Treatment of Pulmonary Toxicity Due To Medicinal Drugs
The treatment of pulmonary toxicity due to medicinal drugs is to discontinue (= to stop taking) the medicinal drug in question. A dose reduction (instead of discontinuation) can be attempted in selected cases only, only under the guidance of an expert physician. Discontinuation (or, if possible, dose reduction under the guidance of an expert physician) should be done in all cases. This approach has been published for many individual medicinal drugs, but it is principally valid for all cases pulmonary toxicity due to medicinal drugs.
As an example to illustrate what can be done, the use of the medicinal drug amiodarone: a) Prescribing the lowest possible dose of amiodarone leads to a lower incidence of pulmonary toxicity. b) Regular monitoring, in order to diagnose any possible pulmonary toxicity early. c) Discontinuation as soon as pulmonary toxicity is detected.
One publication summarises the most important points about amiodarone-induced pulmonary toxicity (AIPT) as follows: "The most serious adverse reaction of amiodarone is pulmonary toxicity (AIPT). AIPT may manifest as chronic interstitial pneumonitis, organising pneumonia, acute respiratory distress syndrome, pulmonary mass, or nodules. On radiological imaging, pulmonary infiltrates induced by amiodarone are usually high in attenuation. On biopsy, the presence of foamy macrophages confirms exposure to amiodarone but not necessarily proves that amiodarone is the responsible cause. Most patients with AIPT respond well to the withdrawal of amiodarone and to the addition of corticosteroid treatment, which is usually given for two to six months."
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