[Clinical and functional disorders in side effects of drugs on the lung]

Although, at 5% of all drug-related adverse reactions in the human organism, drug-associated injuries to the lungs are not very common, their consequences can be substantial: the disordering of the organ, often detected late, can lead to irreversible fibrosis. The detection of a drug-induced adverse reaction in the lungs is difficult on account of the usually complex situation presenting: specific pathological signs are lacking, the underlying disease being treated may itself mimic adverse drug reactions, and often several drugs or forms of treatment are being employed simultaneously, so that the causal drug is difficult to identify. In principle, a differentiation must be made between cytotoxic drugs that "follow" a dose-effect curve, and idiosyncratic, sporadic effects, together with dose that involve the lung via drug-induced erythematodes. In contrast, undesired adverse effects manifesting in the airways, pulmonary vessels, pleura or respiratory muscles are usually easier to diagnose and treat. In the daily application of potentially pulmotoxic drugs, the decisive point is monitoring by means of pulmonary function parameters, which may preceded clinical manifestation by weeks. In this manner, irreversible damage can be avoided.