary illnesses. In most cases the diagnosis of drug induced pulmonary toxicity is done by exclusion after all other etiologies of lung compromise have been eliminated. Transbronchial or even open surgical lung biopsy is in many times only of limited value on changing the treatment strategy, however it frequently poses a significant risk of developing pre and post-operative complications. It has to be cautiously considered on individual basis after evaluating potential risks and benefits of the intervention. Apart from affecting the pulmonary parenchyma drugs can exert their toxic effects on pulmonary vascular system, pleura, mediastinal structures as well as on the neuromuscular system driving and executing the respiratory effort. In conclusion, prior to initiating any medication therapy it is paramount to estimate the potential risks and benefits on the pulmonary system and notify the patient in order to make an adequate informed decision regarding starting or declining specific medical intervention (Tab. 3, Ref. 45). Text in PDF www.lekarsky.herba.sk. (http//www.lekarsky.herba.sk.) © 2022, Lekarsky Obzor.All Rights Reserved.