Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Kendig > Lung Injury Caused By Pharmacologic Agents > Flashcards

Lung Injury Caused By Pharmacologic Agents Flashcards

1
Q

Most frequent offenders

A

Chemotherapeutic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most frequent clinical syndrome

A

Diffuse interstitial pneumonitis and fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk factors associated with cytotoxic drug therapy

A

Cumulative dose
Age of patient
Radiation
O2 therapy
Use of other toxic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Criteria for diagnosing drug-induced lung disease

A
  1. History of ingestion of drug known to cause lung injury
  2. Clinical manifestations have been reported to be induced by the drug
  3. Other causes have been ruled out
  4. Improvement on discontinuation of drug
  5. Exacerbation after resuming drug
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

2 patterns of bleomycin toxicity

A
  1. Progressive fibrosis
  2. Acute hypersensitivity reaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Severe pneumonitis in adults develops after administration of this amount of bleomycin

A

283 mg/m2
*less severe if slow IV administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

___ and ___ receiving bleomycin have increased risk for radiation pneumonitis

A

Pediatric sarcoma
Hodgkin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pulmonary injury due to bleomycin occurs by:

A

Direct injury
1. Oxidant injury through production of reactive O2 metabolites and inactivation of antioxidants
2. Induces apoptosis of AEC type II

Immunologic reaction
1. Generates inflammatory mediators
2. Increased collagen synthesis by fibroblasts through TGFb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

PFT of bleomycin lung injury

A

Restrictive (low VC, TLC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Gas properties of bleomycin lung injury

A

Reduced DLCO
Reduced arterial O2 saturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Signs of bleomycin lung injury

A

DRY HACKING COUGH
Dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CXR findings of bleomycin lung injury

A

Diffuse linear densities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Biopsy findings in bleomycin lung injury

A

Interstitial pneumonitis
Fibrosis
Extensive alveolar damage with hyperplasia of type II cells, mostly subpleural and basilar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Monitoring of bleomycin lung injury

A

Serial DLCO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management of bleomycin lung injury

A

Withdrawal
Supportive
CS in severe toxicity, hypersensitivity reactions, and eosinophilic pneumonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mechanism of cyclophosphamide lung toxicity

A
  1. Oxidant and inflammatory
  2. Immune
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pulmonary reactions in total doses of cyclophosphamide between __ and __

A

0.15 and 50 g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Chest wall deformity secondary to failure of lung growth during adolescent growth spurt is a striking feature of:

A

Cyclophosphamide lung toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Herald onset of cyclophosphamide lung toxicity

A

SUBACUTE DRY COUGH
Dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

PE of cyclophosphamide lung toxicity

A

Tahcypnea
Diffusely diminished breath sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PFT of cyclophosphamide lung toxicity

A

Restrictive
Hypoxemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Biopsy findings of cyclophosphamide lung toxicity

A

Interstitial fibrosis
Alveolar exudates
Atypical alveolar epithelial cells

23
Q

Treatment of cyclophosphamide lung toxicity

A

Withdrawal
Supportive
CS

24
Q

Etoposide lung toxicity

A

Alveolar hemorrhage

25
Q

Mechanism of methotrexate lung toxicity

A

MAP kinase pathway activation causing cytokines activation

26
Q

Features of methotrexate toxicity

A

Hypersensitivity pneumonitis
Decreased DLCO

27
Q

CXR abnormalities in methotrexate toxicity

A

Bilateral interstitial infiltrates
Mixed interstitial and alveolar infiltrates

28
Q

Treatment of methotrexate toxicity

A

Withdrawal
CS
Avoid resuming

29
Q

Cytosine arabinoside (Ara-C) toxicity

A

Pulmonary edema

Rare:
ARDS
BOOP

30
Q

Gemticabine toxicity

A

ARDS

31
Q

Procarbazine, VM-26, vinca alkaloids toxicity

A

Hypersensitivity pneumonitis

32
Q

Imatinib toxicity

A

Pleural effusion, pulmonary edema

33
Q

IL-2 toxicity

A

Vascular leak syndrome (pleural effusion, pulmonary edema)
Increased AaDO2 gradient
Decreased FVC, FEV1, DLCO

34
Q

ATRA toxicity

A

Interstitial infiltrates
Pleural and pericardial effusion
Hyperleukocytosis

35
Q

Treatment of ATRA toxicity

A

CS (dexamethasone 10mg/day)

36
Q

Nitrofurantoin PFTs

A

Restrictive
Reduced DLCO

37
Q

2 clinical patterns of nitrofurantoin toxicity

A
  1. Acute - fever, cough, dyspnea; bilateral interstitial or alveolar infiltrates with or without pleural effusion
  2. Chronic - cough, dyspnea, chest pain months to years after intake; lupus-like syndrome: pleural effusion is less common
38
Q

Treatment and prognosis of nitrofurantoin toxicity

A

Withdrawal
CS
May not resolve completely

39
Q

Sulfasalazine toxicity

A

Obstructive > restrictive
Hypoxemia
Eosinophilia

40
Q

Carbamazepine, levetiracetam toxicity

A

DRESS
Restrictive pattern
Reduced DLCO

41
Q

Minocycline toxicity

A

DRESS
Eosinophilic pneumonia

42
Q

Penicillamine toxicity

A

Short: hypersensitivity
Intermediate: diffuse alveolitis, bronchiolitis obliterans
Prolonged: alveolar hemorrhage

43
Q

PFT in penicillamine toxicity

A

BO: obstructive
Alveolitis, hypersensitivity: restrictive

44
Q

Other immunomodulatory agents with lung toxicity

A

Rituximab (RALI)
Alemtuzumab
Cetuximab
Trastuzumab
Tacrolimus
Sirolimus
Pegylated interferon

45
Q

Amiodarone toxicity

A

Rapidly progressive alveolar hemorrhage
ARDS

46
Q

Risk for ARDS in amiodarone

A

High FiO2
Cardiothoracic surgery
Contrast

47
Q

BAL fluid in amiodarone toxicity

A

“Amiodarone effect”
Accumulation of drug in the macrophage lysosomes
Foamy macrophages

48
Q

HMG-CoA reductase inhibitors (statins) toxicity

A

Restrictive pattern
Reduced DLCO
Foamy macrophages
Phospholipidosis

49
Q

LTRA toxicity

A

EGPA

50
Q

Aspirin and NSAIDs toxicity

A

Bronchoconstriction in aspirin-exacerbated respiratory disease (chronic sinusitis, polyposis, severe asthma)

51
Q

Heroin overdose

A

Pulmonary edema

52
Q

Crack cocaine

A

Air leak
Pulmonary edema
Interstitial pneumonitis
BOOP

53
Q

Cannabis

A

Chronic bronchitis
Emphysematous changes

54
Q

OCPs

A

Venous thrombosis
Pulmonary embolism

Kendig (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions