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Pleural effusions: pathophysiology and management

C O Andrews1, M L Gora

  • 1College of Pharmacy, University of Cincinnati, OH.

The Annals of Pharmacotherapy
|July 1, 1994
PubMed
Summary
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Pleural effusions are fluid accumulations in the pleural space. Intrapleural talc, bleomycin, and doxycycline are effective for recurrent effusions, with doxycycline being a safe and inexpensive option.

Area of Science:

  • Pulmonology
  • Thoracic Medicine
  • Critical Care

Background:

  • Pleural effusion involves fluid accumulation in the pleural space due to disrupted fluid balance.
  • Management of transudative effusions targets the underlying condition.
  • Recurrent, symptomatic effusions often require palliative treatment.

Purpose of the Study:

  • To review the pathophysiology and management of pleural effusions.
  • To evaluate available agents for pleural sclerosis.

Main Methods:

  • MEDLINE search from 1966 to present for clinical studies on pleural effusions.
  • Screening of references for additional published information.
  • Inclusion of all clinical trials in the review.

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Main Results:

  • Talc, bleomycin, and doxycycline are effective intrapleural sclerosing agents for symptomatic pleural effusions.
  • Adverse effects commonly include fever and pain; talc may require anesthesia, and bleomycin has dosage limits.
  • Doxycycline is supported by uncontrolled trials, offering an effective, safe, and inexpensive alternative.

Conclusions:

  • Pleural effusions are characterized by fluid accumulation in the pleural space.
  • Intrapleural administration of talc, bleomycin, and doxycycline effectively treats recurrent, symptomatic pleural effusions.
  • Doxycycline presents a cost-effective and potentially safer alternative to bleomycin and talc.